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Quality appraisal of clinical guidelines for surgical site infection prevention: A systematic review

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  • Brigid M Gillespie
  • Claudia Bull
  • Rachel Walker
  • Frances Lin
  • Shelley Roberts
  • Wendy Chaboyer

Abstract

Background: Surgical site infections (SSI) occur in up to 10% of surgeries. Wound care practices to prevent infections are guided by Clinical Practice Guidelines (CPGs), yet their contribution to improving patient outcomes relies on their quality and adoption in practice. We critically evaluated the quality of CPGs for SSI prevention during pre-, intra- and post-operative phases of care. Methods: We systematically reviewed the literature from 1990–2018 using the Cochrane Library, CINAHL, EMBASE, MEDLINE, ProQuest databases and five guidelines repositories. We extracted characteristics of each guideline using purposely-developed data collection tools. We assessed overall quality using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool. Results: Combined searches of databases and repositories yielded 5,910 citations. Of these, we reviewed 215 full text documents. The final sample included 15 documents: 6 complete CPGs, 3 CPG updates, and 6 supplementary documents. The overall %mean scores across AGREE II domains for CPGs were: 1) scope and purpose (%mean ± SD = 86.3±23.5); 2) stakeholder involvement (%mean ± SD = 64±31.0); 3) rigour of development (%mean ± SD = 68.7±30.6); 4) clarity and presentation (%mean ± SD = 88.5±16.7); 5) applicability (%mean ± SD = 44±30.2); and, 5) editorial independence (%mean ± SD = 61±37.6). Based on individual AGREE II domains and overall scores, we appraised 4 out of 6 CPGs (inclusive of updates) as “recommended” for use in practice. Overall agreement among appraisers was excellent (ICC 0.86 [95%CI 0.73–0.94] - 0.98 [95%CI 0.96–0.99]; p

Suggested Citation

  • Brigid M Gillespie & Claudia Bull & Rachel Walker & Frances Lin & Shelley Roberts & Wendy Chaboyer, 2018. "Quality appraisal of clinical guidelines for surgical site infection prevention: A systematic review," PLOS ONE, Public Library of Science, vol. 13(9), pages 1-17, September.
    • Handle: RePEc:plo:pone00:0203354
    DOI: 10.1371/journal.pone.0203354
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    References listed on IDEAS

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    1. Don Husereau & Michael Drummond & Stavros Petrou & Chris Carswell & David Moher & Dan Greenberg & Federico Augustovski & Andrew Briggs & Josephine Mauskopf & Elizabeth Loder, 2013. "Consolidated Health Economic Evaluation Reporting Standards (CHEERS) Statement," PharmacoEconomics, Springer, vol. 31(5), pages 361-367, May.
    2. David Moher & Alessandro Liberati & Jennifer Tetzlaff & Douglas G Altman & The PRISMA Group, 2009. "Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-6, July.
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    1. Brigid M. Gillespie & Rachel Walker & Frances Lin & Shelley Roberts & Anne Eskes & Jodie Perry & Sean Birgan & Paul Nieuwenhoven & Elizabeth Garrahy & Rosalind Probert & Wendy Chaboyer, 2020. "Wound care practices across two acute care settings: A comparative study," Journal of Clinical Nursing, John Wiley & Sons, vol. 29(5-6), pages 831-839, March.

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