Abstract

NAVARRO YEPES, José  and  RUBIO MARTINEZ, Pedro Luis. Clinical guidelines on the deterioration of the skin integrity: do they all say the same?. Gerokomos [online]. 2012, vol.23, n.3, pp.132-136. ISSN 1134-928X.  https://dx.doi.org/10.4321/S1134-928X2012000300008.

Introduction: The guides' great proliferation, protocols and other intrumentos of support on the clinical decision in the prevention and treatment of the sores by pressure (UPP) it is accompanied of a wide variability that reflects inconsistencies and low quality of these documents. The evaluation of the guides of clinical practice (GPC) on deterioration of the cutaneous integrity in Spain becomes difficult due to the fact that frequently there is absence of key elements for his identification. This way before using it she is interested in assuring the user of GPC that it is possible to qualify as a trustworthy qualit guide, valid, useful and. The GPC must be adapted to the population the one that is going to be applied. This brings I obtain the need to submit them to a process of validation of his quality. Objectives: To determine the quality of the CPG on UPP by the spanish version of the instrument AGREE.Comparar the quality of the GPC pu used in the SNS. Material and methods: This one study tries to submit to evaluation by means of the intrumento AGREE of 8 GPC on deterioration of the cutaneous integrity, used in different hospitals of the National System of Health. Results: Al to compare the punctuations standardized by areas, we obtain that 5 GPC overcomes 60 points, being catalogued like "very recommended", 3 GPC with punctuations between 60-30 points, catalogued since "recommended with conditions". No one found no GPC with punctuations lower than 30 points, catalogued like " not recommended ". Conclusions: 1. The process of drawing up a CPG in the deterioration of the skin integrity, it is costly, requires much time and human resources, as well as staff with experience in the development of guides, skills in bibliographic search and critical reading of articles, which poses a significant barrier to the development of these. 2. The adaptation of the GPC high-quality, based on the existing evidence, it is an effective option and efficient that avoids unnecessary duplication of efforts and decreases variability care with the consequent economic savings for the health system. 3. If they appear new evidence on the recommendations in the prevention and treatment of the deterioration of the skin integrity, it is desirable incorporate them into your GPC adaptada. 4. The guides with greater methodological rigor in its development and that therefore may be recommended for its use are: Guide to clinical practice of nursing: prevention and treatment of pressure ulcers and other chronic wounds. Valencian Health Service and the clinical practice guideline for the prevention and treatment of the UPP. 5. The AGREE instrument does not appreciate the impact of a guide on the results of the patients, nor the content of clinical recommendations implemented in a local context, aspect that must be taken into account to make an overall judgment on the utility of guias. 6. More studies were needed on comparison of CPG on the deterioration of the skin integrity, in order to reach a consensus between the specialized care and primary care.

Keywords : Guides of clinical practice; Pressure ulcer; Chronic wounds; AGREE instrument.

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