Clinical practice guideline appraisal and algorithm development to identify recommendations related to nursing practice for post-stroke dysphagia

Aims and ObjectivesTo assess the methodological quality of current clinical practice guidelines related to post-stroke dysphagia and develop an algorithm using nursing process as a framework for clinical nursing. BackgroundDysphagia is a serious complication of stroke. Yet the recommendations related to nursing in guidelines have not been systematically sorted out, so they are difficult for nurses to use to guide clinical nursing practice. DesignSystematic review. MethodsA systematic review of literature was performed using the PRISMA Checklist. A systematic search for relevant guidelines published between 2017 and 2022 was conducted. Appraisal of Guidelines for Research and Evaluation II instrument was used to assess methodological quality. Recommendations related to nursing practice from high-quality guidelines were summarised and developed into an algorithm to provide reference for the standardised construction of nursing practice scheme. Results991 records were initially identified from database searches and other sources. Finally, 10 guidelines were included, of which 5 were rated as high quality. A total of 27 recommendations from the 5 highest-scoring guidelines were summarised and used to develop an algorithm. ConclusionsThis study indicated deficiencies and variability in current available guidelines. Based on five high-quality guidelines, we developed an algorithm to facilitate nurses' adherence to guidelines and contribute to evidence-based nursing. In the future, high-quality guidelines, together with large-sample and multi-centre clinical researches are suggested to give more scientific and convincing evidence to nursing of post-stroke dysphagia. Relevance to Clinical PracticeThe findings indicate that nursing process may provide a unified framework for standardised nursing of different diseases. Nursing leaders are recommended to adopt this algorithm in their units. In addition, nursing administrators and educators should promote the application of nursing diagnosis to help nurses foster nursing thinking mode. Patient or Public ContributionNo patient or public involvement in this review.