Development Of Evidence-based Practice Protocols For High Risk Of Diabetic Foot Ulcers

Objective:Intergrate the recommendations from high risk of diabetic foot ulcers clinical practce guidelines,and synthesis the evidence of relevant Chinese medicine nursing,develop an evidence-based practice protocol for high risk of diabetic foot ulcers,and evaluate the quality of it.Methods:1.Use the AGREE II to assess the quality of clinical practice guidelines for the management of high risk with diabetic foot,comprehensive the recommendations with Chinese nuses can be used.2.Search the relevent Chinese medicine nursing literature,and to carry out a systematic review or descriptive analysis,and follow the GRADE system to classification of the evidence level and the strength of recommendations.3.According to the method of evidence-based medicine,to develop the protocol.Results:1.Search for clinical practice guideline,including a total of 6 guidelines.Using AGREE? scale to evaluate the guidelines,the standard score of scope and purpose,stakeholder involvement,rigour of development,clarity of persentation,applicability and editorial independence are 87.04%?71.91%?75.12%?83.95%?66.44%and 70.83%.The quality of 4 guidelines are A level,and the quality of the other 2 guidelines are B leve.2 researchers sort out its content,list 20 recommendations.And invited clinical experts to evaluate the recommendations.Delete 5,and retaining the recommendations of 15.2.The searching topics were determine by literature research and clinical research.The topic were identified in Chinese medicine foot soak,acupoint massage,therapy of iontophoresis of Chinese drug,acupoints stick,moxibustion,wax therapy and auricular point sticking.The topic of Chinese medicine foot soak and acupoint massage had have its own systematic review,the topic of moxibustion and wax therapy had not searched systematic review,and out research team established the systematic review,and the other there topics were only make a describe analysis.Evaluate the quality of all the literature.The evidence level of Chinese medicine foot soak is moderate,the evidence level of acupoint massage,therapy of iontophoresis of Chinese drug,acupoints stick and wax therapy are low,and the evidence level of moxibustion and auricular point sticking are very low.The recommendation strength of Chinese medicine foot soak,therapy of iontophoresis of Chinese drug and wax therapy are strong,the recommendation strength of acupoint massage and acupoints stick are weak,the recommendation strength of moxibustion is weak not,and the recommendation strength of auricular point sticking is nothing.3.The applicability of the prtocol display that the meaning of clinical is good,but sometimes it may be influenced by the patients compliance,the equipment in hospital and so on.Using AGREE II scale to evaluate the protocol,the standard score of scope and purpose,stakeholder involvement,rigour of development,clarity of persentation,applicability and editorial independence are 98.15%,96.30%,88.19%,87.04%,79.17%and 97.22%,the overall quality of A.Conclusion:This study developed the protocol,and its quality is good,can be recommended for clinical practice.