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Validation of evidence-based clinical practice guideline: Nursing intervention for newly diagnosed pulmonary tuberculosis patients at community setting

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Abstract:

Background: Tuberculosis is a major contributor to disease burden in the developing countries. It is considered the second fatal disease all over the world and the third most important public health problem in Egypt. The direct causes of increasing the burden of tuberculosis are the inconsistent and fragmented health services. The nursing interventions of tuberculosis in community settings require a system of recommendations that ensure the consistency of care. Objective: The present study aimed at providing a valid evidence-based clinical guideline that assists nurses to intervene consistently to the newly diagnosed patient with pulmonary tuberculosis. Methods: The intended guideline was developed according to the criteria of the Scottish Intercollegiate Guidelines Network (SIGN) and the American Academy of Neurology. This guideline was developed based on the need for assessments of the intended users (nurses) and the end-point beneficiaries (newly diagnosed patients with pulmonary tuberculosis). The development process of the guideline consisted of seven main steps. The SIGN appraisal tools were used for the critical appraisal phase of the retrieved studies, and the ‘‘Appraisal of Guidelines for Research & Evaluation (AGREE) Instrument’’, that was used for appraising the internal validity of the developed guideline. Results: The developed guideline included thirty recommendations categorized into four main themes, which are assessment, nursing diagnosis, nursing care plan and implementation of care plan. The overall assessment of the guideline revealed that two-thirds of academic appraisers strongly recommended the guideline to be used in practice and most of practitioner nurses and practitioner physicians recommended the guideline to be in practice. Conclusion: The development of this guideline was based on the needs of the targeted users (nurses) and end-point beneficiaries (patients). It was strongly recommended by the appraisers to be used in the outpatients chest clinics. The study recommended that this developed guideline should be disseminated to the policy makers to be approved for application.

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