臨床診療指引的發展過程—以「台灣慢性腎臟病臨床診療指引」為例

The Process of Developing Clinical Practice Guidelines: Example of the ＂2015 Taiwan Chronic Kidney Disease Clinical Guidelines＂

劉雪娥(Hsueh-Erh Liu) ； 李秀芳(Hsiu-Fang Lee) ； 郭懿萱(Yi-Hsuan Kuo)

《護理雜誌》 63卷2期 (2016/04) Pp. 26-32

https://doi.org/10.6224/JN.63.2.26

摘要

臨床診療指引（clinical practice guidelines, CPGs），係透過系統性文獻回顧來綜整與實證相關之最佳疾病照護方式，以協助醫療團隊及病人做最適當的醫療決策，並提供具效能（effective）及效率（efficient）之照護模式，進而增進臨床照護品質。近年來，中央健康保險署與國家衛生研究院已分別針對國人常見之重大疾病出版相關之臨床指引，2015年發行之「台灣慢性腎臟病臨床診療指引」（Taiwan Chronic Kidney Disease ClinicalGuidelines）即為一例。因此，本文藉簡介此臨床診療指引之重點，來說明臨床診療指引的發展過程。此外，亦介紹台灣現有之本土護理相關指引及其發展過程，期能拋磚引玉，催生腎臟護理相關指引，以提升國內腎臟照護之水準。

關鍵字

臨床診療指引 ； 照護指引 ； 慢性腎臟病

並列摘要

Clinical practice guidelines (CPGs), representing the current best-practice guidelines and recommendations for care, are supported by systematic review and evidence-based research. CPGs provide an effective and efficient approach to caring for patients and improving quality of care. Recently, the National Health Insurance Administration and National Institutes of Health developed CPGs for major diseases in Taiwan. This paper introduces the process that was used to develop one of these CPGs, the Taiwan Chronic Kidney Disease Clinical Guidelines, which was published in 2015. Further, we introduce the general development of published nursing guidelines in Taiwan. These CPGs are expected to initiate various renal-care guidelines and to promote the quality of renal care in the country.

並列關鍵字

clinical practice guideline ； care guideline ； chronic kidney disease

參考文獻

莊雅雯（2013）．慢性腎臟病衍生末期腎臟病及死亡的危險因子分析（未發表的碩士論文）．臺中市：中國醫藥大學公共衛生學系碩士班。[Chuang, Y. W. (2013). Risk factors associated with end-stage renal disease and fatality in patients with chronic kidney disease (Unpublished master’s thesis). China Medical University, Taichung City, Taiwan, ROC.]

王淑麗（2013）．比較有無參與慢性腎臟病整體照護計畫對病人之照護成效（未發表的碩士論文）．高雄市：高雄醫學大學護理學研究所。[Wang, S. L. (2013). The effect of multidisciplinary integrated care program on chronic kidney disease progression (Unpublished master’s thesis). Kaohsiung Medical University, Taiwan, ROC.]

胡月娟、江蕙娟、林豐裕（2014）．護理之家住民口腔照護指引的建立與成效評值．護理暨健康照護研究，10（2），143–153。[Wu, Y. J., Chiang, H. C., & Lin, F. Y. (2014). Establishing and evaluating the effectiveness of a set of oral care guidelines for nursing home residents. Nursing and Healthcare Research, 10(2), 143–153.]doi:10.6225/JNHR.10.2.143

張黎露、許麗珠、周文珊、張文、張淑惠、李佩怡、林盈秀（2013）．抗癌化療藥品外滲照護指引．腫瘤護理雜誌，13（6），55–73。[Chang, C. L., Sheu, L. C., Chou, W. S., Chang, C. W., Chang, S. H., Lee, P. Y., & Lin, Y. S. (2013). Clinical practice guideline: Prevention and management of chemotherapy extravasation. The Journal of Oncology Nursing, 13(6), 55–73.]

周繡玲、謝嘉芬、李佳諭、江孟冠、紀雯真（2011）．癌症病人口腔黏膜炎臨床照護指引．腫瘤護理雜誌，11，61–85。[Chou, H. L., Hsieh, C. F., Lee, C. Y., Chiang, M. G., & Chi, W. C. (2011). Clinical practice guideline on oral mucositis in cancer patients. The Journal of Oncology Nursing, 11, 61–85.]