gms | German Medical Science

Background: In Switzerland, nurses are legally obliged to offer care based on state of the art. National evidence-based nursing guidelines would provide best possible aids for decision-making in favour of structured care. However, there is no national strategy at the federal level, which prescribes the development of guidelines. Thus, the development of guidelines is inconsistent and often does not correspond to scientific standards. There is a lack of national evidence-based nursing guidelines which could give recommendations for health care facilities in Switzerland.

Context: To meet the needs for evidence-based guidelines, the ‘Supportive Care Network Oncology’ (SCNO) in collaboration with the ‘Swiss Centre for Evidence-Based Nursing’ intends to develop guidelines for oncology care on a consistent, high quality level. The following topics are addressed: mucositis, neutropenia, nausea and vomiting, and fatigue. The SCNO consists mainly of nurses with no scientific background.

Description of best practice: As a first guideline ‘Prevention and Treatment of Cancer Therapy-induced Mucositis’ was developed. On this basis, patients’ perspectives were examined, patient-relevant outcome measures and clinical issues were developed and also existing guidelines and reviews were analyzed concerning their methodological quality. Based on the most relevant sources recommendations were derived, structure and outcome criteria were formulated, a flowchart was developed and a consultation with experts was carried out.

Lessons for guideline developers:One of the biggest challenges in guideline development process was to generate recommendations. It became obvious that the basic understanding for evidence-based nursing should be better trained. Also the need for national strategies became clear.