Arrhythmias are a significant health burden in Australia, responsible for about 1% of deaths annually. The Australian Resuscitation Council (ARC) ‘Guideline 11.9 Managing Acute Dysrhythmias’ was designed to guide doctors, paramedics and nurses in the emergency management of arrhythmias. It is important to have high quality clinical practice guidelines to aid the treatment of these arrhythmias. The AGREE II tool utilised is widely used to asses clinical practice guidelines for quality. The objective of this study was to assess the quality of the ARC clinical practice guideline ‘Guideline 11.9 Managing Acute Dysrhythmias’.
Methods
Two raters assessed the six domains of quality of the ARC arrhythmia guideline using the AGREE II tool. The inter-rater agreement between the raters was measured with the intraclass correlation coefficient (ICC 2, 1).
Results
Inter-rater agreement was good at 0.73 (95% CI 0.45 to 0.88). Both raters assigned the ARC guideline 11.9 Managing Acute Dysrhythmias a score of three, for a combined score of three out of a possible seven on the AGREE II rating scale.
Conclusions
The use of the ARC guideline 11.9 Managing Acute Dysrhythmias is not recommended based on this assessment with the AGREE II tool. Emergency departments and prehospital systems should consider not using this arrhythmia guideline to guide their practice, but to look elsewhere for a higher quality guideline.
Australian Resuscitation Council.Guideline 1.4 Principles and Format for Developing Guidelines, 2010. Available at: www.resus.org.au/ [Accessed 10 November 2014].
EbbenR.H., VloetL.C., VerhofstadM.H., MeijerS., Mintjes-de GrootJ.A., van AchterbergT.Adherence to guidelines and protocols in the prehospital and emergency care setting: a systematic review.Scand J Trauma Resusc Emerg Med2013; 21: 9.
11.
BurlsA.AGREE II - improving the quality of clinical care.Lancet2010; 376: 1128–9.
MorleyP.T., AtkinsD.L., BilliJ.E.Part 3: Evidence evaluation process: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations.Resuscitation.2010; 81(Suppl 1): e32–40.
CochraneL.J., OlsonC.A., MurrayS., DupuisM., ToomanT., HayesS.Gaps between knowing and doing: understanding and assessing the barriers to optimal health care.J Contin Educ Health Prof2007; 27(2): 94–102.
18.
SimpsonF., DoigG.S.The relative effectiveness of practice change interventions in overcoming common barriers to change: a survey of 14 hospitals with experience implementing evidence-based guidelines.Journal of Evaluation in Clinical Interventions2007; 13(5): 709–15.
19.
BakerR., Camosso-StefinovicJ., GilliesC.Tailored interventions to overcome identified barriers to change: effects on professional practice and health care outcomes. Cochrane Database of Systematic Reviews 2010, Issue 3. Art. No.: CD005470. DOI: 10.1002/14651858.CD005470.pub2 [cited 2014 26 March]; Available at: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD005470.pub2/pdf
ScottI.A., GuyattG.H.Clinical practice guidelines: the need for greater transparency in formulating recommendations.Med J Aust2011; 195(1): 29–33.
22.
Australian Resuscitation Council - Home 2013. Available at: www.resus.org.au/Default.htm. [Accessed 10 October 2013].
23.
Australian Resuscitation Council, ARC Representatives 2013. Available at: www.resus.org.au/council.html [Accessed 10 October 2013].
24.
McAnultyJ.A.Arrhythmias in Pregnancy.Cardiol Clin2012; 30: 425–34.
25.
VitryA.I., ZhangY.Quality of Australian clinical guidelines and relevance to the care of older people with multiple comorbid conditions.Med J Aust2008; 189: 360–5.
26.
MorleyP.T., AtkinsD.L., BilliJ.E.Part 3: Evidence evaluation process: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations.Circulation2010; 122(16 Suppl 2): S283–90.
FieldJ.M., HazinskiM.F., SayreM.R.Part 1: executive summary: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.Circulation2010; 122(18 Suppl 3): S640–56.
29.
ShekelleP.G., OrtizE., RhodesS.Validity of the Agency for Healthcare Research and Quality clinical practice guidelines: how quickly do guidelines become outdated?JAMA2001; 286(12): 1461–7.
30.
DeakinC.D., NolanJ.P., SundeK., KosterR.W.European Resuscitation Council Guidelines for Resuscitation 2010 Section 3. Electrical therapies: Automated external defibrillators, defibrillation, cardioversion and pacing.Resuscitation2010; 81: 1293–304.
