A Systematic Review and Quality Assessment of Clinical Practice Nursing Guidelines for Ostomy Care
Bibliographic record
Abstract
Background: People living with an intestinal stoma require specialized interdisciplinary care throughout their surgical journey and beyond. We evaluated nursing guidelines focused on the clinical management of people living with intestinal ostomies, identified knowledge and system gaps, and supported the development of evidence-based patient care pathways. Methods: A systematic literature search was conducted across MEDLINE, Embase, and major nursing organization websites up to March 25, 2024, to identify evidence-based practical guidelines developed by nursing organizations for caring for patients with intestinal stomas post-ostomy formation. We summarized the evidence and critically appraised it using the AGREE II instrument. Results: Fourteen nursing guidelines met the inclusion criteria, from Australia, Canada, Italy, the UK, the USA, and three international working groups, ranging from 2013 to 2023. These guidelines offer extensive coverage of ostomy care topics and provide valuable first-line care experience and consensus statements, particularly for postoperative stoma and peristomal care. In the AGREE II assessment, most guidelines were rated as moderate quality (scores <6), with recommended modifications primarily in the rigor of development and applicability. Conclusions: Critical appraisal of clinical practice nursing guidelines for ostomy care highlights both strengths and areas for improvement and expansion within existing guidelines. These insights are essential for non-nursing healthcare providers and contribute to the development of patient care pathways for individuals with Crohn’s disease and permanent ileostomies.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.167 | 0.516 |
| Meta-epidemiology (narrow) | 0.002 | 0.002 |
| Meta-epidemiology (broad) | 0.014 | 0.013 |
| Bibliometrics | 0.036 | 0.031 |
| Science and technology studies | 0.003 | 0.004 |
| Scholarly communication | 0.008 | 0.007 |
| Open science | 0.006 | 0.005 |
| Research integrity | 0.004 | 0.003 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".