A review of clinical practice guidelines on the management of preeclampsia and nursing inspiration

Abstract

Objectives: To review, evaluate, and synthesize the recommendations of guidelines on preeclampsia (PE) from a nursing perspective. Methods: This is a systematic review of international and national guidelines on PE. Electronic databases and related guideline websites were searched from 2013 to 2023. After systematic retrieval and screening, we used the AGREE II tool to appraise the methodological quality of guidelines that met the eligibility criteria. Then, we analyzed and summarized the recommendations using descriptive analysis and the framework method. Furthermore, we rated the quality of evidence and the strength of the recommendations using the GRADE approach. Results: Ten guidelines were included, among which eight were deemed “clinically useful” and records were extracted. In total, 31 recommendations, including 46 items on the nursing management of PE, were summarized from three aspects: 1) antenatal care (18 recommendations), including the assessment and regular monitoring of PE, standardized blood pressure (BP) measurement, prevention education for PE, antihypertensive agent monitoring, and magnesium sulfate (MgSO4) use; 2) intrapartum care (4 recommendations), including childbirth care; 3) postpartum care (9 recommendations), including regular nursing monitoring, breastfeeding care and longer-term health counseling. Most of the evidence was rated as “very low” (19/46) or “moderate” (15/46) quality. For the strength of the recommendations, 30 items were graded as “strong” and 16 items were rated as “weak”. Conclusions: This study provides professional, evidence-based nursing care resources both for preservice education for nursing staff and health care education for women with PE to help them detect and treat PE in a timely manner.

Keywords

• Clinical practice guidelines
• Evidence-based practices
• Preeclampsia
• Systematic review