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Clinical guidelines are viewed as an important tool in the quest to promote evidence based practice. Consequently, there has been a proliferation in guideline development at a national and local level. This paper describes what clinical guidelines are and how they have been developed by a national organisation--the Royal College of Nursing (RCN). Drawing on the development of two tissue viability guidelines: The Management of Patients with Venous Leg Ulcers and Risk Assessment and Prevention of Pressure Ulcers, some challenges inherent in guideline development are outlined. Certain desirable attributes that a clinical guideline should exhibit in order for it to be utilisable and effective in practice are outlined as these provide a standard for guideline developers. In reality the practice of guideline development will depend upon the topic, the experience of the guideline group, the purpose of the guidelines and the evidence available. Our experience suggests that producing a clinically valid and utilisable guideline is a labour and resource intensive process. It is also time consuming. An alternative strategy to developing local guidelines from scratch would be to adapt an existing guideline to local circumstances. A stepwise process is presented in the paper to assist people with this process.

The RCN has produced an evidence-linked clinical guideline on risk assessment and prevention of pressure ulcers THE HUMAN suffering and financial costs of I pressure ulcers, the variation in practice in the UK and a growing body of knowledge highlight the need for recommendations for practice. The NHS Executive commissioned the Royal College of Nursing (RCN) to produce an evidence-linked clinical guideline on risk assessment and prevention of pressure ulcers. The guideline complements and builds on the work others have undertaken, for example the European Pressure Ulcer Advisory Panel (EPUAP 1999).

Clinical guidelines are viewed as an important tool in the quest to promote evidence based practice. Consequently, there has been a proliferation in guideline development at a national and local level. This paper describes what clinical guidelines are and how they have been developed by a national organisation--the Royal College of Nursing (RCN). Drawing on the development of two tissue viability guidelines: The Management of Patients with Venous Leg Ulcers and Risk Assessment and Prevention of Pressure Ulcers, some challenges inherent in guideline development are outlined. Certain desirable attributes that a clinical guideline should exhibit in order for it to be utilisable and effective in practice are outlined as these provide a standard for guideline developers. In reality the practice of guideline development will depend upon the topic, the experience of the guideline group, the purpose of the guidelines and the evidence available. Our experience suggests that producing a clinically valid and utilisable guideline is a labour and resource intensive process. It is also time consuming. An alternative strategy to developing local guidelines from scratch would be to adapt an existing guideline to local circumstances. A stepwise process is presented in the paper to assist people with this process.