Iranian Journal Of Nursing and Midwifery Research
Volume:28 Issue: 5, Sep-Oct 2023

More than 30% of women experience at least one abortion. To date, there has been no comprehensive mobile health project on the impact of technology on access to abortion, contraception, and post‑abortion follow‑up. The purpose of this study was to review published studies on the role of electronic health in the prevention of unwanted pregnancy, abortion, and post‑abortion follow‑up.

The Web of Science, PubMed, ScienceDirect, and EMBASE databases were searched to find relevant articles published between 2008 and 2018. A systematic review study was conducted on 33 relevant articles. All studies related to the use and impact of electronic health on unwanted pregnancy prevention, abortion and post‑abortion follow‑up in English from January 2008 to December 2018 were included. The quality of the studies was evaluated using the PRISMA‑S.

Thirty‑three studies met the inclusion criteria for the review. The Studies were divided into four main groups of women’s experiences on the use of mobile health and telemedicine technologies for at‑home medical abortion, unwanted pregnancy prevention, abortion, and post‑abortion follow‑up. The results showed the significant impact of using electronic health on unwanted pregnancy prevention, abortion, and post‑abortion follow‑up.

Health technologies have the potential to be used as a low‑cost and accessible method to replace abortion services. They can facilitate remote care and quick access to information to complete the gaps in access to abortion. Therefore, it is necessary for health service providers to be aware of the possibility of the client’s access to electronic health tools.HighlightsMaryam Ahmadi: PubMed, Google Scholar

Tracheostomy care is a standard procedure that nurses perform in Critical Care Units (CCUs) to reduce complications from tracheostomy. The literature indicates a clear variety of care and practice in managing tracheostomy patients within the healthcare system. This study was conducted to assess the knowledge level of tracheostomy care among nurses in CCUs in Jordanian hospitals.

A cross‑sectional descriptive design was used for this study. A convenience sample of 260 nurses working in the CCUs of four government hospitals completed a self‑reported structured questionnaire. Data were collected from January 2021 to March 2021. A t‑test and one‑way Analysis of Variance (ANOVA) were used to assess the differences among socio‑demographic variables in terms of knowledge score.

The result revealed that the level of knowledge was suboptimal. There was a statistically significant difference in the mean level of knowledge regarding tracheostomy care (in all dimensions) by age (F = 22.595, p </em>< 0.001), educational level (F = 355.30, p </em>< 0.001), and work experience (F = 13.63, p </em>< 0.001). For gender, there was a statistically significant difference in knowledge of the tracheostomy suctioning dimension (p </em>= 0.001).

The level of knowledge among nurses regarding tracheostomy care was moderate, indicating an urgent need for educationHighlightsRasha Abu Sahyoun: PubMed, Google Scholar

The Helping Babies Breathe (HBB) program is a simple neonatal resuscitation protocol implemented in low‑resource clinical systems. Therefore, it is necessary to train midwives on the implementation of this program and ensure the sustainability of the learned materials. The present study aimed to assess the impact of continued social network‑based learning based on midwives knowledge and implementation of the HBB program.

This randomized controlled field trial was performed on 50 midwives who were selected by the available sampling method. All midwives attended the HBB workshop; thereafter, in the intervention group, the learned materials were reinforced for 3 months using WhatsApp messenger. Data were collected using Objective Structured Clinical Examination (OSCE), which was administered before the HBB program and 3 months later (HBB guide; 2th Ed, 2018). The data were analyzed in SPSS software (version 19) using independent and paired t‑tests.

Based on the results, the mean knowledge score was not significantly different in both groups (control and intervention) immediately after the workshop. The mean scores of knowledge and skill variations did not decrease significantly in the WhatsApp group during the 3 months; nonetheless, a marked decrease was observed in the control group (t21 </sub>= 16.68, p </em>< 0.05).

The results of this study pointed out that continued social network‑based education promoted the knowledge and skills of health care providers, highlighting the importance of social networks in education.

Maternal health is the mother’s state of well‑being before, during, and after conception. Studies have suggested that the increasing maternal mortality rate is preventable provided maternal health services are accessible during pregnancy. This study explored the association between socioeconomic status and the utilization of maternal health services in the Federal Medical Centre (FMC), Abeokuta, Ogun State.

This study is a cross‑sectional survey. One hundred and eighty‑eight pregnant women from the antenatal unit of a tertiary hospital in Southwestern Nigeria were selected using a convenience sampling technique. Data were collected via a pretested, self‑designed questionnaire. The descriptive statistics were used to analyze the resulting data, and the hypotheses were tested using the Pearson product‑moment correlation at 0.05 level of significance.

From the study, 72 (38.30%) and 58 (30.90%) agreed that their income and occupation influence their maternal health services utilization. Significant relationship (p </em>< 0.05) existed between maternal health service utilization and age and between socioeconomic factors (occupation and income level) and utilization of maternal health services of pregnant women.

Overall, this study revealed that the level of utilization of maternal health services among expectant women attending FMC is moderate. As this study has shown that socioeconomic factors influence the utilization of maternal health services, we recommend that interventions by health workers targeted at improving the utilization of maternal health services should consider these factors when designing such interventions. It is hoped that this will contribute to reducing maternal mortality and morbidity in this state.

Gestational diabetes is the most common medical complication in pregnancy, and the psychosocial health of women suffering from this condition affects their adherence to treatment and self‑efficacy. However, since it is not possible to design interventions dealing with all of these needs, the aim of this study was to prioritize the psychosocial supportive needs of women with gestational diabetes.

This was a modified Delphi design study involving 22 experts who were selected using purposive and snowball sampling methods. The study was conducted between April 2021 and June 2021. First, the psychosocial needs of diabetic pregnant women were extracted through a qualitative study involving interviews with multidisciplinary specialists and diabetic pregnant mothers (22 participants) and a systematic review of reputable scientific databases. Throughout the two Delphi stages, the questionnaire was classified, quantified, and analyzed.

Based on the results of this study, the following are the top priorities when addressing the psychosocial needs of mothers with gestational diabetes: paying attention to and identifying the mother’s worries and anxiety, husband and family support for diabetic pregnant women, the inclusion of specialized nutrition counseling services in mothers’ treatment plan, timely education of mothers about diabetes and its complications, and proper nutrition for diabetic mothers.

The priorities of the supportive needs obtained in this study can be used to design interventions aimed at promoting psychosocial health, reducing stress and anxiety, and improving medication adherence in women with gestational diabetes.

Working as a child can have various effects on all aspects of children’s health. Investigating and identifying issues related to the health of working children can be useful in promoting their health. Therefore, in this qualitative study, we examined issues related to the mental health and behavior of working children.

This qualitative study was conducted in Tehran, Iran, in 2021 with the contractual content analysis approach. The main participants (N = 32) in this study were working children aged 10 to 18 years. To collect data, in‑depth and semi‑structured interviews were conducted with working children, their parents, and the center officials. In addition to the interview, some field notes were also taken from interactions between working children. After each interview, they were transcribed and coded. After 27 interviews, the data were saturated, no new code was extracted, and further interviews were conducted to ensure data saturation. Data analysis was performed based on the proposed method of Lundman and Graneheim.

The results revealed the three main categories of mental distress (fear and anxiety, depression, loneliness and isolation, decreased self‑confidence, and decentralized mind), social anger (negative social role modeling, harassment and harm of others, reprehensible and antisocial behavior, disregard for the property of others, disrupted relationships, and violence), and in‑group commitment (self‑censorship outside the group, individual independence and group cohesion, and caring for the group).

Most working children suffer from various forms of mental and behavioral issues, which, if not taken care of, can have irreparable consequences.

Despite the difficulty of making decisions providing facilitating mediators and removing barriers to making decisions about choosing the right path to donate the organs of brain‑dead patients by families can assist in improving the services and help the lives of fellow human beings. This study aimed to explain the decision‑making mediator for organ donation in families with brain‑dead patients in a cultural context.

This qualitative study with a critical ethnographic approach was conducted based on Carspecken’s stages from August 2021 to March 2022. In this regard, 22 participants were selected through the purposive sampling method and considering the inclusion and exclusion criteria. Sampling was continued until data saturation. After obtaining the required ethical approval, data collection was performed through observation, semi‑structured interviews, and document review. All data were recorded and managed using MAXQDA 18 software.

Based on the results, the main themes and subthemes of this study included “inefficient decision‑making mediator” (the shadow of the socioeconomic situation on the medical status of organ recipients, as well as pessimistic influential individuals, social accountability, dialect difference, and ethnic beliefs) and “efficient decision‑making mediator” (social learning, material, and spiritual motivation, mother role, and divine reward).

The results of this study, derived from a cultural context, can be applied to carrying out future applied and empirical research. Moreover, they can be used in the field of various nursing roles, especially management, care, and education.

The COVID‑19 pandemic has significantly affected the lives of the community. The resulting social constraints and the physical and psychological consequences are also expected to affect sexual health. The present study aims to determine the status of sexual function, desire, and satisfaction of couples during the outbreak of COVID‑19.

This is a descriptive online cross‑sectional study on 400 married individuals living in Qazvin, Iran, from October 15 to November 12, 2020. The multi‑stage random cluster method is used for sampling. The following questionnaires have been used for data collection: Female Sexual Function Index (FSFI), Rosen male sexual function, Larson’s sexual satisfaction, and Hurlbert Index of Sexual Desire (HISD). The questionnaires were sent to participants through online messengers. The obtained data were analyzed by SPSS software (v25).

The findings show that only 19.20% of study participants had sex three or more times a week. Most of the participating women (56.90%) had sexual dysfunction, while most men (64.30%) had proper sexual function. Also, the majority of participants had moderate sexual desire (46%) and high sexual satisfaction. The primary predictors of sexual dysfunction in men and women during the outbreak of COVID‑19 were “employment in health centers” (B = ‑9.34, p </em>= 0.007) and “spouse working in health centers” (B = ‑6.16, p </em>= 0.007), respectively.

The psychological burdens of the COVID‑19 pandemic and resulting measures, such as prevention protocols, affect couples’ sexual relations. Therefore, interventions are necessary to improve the quality and health of the sexual life of couples.

Hospital Safety and Health Management System (HSH‑MS) and Hospital Safety Climate (HSC) are the significant elements to develop safe work practices. The current study aimed to examine the dimensions of HSH‑MS and HSC and the association with the prevalence of Needlestick and Sharp Injury (NSI) and NSI recidivism.

A cross‑sectional study was conducted among 1070 nurses in Iranian hospitals (89% response rate).

More than 54% (n </em>= 579) had sustained at least 1 NSI in the previous year. The NSI recidivism rate was 8.6% and recidivists were more likely to be younger, female, married, with higher Body Mass Index (BMI), and on night shift. Two aspects of HSH‑MS including management leadership and employee participation were associated with the incidence of NSIs Odds Ratio (OR): 1.91 and 95% Confidence Interval (CI): 0.69–1.21; OR: 1.29 and 95% CI: 0.92–1.82) and NSI recidivism rate (OR: 1.98 and 95% CI: 0.55–1.74; OR: 1.12 and 95% CI: 0.83–1.49). Furthermore, three dimensions of HSC comprising management support (OR: 1.02 and 95% CI: 0.93–1.11 for NSIs; OR: 1.21 and 95% CI: 0.77–1.22 for NSI recidivism), absence of job hindrances (OR: 1.06 and 95% CI: 0.98–1.16 for NSIs; OR: 1.11 and 95% CI: 0.96–1.30 for NSI recidivism) and cleanliness/orderliness (OR: 1.07 and 95% CI: 0.98–1.08 for NSIs; OR: 0.84 and 95% CI: 0.87–0.97 for NSI recidivism) were correlated with reduced NSIs risk.

This study suggests that HSH‑MSs and employees’ safety climate are significant factors, which are correlated with not only the prevalence of recurrent NSIs but also the single NSI in hospitals.

The efficacy of Assisted Reproductive Techniques (ARTs) or technologies used to treat infertile couples has been approved. One such technique is embryo donation. However, there is insufficient knowledge of the experiences of mothers receiving donated embryos. Thus, the present study was conducted with the aim to determine the experiences of mothers receiving donated embryos.

This qualitative conventional content analysis study was conducted in 2018 for 8 months (from February to September). The research setting was Royan Institute. Mothers receiving donated embryos were selected from among those who were pregnant or were at the postpartum stage using the purposive sampling method. A total of 15 interviews were performed with 13 participants. The qualitative data were collected using deep unstructured interviews and analyzed using the Graneheim and Lundman (2004) method in (version 10; VERBI GmbH, Berlin, Germany) software.

Data analysis resulted in 412 open codes that were then categorized into 7 main categories and their subcategories. The main categories were as follows: sociocultural constraint, feeling of insecurity in personal and family identity, protection of personal and family identity, confounded support, pressure and hardship, and achieving relative tranquility.

The results of this study showed that the mothers who underwent embryo donation experienced feelings of insecurity regarding both individual and family identities, were confronted with sociocultural difficulties, and faced various pressures. It is suggested that future care plans be focused on the identity crisis of these families and the children resulting from these methods, and that future plans balance the socioeconomic pressures resulting from the use of these methods.

Family members of Chronic Mental Disorders (CMD), who are responsible for patient care, face many physical, psychological, and social problems which make them face the burden of care. This study aimed to investigate the effect of a psychosocial health promotion program on the care burden of family caregivers of patients with CMD.

This is a quasi‑experimental study that was conducted in two intervention and control groups in the form of pretest and posttest. This study was performed on 67 family caregivers of patients with CMD in Farabi and Noor centers in Isfahan, Iran. Participants in this study were randomly divided into two intervention and control groups. Data from the intervention and control groups were collected in two stages, before and after the intervention by demographic information form and Zarit burden questionnaire. The intervention group received a web‑based psychosocial health promotion program in eight sessions in 4 weeks. At the end of the intervention, the Zarit questionnaire was completed by the intervention and control groups.

The mean score of care burden between the intervention and control groups was not statistically significantly different before the implementation of the program (p </em>= 0.534). But after the intervention, the mean score of care burden was significantly different between the two groups (t</em>65 = 3.43, p </em>= 0.001).

This study provides evidence for the benefits of web‑based psychosocial health promotion program in reducing the perceived care burden of the caregiver of CMD.

The evaluation of geriatric care in the emergency departments is necessary to improve the quality of care. This study aimed to determine the status of geriatric nursing care from the perspective of nurses working in the emergency department of hospitals.

This study was a cross‑sectional research study. Through census sampling, 252 nurses working in the emergency departments of hospitals of Ardabil Province were selected. The status of elderly care was assessed using the Geriatric In‑Hospital Nursing Care Questionnaire. Data were analyzed using independent and one‑sample t‑tests and analysis of variance.

The mean (GerINCQ) score of the participants [mean (SD): 237.30 (75.30)] was significantly higher than the criterion score (201) (p = 0.001). The scores of the sub‑scales of perception of elderly care [mean (SD): 45.42 (7.53)], aging‑sensitive care delivery [mean (SD): 41.55 (10.25)], professional responsibility [mean (SD): 39.62 (9.86)], and attitude toward caring for elderly [mean (SD): 56.14 (12.53)] were significantly higher than the standard score (p = 0.001). However, the score of performed intervention [mean (SD): 38.36 (8.42)] was significantly (p = 0.02) lower than the criterion score (39). The score of professional responsibility and attitude toward elderly care was higher in women than men, and this difference was statistically significant (p < 0.05).

The results showed that aging‑coordinated care delivery, professional responsibility, and attitudes and perceptions of nurses toward elderly care were satisfactory, but performed intervention was unfavorable. According to the results of this study, nursing service managers can improve the quality of elderly nursing care through appropriate policies, fixing the workforce shortage, and closely monitoring elderly care in the emergency departments.

Students are a significant source of data for the evaluation of clinical instructors’ performance. This study was undertaken with the aim of adaptation and validation of the Persian version of the Maastricht Clinical Teaching Questionnaire (MCTQ). The main objective of the researchers in this study was to evaluation the psychometric properties of the Persian version of the Maastricht Clinical Training Questionnaire (P-MCTQ) in Iran, considering cultural and social differences.

This methodological study was conducted from 2019 to 2021 at four teaching hospitals affiliated with Sabzevar University of Medical Sciences, Iran. Qualitative and quantitative face and content validity, and construct validity methods were used for the validity evaluation. Stability and internal consistency methods were used, respectively, for the reliability evaluation of the questionnaire. Exploratory Factor Analysis (EFA) stage, 264 students studying in the fields of nursing, midwifery, anesthesiology, operating room, emergency medicine, and laboratory sciences completed the P‑MCTQ.

The value of scale-content validity index (0.92) is indicative of the overall content validity of the questionnaire. EFA extracted a single‑factor structure that could explain the overall variance of the clinical education structure at about 76.61%. The alfa and intraclass correlation values were equal to 0.98 and 0.82, respectively, indicating the excellent internal consistency and high overall stability of the questionnaire.

The P‑MCTQ is a valid and reliable tool for the evaluation of the teaching performance of clinical instructors.

Nausea, vomiting, and anxiety are common complications during and after spinal anesthesia. Auriculotherapy as a complementary medicine can be useful for reducing nausea, vomiting, or anxiety. This study was performed to evaluate the effects of auriculotherapy on nausea, vomiting, and anxiety in patients undergoing elective Cesarean Section (CS) with spinal anesthesia.

The present study was a clinical trial study that was performed on 56 pregnant women selected as CS candidates in Ommolbanin Hospital in Mashhad during the years 2016–2017. In the intervention group, 1 h before spinal anesthesia, auricular acupoint stimulation was performed at four points bilaterally, for 20–30 seconds at each point. Evaluations were done by the following questionnaires: State‑Trait Anxiety Inventory (STAI), Visual Analog Scale (VAS), and Vomiting Assessment Form.

The mean anxiety (SD) before the intervention in the intervention group and the control group was 47.88 (8.67) and 47.84 (10.49), respectively, and 4 h after the intervention, it was 40.23 (10.19) and 42.88 (12.18) in the intervention and control groups, respectively. These results were significant in the intervention group (p </em>= 0.008). 30–40 min before and 4 h after the surgery, the severity of nausea and vomiting was low in both groups and no significant difference was observed between the two groups during the surgery and in the recovery room (p </em>> 0.05).

According to the results, auriculotherapy could reduce anxiety in CS patients with spinal analgesia. The results also showed that auriculotherapy reduced the severity of nausea and vomiting, but these changes were not significant.

Organizational ethics focuses on the importance of how organizations behave when faced with specific situations and decisions. This study aims to identify and prioritize organizational ethics indicators in Imam Khomeini Hospital Complex (IKHC) in Iran.

This was a mixed‑method research project. To recognize hospital ethics indicators, 18 semistructured interviews were conducted and 38 indicators were identified through thematic analysis. In the next stage, a quantitative approach was adopted to use the importance‑performance matrix for data analysis. This part was a descriptive survey with a statistical population consisting of nurses, medical, clinical, and administrative staff. The questionnaire was distributed using the random sampling method, and a total of 349 samples were collected.

Based on the interviews and open coding, 73 themes were identified for organizational ethics indicators and classified into two main groups: “ethics drivers in hospital” and “personal ethics.” After measuring content validity, 35 indicators of organizational ethics in IKHC were examined in terms of importance and performance. The results showed that nine indicators had high importance and poor performance, 11 had high importance and performance, nine had low importance and performance, and finally six indicators had low importance and high performance, and according to these findings, practical suggestions were put forward.

Based on the identified indices and by applying importance‑performance analysis, it is recommended to continually assess the status of ethics in hospitals and offer strategies for improving organizational ethics.

For many reasons, some care services may be missed. This study was conducted to investigate missed care, the related factors, and solution for decreasing them.

A descriptive, cross‑sectional study was performed on 122 nurses. A multi‑part tool was used to gather information, which included demographic information, the Missing Nursing Care and Related Organizational Factors, and Missed Nursing Care Reduction Strategies Questionnaire. Descriptive and inferential statistical tests including ANOVA, independent t‑test, and the Pearson correlation were used.

The mean score (SD) of the Missing Nursing Care Questionnaire was 82.04 (8.50); thus, the amount of missed nursing care is very high. Additionally, the mean score (SD) of the Organizational Factors Questionnaire related to it was 30.98 (9.35). Considering the maximum score of the questionnaire (80), the role of organizational factors in the incidence of missing nursing care is relatively moderate. There was also a weak and inverse correlation between organizational factors and missed nursing care (r = −0.30, p </em>< 0.01, df = 120). Based on the results, increasing the number of nurses and their level of knowledge has the greatest 67.21 (%) and least 34.42 (%) impact on reducing the incidence of missed nursing care.

According to the results, the prevalence of missed nursing care was high. However, the contribution of organizational factors to it is relatively little. This suggests that from the perspective of nurses, factors other than organizational factors related to the workplace can lead to missing care.

Noncompliance with treatment in the elderly with Heart Failure (HF) may result in a lack of recovery, a decrease in longevity, rehospitalization, and additional costs. Therefore, this study was conducted to determine the effect of self‑care education on adherence to treatment among elderly patients with HF.

This study was a parallel clinical trial on 90 elderly people over 60 years of age who were hospitalized in cardiac wards. Data were collected using a demographic characteristics form and the adherence to treatment questionnaire. Individuals who met the study inclusion criteria were randomly allocated to the intervention and control groups. The intervention group training was performed before and after discharge. The adherence to treatment questionnaire was completed again by both groups 2 months after discharge. Data were analyzed using Chi‑squared test; ex. (?2 = 3.95, df = 1, p = 0.046), paired and independent t</em>‑tests, and analysis of covariance.

The mean (standard deviation) total score of adherence to treatment in the intervention group was 39.71 (4.51) and 78.72 (10.47) before and after the self‑care education, respectively. Paired t</em>‑test showed a significant difference in both groups after the intervention compared to before the intervention, and independent t</em>‑test showed a significant difference between the groups after the intervention (p </em>= 0.001).

Self‑care education before discharge and home‑based education were effective in promoting adherence to treatment among patients with HF. Therefore, self‑care education before discharge may improve adherence to treatment among elderly patients with HF.

Although art and aesthetics are important aspects in nursing care, there is scarcity of literature regarding this area, particularly in relation to patient expectations of art nursing care. This study aims to explore the perceptions of patients with burn injuries regarding art nursing care.

The present phenomenological study was conducted on 14 patients with burn injuries based on convenience and purposive sampling. Data were collected through deep open‑ended and semi‑structured interview. Data analysis was performed based on van Manen’s Hermeneutic Phenomenology.

Patients’ experience of art nursing care emerged in the form of three main themes, including “being a healer for patients’ wounds”, “skilled and specialized care”, “praiseworthy care”, and six subthemes.

The patients in the burn unit demonstrated an understanding and appreciation for the qualities of patience, hard work, compassion, and love that the nurses possess. They also noted the meticulous attention paid by the nurses to their needs, which exemplifies the purest human traits and professional characteristics in patient care and can be seen as an art form in nursing.

One of the factors effective in controlling acute coronary syndrome (ACS) symptoms, such as heart failure, is sufficient knowledge of the disease, factors effective on its occurrence, and its prevention. Moreover, the improvement of self‑efficacy, which is a predictor of important life factors in these patients, such as treatment process and quality of life (QOL), must be considered as one of the main goals of nursing care for these patients. The aim of this study was to determine the effect of the family‑centered self‑care program on the health literacy level and self‑efficacy of patients with ACS during hospital discharge.

The present study was a quasi‑experimental study performed with a pretest‑posttest design. The statistical population of the study consisted of all patients with ACS hospitalized at Shahid Chamran Hospital in Isfahan in 2020. Through the convenience sampling method, 50 patients were selected and randomly divided into intervention and control groups. For the intervention group, 6 sessions of 45–60 minutes of family‑centered self‑care intervention were held. The subjects completed the Health Literacy for Iranian Adults (HELIA) questionnaire before and after the intervention. Data were analyzed using Chi‑square test, independent t</em>‑test, and paired t</em>‑test in the SPSS statistical software.

The mean score of health literacy did not significantly differ between the intervention and control groups before the intervention (p </em>> 0.050). However, after the intervention, this rate was equal to 82.16 (7.94) and 60.85 (15.71) in the intervention and control groups, respectively, which was significantly higher in the intervention group compared to the control group (p </em>< 0.001). Furthermore, there was no significant difference between the two groups in terms of the mean self‑efficacy score before the intervention (p </em>> 0.05). However, after the intervention, this score was significantly higher in the intervention group 34.71 (10.11) compared to the control group 35.22 (13.30).

Family‑centered self‑care program after discharge, as a simple, applicable, and efficient method can improve the health literacy level and self‑efficacy of patients with ACS.

Dear Editor,The provision of quality health services has become a major concern for policymakers and societies worldwide. The World Health Organization emphasizes that the quality of care is crucial to establishing trust in healthcare professionals. Clinical Practice Guidelines (CPGs) are scientific statements designed to assist physicians and patients in making informed decisions regarding appropriate and high‑quality care for specific clinical conditions.[1] However, despite the significant cost incurred in developing and publishing numerous CPGs over the past decade, their quality varies greatly. The American Institute of Medicine has outlined eight desirable features for CPGs in a prominent report, but unfortunately, most developed guidelines do not meet these criteria.