A systematic review on the impact of national guidelines on clinical practice and patient safety in the context of perioperative care

This systematic review identifies and assesses national guidelines that are used to improve clinical practice and patient safety in perioperative care. The authors searched, MEDLINE, Embase, Cumulative Index of Nursing and Allied Health Literature (CINAHL Plus) and Health Management Information Consortium (HMIC) to identify relevant studies published from January 2014 until May 2024. Two researchers screened a total of 727 studies (which yielded 37 eligible studies), extracted data and rated study quality using the Mixed Methods Appraisal Tool (MMAT). The most common national guidelines identified were the Enhanced Recovery After Surgery (ERAS) and the WHO Surgical Safety Checklist (WHO SSC). 13 studies identified improvements in morbidity, 10 a decrease in length of stay and 1 a decrease in readmission. Strength of evidence was high (18 studies rated as high), with most studies being pre-post evaluations. The evidence leans to suggest that the implementation of national guidelines can improve patient outcomes, however, this conclusion should be considered in light of all the available evidence.