The dissemination of the Prevention and Treatment of Pressure Ulcers Clinical Practice Guideline 2014 in the academic literature

To the Editor, Clinical practice guidelines (CPGs) are widely used in healthcare to optimize patient care and to improve outcomes. Since the early 1990s, numerous national and international pressure ulcers/injuries CPGs have been published and updated. However, developing and updating guidelines in itself will not improve patient care without effective dissemination and implementation. Dissemination is the process through which new health information is spread from developers/researchers to health professionals who will implement new practice. Effective dissemination of a guideline is a necessary first step in achieving the best clinical practice recommended within a guideline. In September 2014, a pressure ulcer/injury CPG was published by the National Pressure Ulcer Advisory Panel, the European Pressure Ulcer Advisory Panel and the Pan Pacific Pressure Injury Alliance. Based on systematic searches and critical appraisals of the literature, recommendations were developed by the international multidisciplinary team overseen by a guideline development group. A full version of the CPG and a brief summary (Quick Reference Guide, QRG) were created. After publication, various dissemination approaches were undertaken, including translation of the CPG and the QRG into languages other than English, presentation at relevant conferences and promotion via websites and social media. However, it is unknown to what extend this guideline was disseminated throughout scientific and professional journals. In order to investigate this issue, we undertook a review is to estimate the number of citations of the international 2014 CPG in the academic literature. A key source of identifying and analyzing citations is citation databases such as Web of Science (Clarivate Analytics, Philadelphia, United States). This database connects cited references of papers with each other allowing forward and backward searches of connected references. Therefore, the database can be used to establish frequency and sources of citations. This system works reliably for journal articles indexed in Web of Science, as well as other document types (eg, text books). However, the Web of Science database indexes non-journal citations in the referencing format in which it was presented in the original publication. Authors often vary the presentation of a citation, for example to conform to journal referencing styles or to adopt default settings in citation software. Format variations influence the way in which the citation is indexed in the Web of Science database; however, Web of Science software algorithms do attempt to unify these variations. Regardless, there is no guarantee that every citation will be correctly identified and linked. Because of this known challenge, we undertook two search approaches in February 2020 to identifying citations of the international 2014 CPG: