Emergency care nurses (ECNs) face several challenges when they assess patients with different symptoms, signs, and conditions to determine patients’ care needs. Patients’ care needs do not always originate from physical or biomedical dysfunctions. To provide effective patient-centred care, ECNs must be sensitive to patients’ unique medical, physical, psychological, social, and existential needs. Clinical practice guidelines (CPGs) provide guidance for ECNs in such assessments. The aim of this study was to evaluate the quality of CPGs for comprehensive patient assessments in emergency care. A quality evaluation study was conducted in Sweden in 2017. Managers from 97 organizations (25 emergency medical services and 72 emergency departments) were contacted, covering all 20 Swedish county councils. Fifteen guidelines were appraised using the validated Appraisal of Guidelines for Research & Evaluation II (AGREE II) tool. The results revealed that various CPGs are used in emergency care, but none of the CPGs support ECNs in performing a comprehensive patient assessment; rather, the CPGs address parts of the assessment primarily related to biomedical needs. The results also demonstrate that the foundation for evidence-based CPGs is weak and cannot confirm that an ECN has the prerequisites to assess patients and refer them to treatment, such as home-based self-care. This may indicate that Swedish emergency care services utilize non-evidence-based guidelines. This implies that ECN managers and educators should actively seek more effective ways of highlighting and safeguarding patients’ various care needs using more comprehensive guidelines.

Background Clinical practice guidelines (CPGs) provide guidance for emergency care clinicians to perform patient assessments. Neglecting CPGs may lead to incomplete or fragmented assessments and cause ad-verse events. However, it is important for CPGs to be evidence based, and patient assessments must be conducted in such a manner that high levels of patient safety can be achieved. The aim of this study was to explore and evaluate the quality of emergency medical services (EMS) and emer-gency departments (EDs) CPGs for comprehensive patient assessments. Methods A national cross-sectional design was used, and the listed managers from 97 organizations (25 EMS and 72 EDs) were contacted, covering all 20 Swedish county councils. Fifteen guidelines were ap-praised using the validated Appraisal of Guidelines for Research & Evaluation II (AGREE II) tool. Results The results revealed that none of the CPGs outlined a comprehensive patient assessment. The main characteristic of the CPGs was their focus on the medical assessment of patients with life-threatening conditions, mostly based on initial assessment and the A-E principle (airway, breathing, circulation, disability, and exposure). According to the AGREE II analysis, the overall quality of the guidelines was poor. CPGs lacked scientific support, underlying evidence, descriptions of how that evidence was collected, and explanations of the criteria used for CPG development. Conclusions This research indicated that there were no Swedish CPGs with comprehensive patient assessments in emergency care and that the foundation for evidence-based CPGs for comprehensive patient assessments was weak.