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Clinical practice guidelines are well-structured and laid down procedures aimed at aiding the practitioner and patient to make informed decision regarding the suitable healthcare for specific clinical condition (Field & Lohr, 1990, P.38). …
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The clinical guidelines are not decisions but are rather tools for assisting in making decision in clinical practice. Their principle focus is in improving the quality of healthcare provision by incorporating new research findings into the clinical practice through inclusion of specific recommendations, sufficient supporting evidence, a simple, and an attractive layout (Wollersheim, Burgers, & Grol, 2005). Application of the clinical practice guidelines has always produced mixed results due to various variables that affect the adoption of guidelines, thus a new approach to implementation of the guidelines should be adopted (Davis & Taylor-Vaisey, 1997). In order to address this problem, several approaches have been suggested including changing of clinical behavior by making the guidelines specific since it is difficult to get people to act on evidence based guidelines (Michie & Johnston, 2004). Further, writing guidelines composed of high behavioural specificity and simple English can be vital in increasing implementation of the guidelines (Michie & Lester, 2005). Additionally, to ensure that the knowledge contained in the guidelines reaches the target, an organized approach that integrates knowledge with workflow using existing electronic clinical decision support systems (ECDS) should be adopted (Entwistle, & Shiffman 2005).... The purpose of the AGREE instrument was to address the issues of variability in guide line quality, thus the AGREE instrument is a tool that is used to assess the methodological rigour and transparency in which a guideline is developed (AGREE Next Steps Consortium, 2009). The original AGREE instrument was revised giving birth to the new AGREE II instrument whose purpose is to provide a framework to: first, assess the quality of guidelines; secondly, provide a methodological strategy for the development of guidelines; and lastly, inform what information and how information ought to be reported in guidelines (AGREE Next Steps Consortium, 2009). According to AGREE Next Steps Consortium 2009, the AGREE II instrument is ‘composed of 23 key items organized within 6 domains, with each domain capturing a unique dimension of the guideline quality: Domain 1. Scope and Purpose is concerned with the overall aim of the guideline, the specific health questions, and the target population (items 1-3); Domain 2. Stakeholder Involvement focuses on the extent to which the guideline was developed by the appropriate stakeholders and represents the views of its intended users (items 4-6); Domain 3. Rigour of Development relates to the process used to gather and synthesize the evidence, the methods to formulate the recommendations, and to update them (items 7-14); Domain 4. Clarity of Presentation deals with the language, structure, and format of the guideline (items 15-17); Domain 5. Applicability pertains to the likely barriers and facilitators to implementation, strategies to improve uptake, and resource implications of applying the guideline (items 18-21); Domain 6. Editorial Independence is
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