Royal Prince Alfred Hospital Royal Prince Alfred Hospital
Newborn Care

RPA Newborn Care Guidelines

Development of RPA Newborn Care Guidelines

The RPA Newborn Care Guidelines have been developed as part of a multidisciplinary effort within RPA Newborn Care. Although there is considerable variation in the scope and style of individual guidelines, in general the following documents the process of development:

  1. Formation of the RPA Newborn Care Guidelines Committee (termed the GRIP meeting Getting Research Into Practice). This is a multidisciplinary group comprising senior Neonatal Medical and Nursing staff, Developmental Paediatrician, Clinical Psychologist, Physiotherapist, and Consumer Representatives where appropriate and available.

  2. Identification of the guideline need within RPA Newborn Care.

  3. The development of a RPA Newborn Care Guideline is facilitated by identifying a content expert appropriate for the area of need. A draft is prepared which is distributed to committee members to critically appraise. The committee then meets and by a series of iterations settles on a final version which is felt to reflect the best evidence available at the time.

  4. Individual RPA Newborn Care Guidelines relating to clinical problems in general have the following structure:

    1. Introduction: identifying the problem, importance and key aspects of diagnosis and management
    2. Incidence and risk factors
    3. Consequences
    4. Diagnosis
    5. Intervention
    6. Key points including levels of evidence
    7. References
    8. Version date
  5. The RPA Newborn Care Guidelines are supported by searches of the literature which include searches of the Cochrane Library for Cochrane Systematic Reviews and CENTRAL for controlled clinical trials relating to questions of treatment, MEDLINE and PREMEDLINE (and others where appropriate) for observational studies relating to questions of aetiology, prognosis, and diagnosis, and additional searches of abstracts of conferences (particularly PSANZ and PAS-SPR), citation lists of review articles and relevant studies and content experts.

  6. The level of evidence upon which a statement is made should be explicit. Documentation of Levels of Evidence and Grades of Recommendation:

    1. Prior to March 2007, the scheme adapted from Improving Health Outcomes, MERGE, NSW Department of Health, 1996 was used.
    2. Subsequent to 2009, the Evidence Based Medicine Levels of Evidence and Grades of Recommendation scheme was used as documented in the NHMRC levels of evidence and grades for recommendations for developers of guidelines form.

  7. Grade of recommendation  Description

    A                                             Body of evidence can be trusted to guide practice

    B                                             Body of evidence can be trusted to guide practice in most situations

    C                                            Body of evidence provides some support for recommendation(s) but care should be taken in its application

    D                                            Body of evidence is weak and recommendation must be applied with caution