ABSTRACT
The purpose of a protocol is to direct healthcare staff along preferred pathways by outlining detailed management plans for discrete conditions. Protocols are considered to be more restrictive than guidelines, and their relevance to clinical situations is limited to certain specific occasions when their rigidity of purpose minimises risk. Recommendations are usually less strongly worded than guidelines, and may be based on less certain evidence. Codes of practice usually relay not only guidelines on safety and efficacy, but also ethical and social aspects of the problems. The key features determining whether local guidelines worked in one initiative were: A well-described systematic review of the literature underpinned the guidelines, with graded recommendations for best practice linked to the evidence. They also include A local implementation plan ensured that all of the practicalities were foreseen and met, stakeholders were supported and predictors of sustainability were addressed.
