Developing complex interventions for nursing: a critical review of key guidelines

Abstract

Aims and objectives: To identify the most comprehensive approach to developing complex interventions for nursing research and practice.

Background: The majority of research in nursing is descriptive and exploratory in nature. There is an increasing professional and political demand for nurses to develop and provide evidence to support their practices. Nurses need to explore current practice and develop and test interventions to provide the evidence required for safe practice.

Design: A literature review using a systematic approach.

Methods: The review was carried out using four databases: CINAHL, PubMed, PsycINFO and BNI (2000-2011), and the search was limited to 'brief interventions' and complex intervention development (January 2000-September 2011). Included papers reported on guidelines for intervention development or 'how' an intervention was developed.

Results: Six papers reported on guidelines for developing interventions. There are many similarities between the guidelines with a similar pattern of guideline development in Europe and the USA. The only guideline reported to have been used in the development of interventions is the Medical Research Council framework (MRC) (A Framework for Developing and Evaluation of RCTs for Complex Interventions to Improve Health, 2000), with 9 of 14 papers that describe the development of an intervention reporting the use of this guideline. The other five papers did not mention the use of any guideline or framework.

Conclusions: The MRC (A Framework for Developing and Evaluation of RCTs for Complex Interventions to Improve Health, 2000) framework appears to be the most widely used guideline reported for developing complex interventions. Although the updated MRC (Developing and Evaluating Complex Interventions, 2008) framework adds considerably to the original MRC (A Framework for Developing and Evaluation of RCTs for Complex Interventions to Improve Health, 2000) framework, other guidelines contribute additional guidance which can inform the development of nursing interventions. These additional guidelines are presented in a model for developing complex interventions for nursing.

Relevance to clinical practice: The model will help nurses planning to develop nursing interventions as it provides additional and nursing-specific guidance to the MRC (Developing and Evaluating Complex Interventions, 2008) framework for the development of complex interventions for nursing practice.

Keywords: complex interventions; frameworks; guidelines; literature review.