July 20, 2012 | | Comments 2
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Nurses identify barriers and facilitators for clinical practice guideline use

Nurses’ adoption and use of clinical practice guidelines is largely affected by external barriers such as social and organizational factors, according to a study published in this month’s issue of American Journal of Nursing.  Clinical practice guidelines, which the Institute of Medicine defines as “systematically developed statements to assist practitioner and patient decisions about appropriate healthcare for specific clinical circumstances,” are designed to close the gap between evidence for best practice and actual patient care. Researchers chose to focus on nurses’ applications of clinical practice guidelines due to several previous studies that found that nurses were most often identified as being primarily responsible for ensuring patient safety.

Researchers examined responses to open-ended survey questions asking nurses about barriers and facilitators to using clinical practice guidelines. The top three most-identified categories for facilitating the use of guidelines were education/orientation/training, communication, and time/staffing/workload; similarly, these were also identified as categories in which there were barriers to guideline use. 44% of nurses responded that their ability to use guidelines was impeded by a lack of time and a heavy workload, while 25% cited a lack of education, orientation, and training and 22% cited poor communication as barriers. Researchers found that 91% of nurses identified at least one external barrier, or those outside of the individual nurse’s control, and 53% of nurses identified more than one external barrier.  Fewer than 10% of nurses identified internal barriers such as lack of awareness of guidelines or willingness to change practice to better adhere to guidelines.

The research suggests that social and organizational factors can be crucial in the use of clinical practice guidelines. Organization leaders should find ways to ensure that nurses receive sufficient education and adequate time to successfully implement guidelines. In addition, effective communication and cooperative teamwork should be encouraged and practiced by everyone within an organization. The study’s researchers conclude that nurses should ideally be involved in all stages of guideline development, implementation, and use.

How do your nurses respond to clinical practice guidelines? What are some ways you have found to ensure guideline use among your nurses? Share your thoughts in the comments section!

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Filed Under: Evidence-based practiceLeadershipnurse education

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About the Author: Katrina Gravel is an editor for the Education division of HCPro.

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  1. This is a great topic. It is imperative that we give nurses the tools to be able to accomplish the tasks we place before them. Frequent open communication can be so beneficial in encouraging continued education. I agree that we need to be a bit more proactive in promoting clinical practice guideline use but in order to achieve this, we must offer the necessary education that is specific to our units. It is unrealistic to expect our teams to embrace a practice that we are not able to show is a “best practice” through evidence based practices.
    In my unit, I have found the nurses are receptive to new practices and protocols that have been thoroughly explained and implemented with the team at the core and patient care in focus.

  2. You can definitely see your enthusiasm in the work you write. The world hopes for more passionate writers like you who aren?ˉt afraid to say how they believe. Always go after your heart.

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