Gabrielle McKee1,2, Mary Kerins1,3, Glenys Hamilton1,4,5, Tina Hansen1,6, Jeroen Hendriks1,7,8, Eleni Kletsiou1,9, Ekaterini Lambrinou1,10, Catriona Jennings1,11, Donna Fitzsimons1,12. 1. 1 Council on Cardiovascular Nursing and Allied Health Professionals (CCNAP), European Society of Cardiology, Sophia Antipolis, France. 2. 2 School of Nursing & Midwifery, Trinity College Dublin, Ireland. 3. 3 Cardiac Rehabilitation, St James Hospital, Dublin, Ireland. 4. 4 Consultant in Nursing Education and Cardiovascular Research, Lancaster, MA, USA. 5. 5 Massachusetts General Hospital, Boston, MA, USA. 6. 6 Department of Cardiology, Zealand University Hospital, Roskilde, Denmark. 7. 7 Centre for Heart Rhythm Disorders, South Australian Health and Medical Research Institute, Adelaide, Australia. 8. 8 Department of Health and Medical Sciences, Linköping University, Sweden. 9. 9 University General Hospital "ATTIKON", Chaidari, Athens, Greece. 10. 10 Department of Nursing, Cyprus University of Technology, Limassol, Cyprus. 11. 11 Department of Cardiovascular Medicine, National Heart and Lung Institute, London, UK. 12. 12 School of Nursing, Queens University, Belfast, UK.
Abstract
BACKGROUND: The European Society of Cardiology (ESC) has a comprehensive clinical guideline development programme, relevant for all clinicians. However, implementation of guidelines is not always optimal. AIM: The aim of this study was to determine nurses' and allied professionals' awareness and barriers regarding clinical guideline implementation. METHODS: A cross-sectional survey was administrated online and in print at EuroHeartCare 2015. A questionnaire was developed which examined awareness and barriers to implementation of ESC guidelines on cardiovascular disease prevention in clinical practice (2012) and ESC guidelines in general. RESULTS: Of the 298 respondents, 12% reported that the prevention guidelines were used in their practice area. Respondents identified, in order of magnitude, that lack of leadership, workload, time, resources and a perception that they were unable to influence current practice were barriers to the use of the prevention guidelines. When asked to rank barriers to use of any ESC guidelines, time (22%) and leadership (23%) were ranked highest. CONCLUSIONS: Implementation of ESC guidelines by nurses, the majority responders in this survey, is a serious problem, requiring urgent improvement to ensure patients receive optimal evidence based care. Issues of leadership, workload, time and resources are significant barriers to guideline implementation. It is of concern that these professionals perceive both that they have little influence on implementation decisions and lack of leadership regarding guideline implementation. Educational and organisational strategies to improve leadership skills are imperative. These will build self-efficacy and empower nurses and allied professionals to advocate for evidence-based care in the clinical environment.
BACKGROUND: The European Society of Cardiology (ESC) has a comprehensive clinical guideline development programme, relevant for all clinicians. However, implementation of guidelines is not always optimal. AIM: The aim of this study was to determine nurses' and allied professionals' awareness and barriers regarding clinical guideline implementation. METHODS: A cross-sectional survey was administrated online and in print at EuroHeartCare 2015. A questionnaire was developed which examined awareness and barriers to implementation of ESC guidelines on cardiovascular disease prevention in clinical practice (2012) and ESC guidelines in general. RESULTS: Of the 298 respondents, 12% reported that the prevention guidelines were used in their practice area. Respondents identified, in order of magnitude, that lack of leadership, workload, time, resources and a perception that they were unable to influence current practice were barriers to the use of the prevention guidelines. When asked to rank barriers to use of any ESC guidelines, time (22%) and leadership (23%) were ranked highest. CONCLUSIONS: Implementation of ESC guidelines by nurses, the majority responders in this survey, is a serious problem, requiring urgent improvement to ensure patients receive optimal evidence based care. Issues of leadership, workload, time and resources are significant barriers to guideline implementation. It is of concern that these professionals perceive both that they have little influence on implementation decisions and lack of leadership regarding guideline implementation. Educational and organisational strategies to improve leadership skills are imperative. These will build self-efficacy and empower nurses and allied professionals to advocate for evidence-based care in the clinical environment.
Authors: Eileen J Carter; William G Greendyke; E Yoko Furuya; Arjun Srinivasan; Alexa N Shelley; Aditi Bothra; Lisa Saiman; Elaine L Larson Journal: Am J Infect Control Date: 2018-02-01 Impact factor: 2.918
Authors: Jennifer L Y Tsang; Katie Ross; Franziska Miller; Ramez Maximous; Priscilla Yung; Carl Marshall; Mercedes Camargo; Dimitra Fleming; Madelyn Law Journal: BMJ Open Date: 2019-04-04 Impact factor: 2.692