Background. Evidence-based practices (EBPs) have been promoted to enhance the delivery of patient care, reduce cost, increase patient and family satisfaction and contribute to professional development. Individual and organisational barriers can hamper the implementation of EBP, which can be detrimental to healthcare delivery. Objective. To determine the individual and organisational implementation barriers of EBP among nurses in a private intensive care unit (ICU). Methods. A quantitative research design was used to collect data from nurses in a private ICU in the Eastern Cape Province, South Africa. The structured questionnaire (Cronbach's alpha: 0.72) was administered to 70 respondents, with a response rate of 93%. Results. Barriers at individual level were identified, and include lack of familiarity with EBP, individual perceptions that underpin clinical decision-making, lack of access to information required for EBP, inadequate sources to access evidence, inability to synthesise the literature available, and resistance to change. Barriers related to organisational support, change and operations were identified. Conclusion. Although the findings were similar to other studies, this study showed that nurses younger than 40 years of age were more familiar with the concepts of EBP. Physicians were perceived as not being very supportive of EBP implementation. In order to enhance healthcare delivery in the ICUs, nurse managers need to take cognisance of the individual and organisational barriers that might hamper the implementation of EBP.

Purpose The purpose of this paper is to critically analyze empirical studies related to the implementation strategies for clinical practice guidelines (CPGs) in intensive care units (ICUs). Design/methodology/approach A systematic review with a narrative synthesis adapted from Popay et al.'s method for a narrative synthesis was conducted. A search using CINAHL, Google Scholar, Academic search complete, Cochrane Register for Randomized Controlled Trials, MEDLINE via PUBMED and grey literature was conducted in 2014 and updated in 2016 (August). After reading the abstracts, titles and full-text articles, 11 ( n=11) research studies met the inclusion criteria. Findings After critical appraisal, using the Joanna Briggs Critical Appraisal Tools, eight randomized controlled trials conducted in adult and neonatal ICUs using implementation strategies remained. Popay et al.'s method for narrative synthesis was adapted and used to analyze and synthesize the data and formulate concluding statements. Included studies found that multi-faceted strategies appear to be more effective than single strategies. Strategies mostly used were printed educational materials, information/ sessions, audit, feedback, use of champion leaders, educational outreach visits, and computer or internet usage. Practical training, monitoring visits and grand rounds were less used. Practical implications Findings can be used by clinicians to implement the best combination of multi-faceted implementation strategies in the ICUs in order to enhance the optimal use of CPGs. Originality/value No systematic review was previously done on the implementation strategies that should be used best for optimal CPG implementation in the ICU.

Background: Job satisfaction among nurses often determines whether they choose to remain in the profession or in the facility where they work. Aim: The study sought to explore and describe the job satisfaction of registered nurses in South Africa through the lens of their nurse unit managers. Methods: A qualitative, exploratory, descriptive design was undertaken. Fourteen unit managers were interviewed and Tesch's method of data analysis was used. Findings: Four themes emerged: ‘staff shortages lead to nurses feeling overwhelmed and frustrated’, ‘nurses’ work performance is undermined by limited resources and poor infrastructure', ‘discontent among nurses with regard to poor top level and human resource management’ and ‘despite challenges, nurses experience rare moments of job satisfaction’. Conclusion: Unit managers need to find ways to enhance existing elements of job satisfaction by emphasising the nurse–patient relationship and teamwork among their staff in order to improve the overall job satisfaction of staff.

Background Job satisfaction is influenced by factors that are interpersonal (between nurse and colleagues), intrapersonal (within the nurse) and extra-personal (external to the nurse). Aim The primary objective of this study was to explore and describe factors influencing the job satisfaction of registered nurses in a particular private critical care unit. The second objective was to make recommendations to enhance the job satisfaction of registered nurses in this private critical care unit. Setting The population consisted of registered nurses in a private critical care unit in the Eastern Cape. Methods This study utilised a quantitative descriptive design. Self-administered questionnaires were distributed amongst registered nurses in the critical care unit. Data were analysed and illustrated through tables. Results Altogether, 39 registered nurses took part in the study. The majority of the participants (82%; n = 32) indicated that they enjoyed working with their team members. In addition, it was apparent that the majority (79%; n = 30) felt that they were sufficiently trained. Staff members felt that they had management support and felt satisfied at their workplace. Areas of concern included salaries, leave, debriefing and recognition. Conclusion The majority of the registered nurses in this private critical care unit were extremely satisfied with their job. However, there were areas where this could be improved. The high levels of satisfaction at this single critical care unit lead to the question whether this situation is common throughout the Eastern Cape, which opens the path for further research in this regard.