Factors Influencing Critical Care Nurses' Adoption of the AACN Practice Alert on Verification of Feeding Tube Placement

Abstract

A closed-book, multiple-choice examination following this article tests your under standing of the following objectives: Methods Critical care nurses were invited to participate in a national, online questionnaire, guided by Rogers' diffusion of innovation framework. Descriptive statistics and logistic regression were used for data analysis. Alpha level was set at 0.05. Results Fifty-five percent of the 370 participating nurses were aware of the practice alert, and 45% had adopted it in practice. Only 29% of the adopters had also implemented all 4 clinical practices. Significant predictors of adoption included BSN or higher nursing education and guideline characteristics of observability and trialability. Predictors of implementation of the clinical practices included staff nurse/charge nurse role, academic medical center, research/web-based information sources, and perception of a policy. Policy was the only significant predictor of implementation of all 4 practices. Adoption of the practice alert was also a predictor for 2 of 4 clinical practices. Conclusions Personal and organizational factors influenced implementation of practices associated with an AACN practice alert. Although a research-practice gap exists, the practice alert was a significant source of information for 2 of the clinical practices.

Adherence to the Women's Preventive Services Guidelines in the Affordable Care Act

“…Only 39.7% of the respondents indicated adherence to a majority of the guidelines (four or more) relevant for their patient population. This is consistent with other reports that show significant adherence variation within a given set of clinical guidelines (Bourgault et al, 2014; Cabana et al, 2001; Christakis & Rivara, 1998). …”

“…Over the past decade, evidence from these studies and others suggested that provider adherence to clinical practice guidelines is often less than optimal, even when general awareness of the guidelines may be high (Bourgault et al, 2014; Cabana & Kim, 2003; Cabana et al, 1999; Carlson, Glenton, & Pope, 2007; Flores, Lee, Bauchner, & Kastner, 2000; Kiyoshi-Teo et al, 2014; O’Laughlen et al, 2013). Multiple factors may promote or limit providers’ adherence and translation of guidelines into improved patient outcomes, and substantial adherence variation within individual recommendations is embedded in different types of guidelines.…”

Methods Used by Critical Care Nurses to Verify Feeding Tube Placement in Clinical Practice

“…1 The methods used by nurses with CCRN certification or who were employed in a unit with Beacon award status did not differ from the methods used by other nurses. CCRN is an acute/critical care specialty certification through AACN.…”

“…A complete description of the sample was previously published. 1 Participants were 23 to 65 years old (mean, 43 years) and had 1 to 40 years (mean, 13 years) of critical care nursing experience. About 83% were AACN members, 51% were CCRN certified, and 14% worked in a Beacon unit.…”

“…1 The term adoption is commonly used to describe the processes of accepting and implementing an innovation such as the AACN practice alert. 18 Implementation is a term commonly used in nursing practice and refers to the action of using an innovation.…”