Nurses' perceived barriers to the implementation of a Fall Prevention Clinical Practice Guideline in Singapore hospitals

Koh, Serena Siew Lin; Manias, Elizabeth; Hutchinson, Alison M.; Donath, Susan; Johnston, Linda

doi:10.1186/1472-6963-8-105

Cited by 79 publications

(104 citation statements)

References 54 publications

(46 reference statements)

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“…Staff commonly directs patients as to how much assistance they require, however intrinsic patient factors such as cognitive impairment, inability to follow directions, confusion, and poor judgment may impede patient compliance with hospital staff recommendations. These factors have consistently been identified as significant risk factors for in patient falls [21][22][23][24][25][26]. However, various hospital fall prevention programs have been implemented in the last decades in hospitals which require predetermined awareness, education and training for all nurses working in direct contact with patients.…”

Section: Discussionmentioning

confidence: 99%

Knowledge and performance among nurses before and after a training programme on patient falls

Enein¹,

Ghany²,

Zaghloul³

2012

OJN

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Section: Discussionmentioning

confidence: 99%

Knowledge and performance among nurses before and after a training programme on patient falls

Enein¹,

Ghany²,

Zaghloul³

2012

OJN

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“…Thus, the perceptions of the users of the guidelines must be fully examined and incorporated into the strategy used to implement the guidelines. agreement with the content of the guidelines, 9 motivation, 40 education and training, 16,40,41 patientassociated reasons, 9,40 access, 40 and lack of time and resources. 9,16,41 We were able to recognize that attitudes are a critical determinant of how guidelines are used by nurses.…”

Section: Discussionmentioning

confidence: 99%

“…Limited studies have been done on facilitators of or barriers to nurses' use of guidelines. Some factors associated with adherence to guidelines are knowledge, 40 awareness and familiarity with the content of the guidelines, nurses read the guidelines for specific information and, consequently, read only relevant sections. The finding that positive attitudes are prevalent regardless of a full reading of the guidelines may indicate that attitudes are largely influenced by messages that nurses receive through education and practices rather than through institution-specific guidelines.…”

Section: Discussionmentioning

confidence: 99%

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Adherence to Institution-Specific Ventilator-Associated Pneumonia Prevention Guidelines

Kiyoshi‐Teo¹,

Cabana²,

Froelicher³

et al. 2014

American Journal of Critical Care

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A closed-book, multiple-choice examination following this article tests your under standing of the following objectives:1. Describe the relationship between the increased availability of guidelines for prevention of ventilator-associated pneumonia (VAP) and current adherence to those recommendations. 2. Identify potential barriers to and facilitators of adherence to guidelines for prevention of VAP. 3. Discuss ideas for incorporating study results into strategies for implementation of guidelines for prevention of VAP. Background Various institution-specific guidelines have been developed to prevent ventilator-associated pneumonia. However, the availability of guidelines does not ensure adherence to recommended strategies. Objective To identify factors that influence adherence to guidelines for prevention of ventilator-associated pneumonia, with a focus on oral hygiene, head-of-bed elevation, and spontaneous breathing trials. Methods A cross-sectional descriptive study of critical care nurses at 8 hospitals in Northern California was conducted. A survey was created to gather information on possible facilitators of and barriers to adherence to institution-specific guidelines for preventing ventilator-associated pneumonia. User factors, guideline qualities, and contextual factors were explored and tested for possible relationships. Results A total of 576 critical care nurses participated in the survey. Each hospital had unique guidelines for preventing ventilator-associated pneumonia. In general, nurses had positive attitudes and reported adhering to the guidelines always or most of the time. Factors associated with adherence differed according to the intervention implemented. The score on the user attitude scale was the strongest and most consistent predictor of adherence across interventions (odds ratio, 3.49-4.75). Time availability (odds ratio, 1.54) and the level of prioritization (odds ratio, 1.86) were also significant predictors. ConclusionThe most consistent facilitator of adherence to guidelines for prevention of ventilator-associated pneumonia was nurses' positive attitude toward the guidelines.

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“…This is partly due to the fact that while adherence to Clinical Practice Guidelines (CPGs) [4] may improve care processes and outcomes and decrease costs, [1,3,5,6] low adherence to CPGs still persists. Suboptimal adherence [2,5,[7][8][9][10] is due to several factors including clinicians disagreement with the content of the guideline, perceived lack of relevance to the patient population or their practice, and resource limitations to implement the guideline. [2,[11][12][13][14] Low adherence to the sepsis guideline is also an issue at * Correspondence: Jean-Paul Collet; Email: JCollet@cw.bc.ca; Address: Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada.…”

Section: Introductionmentioning

confidence: 99%

Barriers to the implementation of sepsis guideline in a Canadian pediatric tertiary care centre

Mosavianpour

Collet

Sarmast

et al. 2016

JNEP

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Introduction: Adherence to Clinical Practice Guidelines for sepsis can improve care processes and outcomes; however, sepsis guideline adherence is plagued by many barriers. The purpose of this article is to report the perceived barriers for implementing a sepsis guideline at British Columbia's Children Hospital. Methods: This is a mixed method study. Data were collected from clinicians using a questionnaire that covered 3 major domains and included two open-ended questions. Quantitative data analysis focused on the Mean Overall Barrier Score (MOBS) in each category using descriptive and inferential statistical techniques. Qualitative data were analyzed thematically through deductive and inductive approaches. Results: A total of 176 clinicians participated in the study. Nurses and physicians were the largest groups of participants (52.7% and 41.2%, respectively). Nurses perceived more barriers (MOBS: 3.3; 95% CI: 3.1-3.4) compared to attending physicians (MOBS: 3.6; 95% CI: 3.3-3.8). The most frequent type of barriers reported was contextual, including environmental and guideline related barriers (MOBS: 3.1; 95% CI: 2.9-3.3), whereas the least barrier reported was lack of motivation (MOBS: 4.0; 95% CI: 3.9-4.2). Clinicians who were highly motivated and perceived less environmental barriers were more likely to use the guideline (Odds Ratio of 2.2 [p = .036] and 2.2 [p = .092], respectively). Conclusions: Motivation was the most important predictor of guideline use while contextual barriers hindered use. Therefore, motivating the clinicians and removing external barriers offers the best chance for successful guideline implementation. Furthermore, removing barriers for the use of sepsis guideline among nursing group needs more consideration.

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Nurses' perceived barriers to the implementation of a Fall Prevention Clinical Practice Guideline in Singapore hospitals

Cited by 79 publications

References 54 publications

Knowledge and performance among nurses before and after a training programme on patient falls

Knowledge and performance among nurses before and after a training programme on patient falls

Adherence to Institution-Specific Ventilator-Associated Pneumonia Prevention Guidelines

Barriers to the implementation of sepsis guideline in a Canadian pediatric tertiary care centre

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