Preconditions for successful guideline implementation: perceptions of oncology nurses

Abstract

BackgroundAlthough evidence-based guidelines are important for improving the quality of patient care, implementation in practice is below expectations. With the recent focus on team care, guidelines are intended to promote the integration of care across multiple disciplines. We conducted an exploratory study to understand oncology nurses' perceptions of guideline implementation and to learn their views on how their experiences affected the implementation.MethodsA qualitative study was used with focus group interviews. We collected data from 11 nurses with more than 5 years of oncology nursing experience in Japan. The data were analyzed using grounded theory.ResultsResults of the analysis identified "preconditions for successful guideline implementation" as a core category. There were 4 categories (goal congruence, equal partnership, professional self-development and user-friendliness) and 11 subcategories related to organizational, multidisciplinary, individual, and guideline levels.ConclusionsAlthough the guidelines were viewed as important, they were not fully implemented in practice. There are preconditions at the organizational, multidisciplinary, individual, and guideline levels that must be met if an organization is to successfully implement the guideline in clinical settings. Prioritizing strategies by focusing on these preconditions will help to facilitate successful guideline implementation.

Factors influencing the implementation of evidence in Chinese nursing practice

“…Meanwhile, constructivist grounded theory also emphasising on revealing patterns and connections rather than to linear reasoning and emphasises understanding rather than explanation (Charmaz, ). In this study, we found the factors ranging from the evidence level, nurses level, patient level, system level and outside system level, which were generally consistent with the literature from other countries (Ploeg, Davies, Edwards, Gifford, & Miller, ; Solomons & Spross, ; Yagasaki & Komatsu, ), as well as the previous published Chinese surveys (Chien et al., ; Wang et al., ; Zhou et al., ). However, this study also extended the results of previous studies by further exploring the blurred boundaries between facilitators and barriers, influences from Chinese cultural impact and project leaders' roles, as well as an emphasis on the importance of point of care in evidence‐based nursing.…”

Towards a general theory of implementation

“…It must be emphasized that this is a worked example of a theory in practice, not a formal data analysis or review, but it does draw on information from seven studies [81-87] that have met the quality criteria for inclusion in a systematic review of qualitative studies of nursing guideline implementation informed by Normalization Process Theory.…”

Program evaluation of neuroscience competency programs to implement evidence‐based practices

“…Use of immediate feedback techniques has been observed to be more effective than traditional tactics, such as didactic education or passive dissemination of information . Likewise, facilitating nurses' understanding of the rationale, or the “why,” behind such guideline recommendations can help nurses align their practice with evidence‐based guidelines …”