Successes and Failures in the Implementation of Evidence-Based Guidelines for Clinical Practice

Grol, Richard

doi:10.1097/00005650-200108002-00003

Cited by 947 publications

(888 citation statements)

References 19 publications

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“…However, failure to implement published clinical guidelines in clinical practice is not an issue that is specific to psychiatry. Grol (28) analysed data from a database of 7000 physicians, studying the implementation of 70 guidelines, with large variation in practice between different physicians and medical conditions. He found barriers to following guidelines included doubts about the value and scientific grounds of the guidelines, resistance to efforts to motivate patients, clinicians' belief that they created extra workload, desire to follow their own fixed routes, belief that guidelines were too complex or too difficult, and a tendency to give in to inappropriate patient preference to avoid conflict.…”

Section: Viii) Poorly Defined Treatment Targets and Inconsistent Monimentioning

confidence: 99%

The decisions regarding ADHD management (DRAMa) study: uncertainties and complexities in assessment, diagnosis and treatment, from the clinician’s point of view

Kovshoff

Williams

Vrijens

et al. 2011

Eur Child Adolesc Psychiatry

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Section: Viii) Poorly Defined Treatment Targets and Inconsistent Monimentioning

confidence: 99%

The decisions regarding ADHD management (DRAMa) study: uncertainties and complexities in assessment, diagnosis and treatment, from the clinician’s point of view

Kovshoff

Williams

Vrijens

et al. 2011

Eur Child Adolesc Psychiatry

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“…Although many guidelines are available, compliance with these guidelines appears to be lacking (Grol, 2001;Schuster et al, 1998;Halfens and Eggink, 1995). As a result, many patients receive inappropriate care (Grol and Grimshaw, 2003).…”

Section: Introductionmentioning

confidence: 99%

The effect of the SAFE or SORRY? programme on patient safety knowledge of nurses in hospitals and nursing homes: A cluster randomised trial

Gaal

Schoonhoven

Vloet

et al. 2010

International Journal of Nursing Studies

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A B S T R A C TBackground: Patients in hospitals and nursing homes are at risk for the development of often preventable adverse events. Guidelines for the prevention of many types of adverse events are available, however compliance with these guidelines appears to be lacking. As a result many patients do not receive appropriate care. We developed a patient safety program that allows organisations to implement multiple guidelines simultaneously and therefore facilitates guideline use to improve patient safety. This program was developed for three frequently occurring nursing care related adverse events: pressure ulcers, urinary tract infections and falls. For the implementation of this program we developed educational activities for nurses as a main implementation strategy. Objectives: The aim of this study is to describe the effect of interactive and tailored education on the knowledge levels of nurses. Design: A cluster randomised trial was conducted between September 2006 and July 2008. Settings: Ten hospital wards and ten nursing home wards participated in this study. Prior to baseline, randomisation of the wards to an intervention or control group was stratified for centre and type of ward. Participants: All nurses from participating wards. Methods: A knowledge test measured nurses' knowledge on the prevention of pressure ulcers, urinary tract infections and falls, during baseline en follow-up. The results were analysed for hospitals and nursing homes separately. Results: After correction for baseline, the mean difference between the intervention and the control group on hospital nurses' knowledge on the prevention of the three adverse events was 0.19 points on a zero to ten scale (95% CI: À0.03 to 0.42), in favour of the intervention group. There was a statistically significant effect on knowledge of pressure ulcers, with an improved mean mark of 0.45 points (95% CI: 0.10-0.81). For the other two topics there was no statistically significant effect. Nursing home nurses' knowledge did neither improve (0 points, CI: À0.35 to 0.35) overall, nor for the separate subjects.

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“…Sin embargo, no basta con disponer de GPC de alta calidad metodológica (o "más confiables"), sino que ellas debieran ser implementadas a través de estrategias efectivas para obtener cambios en la práctica clínica y mejoramiento en los resultados de salud de los pacientes 29,30 . La evidencia respecto a los efectos de las diferentes estrategias de implementación muestra resultados modestos y altamente variables 31,32 .…”

Section: Difusión Diseminación E Implementación De Gpcunclassified

Guías de práctica clínica: una introducción a su elaboración e implementación

Pantoja

Soto

2014

Rev. méd. Chile

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Successes and Failures in the Implementation of Evidence-Based Guidelines for Clinical Practice

Cited by 947 publications

References 19 publications

The decisions regarding ADHD management (DRAMa) study: uncertainties and complexities in assessment, diagnosis and treatment, from the clinician’s point of view

The decisions regarding ADHD management (DRAMa) study: uncertainties and complexities in assessment, diagnosis and treatment, from the clinician’s point of view

The effect of the SAFE or SORRY? programme on patient safety knowledge of nurses in hospitals and nursing homes: A cluster randomised trial

Guías de práctica clínica: una introducción a su elaboración e implementación

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