The resistance to changing guidelines – what are the challenges and how to meet them

Bosse, G.; Breuer, J; Spies, Claudia

doi:10.1016/j.bpa.2006.02.005

Cited by 72 publications

(57 citation statements)

References 44 publications

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“…To improve sustainably the level of performance quality, it is well known that a combination of methods in continuous team training -comprising clinical, management and organizational skills as well as communication, decision-making and leadership skills -is necessary. 4,6,7 Nevertheless, it is too costly to train an entire team non-specifically, without knowing precisely what areas and levels of educational training are required. The joint commission for DIN ISO certification (DIN, Deutsches Institut für Normierung; available at: http://www.din.de/cmd?level=tpl-home& contextid=din) DIN ISO 9000 2000 criteria, upon which the SOP used in this study was based, requires that the educational efforts needed for the implementation of an SOP should be assessed.…”

Section: G Bosse W Schmidbauer CD Spies Et Al Sop Adherence In Copmentioning

confidence: 99%

“…13 Barriers that hinder the implementation of guidelines are complex and multifactorial including: structural barriers (poor access to guidelines); personal barriers (psychological perception that the guidelines will not improve outcomes); and environmental/ social barriers (resistance to peer pressure to adhere to the guidelines). 6 Lohr et al 14 described the fear, on the part of clinicians, that guidelines rebut clinical intuition and pathophysiological rationale; Pollock et al 15 have attributed a causal connection to a lack of time for physicians to be able to read the latest research results. Forsetlund and Bjørndal 16 described the fact that physicians often attach more importance to clinical experience than to scientific evidence.…”

Section: G Bosse W Schmidbauer CD Spies Et Al Sop Adherence In Copmentioning

confidence: 99%

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Adherence to Guideline-Based Standard Operating Procedures in Pre-Hospital Emergency Patients with Chronic Obstructive Pulmonary Disease

et al. 2011

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This study investigated improvements in pre-hospital care for patients with acute exacerbated chronic obstructive pulmonary disease (aeCOPD) achieved by using a standard operating procedure (SOP). An SOP for pre-hospital treatment of patients with aeCOPD was designed based on valid national guidelines. A total of 1000 Emergency Medical Service patient care reports were analysed prospectively: 500 before and 500 after introduction of the SOP. Overall guideline adherence was 34.6% before and 53.8% after introduction of the SOP; this increase was not statistically significant. After SOP introduction, the administration of β2-mimetics by inhalative, intravenous and subcutaneous routes increased significantly. The level of knowledge of the national guidelines was rated at 67% by emergency physicians during self-assessment, but was only 33% when physicians were asked specific questions during interview. Introducing the SOP for patients with aeCOPD did not significantly improve adherence to valid national guidelines, but did help to improve specific elements of therapy.

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Section: G Bosse W Schmidbauer CD Spies Et Al Sop Adherence In Copmentioning

confidence: 99%

Section: G Bosse W Schmidbauer CD Spies Et Al Sop Adherence In Copmentioning

confidence: 99%

Adherence to Guideline-Based Standard Operating Procedures in Pre-Hospital Emergency Patients with Chronic Obstructive Pulmonary Disease

et al. 2011

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“…[1] This short review addresses the issues of permitting preoperative free fluids in view of lack of associated risk, and actively encouraging preoperative consumption of carbohy dratecontaining free fluids due to the associated clinical benefits.…”

mentioning

confidence: 99%

Carbohydrate loading in the preoperative setting

Hill

Miller

2015

S Afr Med J

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“…The implementation of guidelines is delayed and incomplete [15], and the resistance to change daily practice should not be underestimated. Moreover, such an implementation is influenced by various interests at many different levels [16]. However, the knowledge of the frequency and variety of errors might contribute to overcome current implementation barriers.…”

Section: Discussionmentioning

confidence: 99%

Administration Safety of Blood Products - Lessons Learned from a National Registry for Transfusion and Hemotherapy Practice

Frietsch

Thomas

Schöler

et al. 2017

Transfus Med Hemother

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Background: Compared to blood component safety, the administration of blood may not be as safe as intended. The German Interdisciplinary Task Force for Clinical Hemotherapy (IAKH) specialized registry for administration errors of blood products was chosen for a detailed analysis of reports. Methods: Voluntarily submitted critical incident reports (n = 138) from 2009 to 2013 were analyzed. Results: Incidents occurred in the operation room (34.1%), in the ICU (25.2%), and in the peripheral ward (18.5%). Procedural steps with errors were administration to the patient (27.2%), indication and blood order (17.1%), patient identification (17.1%), and blood sample withdrawal and tube labeling (18.0%). Bedside testing (BST) of blood groups avoided errors in only 2.6%. Associated factors were routine work conditions (66%), communication error (36%), emergency case (26%), night or weekend team (39%), untrained personnel (19%). Recommendations addressed process and quality (n = 479) as well as structure quality (n = 314). In 189 instances, an IT solution would have helped to avoid the error. Conclusions: The administration process is prone to errors at the patient assessment for the need to transfuse and the application of blood products to patients. BST is only detecting a minority of handling errors. According to the expert recommendations for practice improvement, the potential to improve transfusion safety by a technical solution is considerable.

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The resistance to changing guidelines – what are the challenges and how to meet them

Cited by 72 publications

References 44 publications

Adherence to Guideline-Based Standard Operating Procedures in Pre-Hospital Emergency Patients with Chronic Obstructive Pulmonary Disease

Adherence to Guideline-Based Standard Operating Procedures in Pre-Hospital Emergency Patients with Chronic Obstructive Pulmonary Disease

Carbohydrate loading in the preoperative setting

Administration Safety of Blood Products - Lessons Learned from a National Registry for Transfusion and Hemotherapy Practice

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