Implementing clinical guidelines in stroke: A qualitative study of perceived facilitators and barriers
Implementing clinical guidelines in stroke: A qualitative study of perceived facilitators and barriers
复制标题
DOI：
10.1016/j.healthpol.2013.04.002
复制
发表时间：
2013-08-01
期刊：
影响因子：
3.3
通讯作者：
Shelley, Emer
中科院分区：
文献类型：
--
作者：
Donnellan, Claire;Sweetman, Susannah;Shelley, Emer
背景：临床指南经常被用作实施循证实践的机制。然而，研究表明，卫生专业人员在遵守这些准则的程度上各不相同。本研究的目的是研究利益相关者和卫生专业人员的看法的促进者和障碍，实施国家中风guidelines in爱尔兰.Methods：定性访谈使用焦点小组进行了利益相关者（n = 3）和多学科团队成员参与中风护理（n = 7）的医院。所有焦点小组访谈都是半结构化的，使用开放式问题。使用NVivo 9软件进行数据管理和分析。结果：从利益相关者和医院多学科团队的焦点小组中出现的主题在讨论的主题方面非常相似。这些是资源，国家卒中指南作为改变的工具，国家卒中指南的特点，地方层面的宣传和社区卒中护理挑战。利益攸关方和保健专业人员认为，促进者包括拥有专用资源、与地方一级相关的方便用户的准则以及在当地拥有支持性倡导者。障碍是资源不足，指导方针的特点和不足的培训和education.Conclusions：这项研究突出了卫生专业人员的观点，许多关键的概念，可能会影响实施中风护理指南。在国家一级引入中风临床指南不足以提高医疗保健质量，因为它们应与教育计划和临床实践调查反馈一起纳入质量保证周期。(C)2013爱思唯尔爱尔兰有限公司版权所有。
Background: Clinical guidelines are frequently used as a mechanism for implementing evidence-based practice. However research indicates that health professionals vary in the extent to which they adhere to these guidelines. This study aimed to study the perceptions of stakeholders and health professionals on the facilitators and barriers to implementing national stroke guidelines in Ireland.Methods: Qualitative interviews using focus groups were conducted with stakeholders (n = 3) and multidisciplinary team members from hospitals involved in stroke care (n = 7). All focus group interviews were semi-structured, using open-ended questions. Data was managed and analysed using NVivo 9 software.Results: The main themes to emerge from the focus groups with stakeholders and hospital multidisciplinary teams were very similar in terms of topics discussed. These were resources, national stroke guidelines as a tool for change, characteristics of national stroke guidelines, advocacy at local level and community stroke care challenges. Facilitators perceived by stakeholders and health professionals included having dedicated resources, user-friendly guidelines relevant at local level and having supportive advocates on the ground. Barriers were inadequate resources, poor guideline characteristics and insufficient training and education.Conclusions: This study highlights health professionals' perspectives regarding many key concepts which may affect the implementation of stroke care guidelines. The introduction of stroke clinical guidelines at a national level is not sufficient to improve health care quality as they should be incorporated in a quality assurance cycle with education programmes and feedback from surveys of clinical practice. (C) 2013 Elsevier Ireland Ltd. All rights reserved.