Nurses' experiences of guideline implementation: a focus group study
Nurses' experiences of guideline implementation: a focus group study
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DOI：
10.1111/j.1365-2702.2008.02754.x
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发表时间：
2009-09-01
影响因子：
4.2
通讯作者：
Kaila, Minna
中科院分区：
文献类型：
--
作者：
Alanen, Seija;Valimaki, Maritta;Kaila, Minna
目的：本研究的目的是解决以下问题：什么样的经验，初级保健护士有指导方针的实施？护士认为影响指南采用的最重要因素是什么？背景：临床指南的实施似乎依赖于多种特定的环境因素。本研究旨在探讨经验的初级保健护士有关准则的实施。设计。定性访谈。方法。数据产生的四个焦点小组访谈涉及护士在芬兰的初级卫生中心的门诊服务。采用有目的抽样方法选择保健中心。归纳内容分析被用来确定新兴的主题从data.Results.Four主要组的因素被确定从数据分析：（一）相关的组织因素，（二）相关的因素，护士，（三）相关的预期后果的因素和（四）相关的因素，病人组。护理人员对指引的认知、接受程度及预期的正面效果有助于指引的执行。组织的支持，特别是适应当地情况的指南，似乎是至关重要的成功implementation.Conclusions。临床指南可以在加强循证护理实践的有前途的工具，因为护士认为他们在病人护理的实际工作工具，所以愿意采用它们。然而，需要管理层和医生的支持，以确保成功实施的指导方针到护理practice.Relevance临床practice.Based上，这项研究的结果和以前的知识的指导方针的实施提出了一些切实可行的建议。选择与临床实践最相关的指南，组织指南适应当地情况，通知所有参与治疗的从业人员，并为采用指南提供明确的指示。
Aims.The aim of the study was to address the following questions: What kind of experiences do primary care nurses have of guideline implementation? What do nurses think are the most important factors affecting the adoption of guidelines?Background.The implementation of clinical guidelines seems to be dependent on multiple context-specific factors. This study sets out to explore the experiences of primary care nurses concerning guideline implementation.Design.Qualitative interview.Methods.Data were generated by four focus group interviews involving nurses working in out-patient services in primary health centres in Finland. Purposive sampling was used to select health centres. Inductive content analysis was used to identify themes emerging from the data.Results.Four main groups of factors were identified from the analysis of data: (i) factors related to the organisation, (ii) factors related to nurses, (iii) factors related to the anticipated consequences and (iv) factors related to the patient group. Nurses' awareness and acceptance of guidelines and the anticipated positive consequences facilitate the implementation of guidelines. Organisational support, especially the adapting of guidelines to local circumstances, seems to be crucial for successful implementation.Conclusions.Clinical guidelines can be promising tools in enhancing evidence-based nursing practice, as nurses see them as practical work tools in patient care and so are willing to adopt them. However, support from management and physicians is needed to ensure the successful implementation of guidelines into nursing practices.Relevance to clinical practice.Based on the findings of this study and previous knowledge of guideline implementation some practical recommendations are suggested. Select the most relevant guidelines to clinical practice, organise the adaptation of guidelines to local circumstances, inform all practitioners involved in treatment and give clear instructions for the adoption of the guidelines.