title: Guidelines on anaemia: effect on primary-care midwives in The Netherlands.
abstract: OBJECTIVE
  To assess the adherence and perceived barriers for implementation of a clinical-practice guideline on anaemia, which was the first national guideline for primary-care midwifery in The Netherlands.
  
  
  METHODS
  Cross-sectional survey study.
  
  
  METHODS
  Primary-care midwifery in The Netherlands.
  
  
  METHODS
  160 midwives (60% response rate).
  
  
  METHODS
  Questionnaire on the knowledge of, and attitudes and self-reported adherence to, 14 key recommendations in the guideline; attitudes to guidelines in general; and perceived barriers to implementation.
  
  
  RESULTS
  The number of midwives agreeing with and adhering to specific recommendations varied between 29 and 90%. Most midwives had a positive attitude to the guidelines. The most relevant general barriers were related to the behaviour of general practitioners and obstetricians (32% of the midwives reported this). Larger numbers of midwives mentioned barriers to specific aspects of the guideline, particularly alternative iron supplementation or dietary supplements (59%), and not prescribing iron supplementation if haemoglobin was low but mean corpuscular volume was normal (49%).
  
  
  CONCLUSIONS
  The guideline on anaemia was well received by primary-care midwives in The Netherlands, but implementation of specific recommendations needs further attention.
  
  
  CONCLUSIONS
  The study provides evidence for the national organisation of midwives to continue with the development and implementation of clinical guidelines.
authors.affiliation: Centre for Quality of Care Research (WOK), University Medical Centre, St Radboud Nijmegen, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
authors.forename: Pien
authors.initials: P
authors.lastname: Offerhaus
authors.forename: Margot
authors.initials: M
authors.lastname: Fleuren
authors.forename: Michel
authors.initials: M
authors.lastname: Wensing
mesh_terms: D000328:Adult; D018798:Anemia, Iron-Deficiency / Q000175:diagnosis / Q000451:nursing*; D003430:Cross-Sectional Studies; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008880:Midwifery / Q000592:standards*; D009426:Netherlands; D024802:Nurse's Role; D009723:Nurse-Patient Relations; D009730:Nursing Assessment / Q000592:standards*; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000175:diagnosis / Q000451:nursing*; D011295:Prenatal Care / Q000592:standards*; D011795:Surveys and Questionnaires