Implementing nursing practice guidelines: a complex undertaking.
Clinical practice guidelines have been proposed to significantly reduce the gap between available scientific evidence and clinical practice. Evidence-based guidelines are also being produced at an ever-increasing pace. However, guidelines do not implement themselves, and the research to support implementation does not provide straightforward answers. What works in one setting does not necessarily work in another. In short, guideline implementation and change of practice is complex and messy. The purpose of this article is to discuss the implementation of clinical practice guidelines using the Promoting Action on Research Implementation in Health Services framework. More specifically, 3 key components are highlighted: (1) the evidence base for guideline recommendations, (2) the clinical context where guidelines are to be implemented, and (3) the nature of facilitation needed to ensure a successful change process. An overview of the literature in the field is provided, and the authors' experiences are shared, and a few recommendations are tentatively provided.
Wallin
Lars
L
Faculty of Nursing, University of Alberta, Edmonton, Canada. lars.wallin@ualberta.ca
Profetto-McGrath
Joanne
J
Levers
Merry Jo
MJ
D002170:Canada; D019317:Evidence-Based Medicine; D006284:Health Plan Implementation; D006801:Humans; D007857:Leadership; D009729:Nursing; D015279:Organizational Culture; D009936:Organizational Innovation; D017410:Practice Guidelines as Topic