title: Evaluation of the dissemination and implementation of a nutritional guideline for pressure ulcer care.
abstract: OBJECTIVE
  In 2004 the European Pressure Ulcer Advisory Panel nutritional working group developed a nutritional guideline for pressure ulcer prevention and treatment. This study investigated the degree to which the guideline was disseminated and implemented in clinical practice.
  
  
  METHODS
  A cross-sectional study was undertaken in health-care organisations in The Netherlands, Germany and the UK. A printed, standardised questionnaire which followed Rogers' model of the innovation-decision process was developed, translated and distributed to 1087 health-care organisations.
  
  
  RESULTS
  The response rate was 33% (n = 363). Sixty-one per cent of respondents knew of the guideline. Twenty-five per cent had applied it to their clinical practice and used it for nutritional screening. The main barrier to the provision of nutritional support appeared to be lack of knowledge and skills.
  
  
  CONCLUSIONS
  One year after its dissemination, more than half of respondents knew of the guideline, with one in four applying it to their practice. The guideline was better disseminated and implemented in The Netherlands and UK than in Germany, where only 4% of participants had used it.
authors.affiliation: Department of General Practice, Maastricht University, The Netherlands. j.meijers@zw.unimaas.nl
authors.forename: J M M
authors.initials: JM
authors.lastname: Meijers
authors.forename: J M G A
authors.initials: JM
authors.lastname: Schols
authors.forename: P A
authors.initials: PA
authors.lastname: Jackson
authors.forename: G
authors.initials: G
authors.lastname: Langer
authors.forename: M
authors.initials: M
authors.lastname: Clark
authors.forename: R J G
authors.initials: RJ
authors.lastname: Halfens
mesh_terms: D003430:Cross-Sectional Studies; D019587:Dietary Supplements; D004750:Enteral Nutrition; D005858:Germany; D019983:Guideline Adherence; D019538:Health Care Surveys; D006801:Humans; D033181:Information Dissemination; D044342:Malnutrition / Q000517:prevention & control*; D009426:Netherlands; D015596:Nutrition Assessment; D003668:Pressure Ulcer / Q000628:therapy*; D006113:United Kingdom