title: Policies and procedures: a tool to support the implementation of clinical guidelines?
abstract: OBJECTIVE
  To explore the use of policies and procedures as a tool to support the implementation of clinical guidelines and to determine the relationship between organizational support and stability with nurses' perception of policy change.
  
  
  METHODS
  Secondary analysis of qualitative and quantitative data collected in the post-intervention phase of the study entitled Evaluation of the Dissemination and Utilization of Best Practice Guidelines by Registered Nurses in Ontario.
  
  
  METHODS
  Eleven agencies across Ontario, Canada.
  
  
  METHODS
  Fifty nursing staff, 32 nurse administrators and 22 clinical resource nurses (90% response) participated in semi-structured interviews. A total of 316 randomly selected nursing staff from 23 participating units in 11 agencies completed questionnaires (65% response).
  
  
  METHODS
  Qualitative data from semi-structured interviews were examined to determine whether participants had modified their policies and procedures as part of the implementation of clinical guidelines. Using SPSS 11.0 for Windows, the authors assessed, using independent t-tests, the relationship between the perception of modification of policies and procedures and the perceptions of organizational support an organisational stability.
  
  
  RESULTS
  While modifications to policies and procedures were made at each agency as part of the implementation of clinical guidelines, 27% of staff disagreed that modifications had been made. Nursing staff who agreed that changes had been made to policies and procedures were significantly more likely to report positive organizational support for clinical guideline implementation.
  
  
  CONCLUSIONS
  Findings suggest the need to increase nursing staffs' awareness of changes to policies and procedures during clinical guideline implementation. Furthermore, results indicate that organizational support may have a positive influence on modifications to policies and procedures that are guided by research-based clinical guideline recommendations.
authors.affiliation: School of Nursing, McGill University, Montreal, QC. i.stpierre@sympatico.ca
authors.forename: Isabelle
authors.initials: I
authors.lastname: St-Pierre
authors.forename: Barbara
authors.initials: B
authors.lastname: Davies
authors.forename: Nancy
authors.initials: N
authors.lastname: Edwards
authors.forename: Patricia
authors.initials: P
authors.lastname: Griffin
mesh_terms: D001291:Attitude of Health Personnel; D002170:Canada; D003430:Cross-Sectional Studies; D004059:Diffusion of Innovation; D006284:Health Plan Implementation; D006801:Humans; D009729:Nursing; D009740:Nursing Staff / Q000458:organization & administration; D009936:Organizational Innovation; D016134:Organizational Policy; D017410:Practice Guidelines as Topic