title: A study of the attitudes and perceived barriers to undertaking clinical governance activities of dietitians in a Welsh National Health Service trust.
abstract: BACKGROUND
  Previous studies of National Health Service (NHS) employees have identified barriers to undertaking clinical governance activities. Little of this research has investigated dietitians; however, where dietitians were included, generally positive attitudes towards research and evidence-based practice were reported alongside the identified barriers.
  
  
  METHODS
  A quantitative, whole population census was undertaken via a questionnaire distributed to 54 dietitians employed by Gwent Healthcare NHS Trust.
  
  
  RESULTS
  Dietitians reported positive attitudes towards clinical governance; however, barriers to undertaking clinical governance activities were identified. The main barriers included lack of time, inadequate funding, the view that direct patient care should always be prioritised over clinical governance activities and inadequate research and critical evaluation skills.
  
  
  CONCLUSIONS
  Findings were similar to those reported in previous studies of NHS staff. Where comparison was possible, all of the barriers identified were reported at lower levels than in previous studies. As the study was purely quantitative in nature, no understanding was gained regarding the nature of identified barriers or what factors influenced the dietitians' attitudes and perceptions. For further in-depth analysis of these factors, a qualitative study is recommended. As the study comprised a whole population census, the findings cannot be generalized to the dietetic profession as a whole, or to other staff groups within or outside of the study Trust.
authors.affiliation: Department of Nutrition and Dietetics, Royal Gwent Hospital, Cardiff Road, Newport, Gwent, UK. Alison.shakeshaft@gwent.wales.nhs.uk
authors.forename: A M
authors.initials: AM
authors.lastname: Shakeshaft
mesh_terms: D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D004046:Dietetics / Q000379:methods / Q000592:standards*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D005791:Patient Care / Q000592:standards*; D011361:Professional Competence; D011787:Quality of Health Care; D011795:Surveys and Questionnaires