Why we do what we do: implementation of practice guidelines by family nurse practitioner students.
OBJECTIVE
To examine who or what influenced family nurse practitioner (FNP) students' implementation of Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of Blood Pressure (JNC-7) guidelines for hypertension management.


METHODS
Eleven FNP students in their final semester completed a clinical course assignment in which they each provided care to five patients with hypertension (N = 55). Written responses to a 10-item tool eliciting patient management data as well as perceived barriers or facilitators to using JNC-7 clinical guidelines in precepted clinical settings were analyzed.


CONCLUSIONS
The extent to which JNC-7 guidelines predicted clinical management of hypertension by student FNPs in primary care settings was congruent with the literature findings, reflecting a wide variation in implementation of guidelines from evidence-based practice (EBP) data. The literature supports utilization of clinical guidelines in patient care. Yet, implementation of guidelines in clinical practice is a complex phenomenon.


CONCLUSIONS
Practitioners are looking for reliable evidence on which to base decision making. In the long term, EBP addresses some of the complexities of effective care delivery. The current trend is toward increasing utilization of evidence in caring for our patients. Implementation of EBP guidelines by preceptors in the workplace should increase as NP preceptors serve as role models of EBP implementation. Rewards may be important factors in implementation.
Martin
Frances
F
School of Nursing at Athens, Medical College of Georgia, Athens, Georgia 30605, USA. mcgfran@yahoo.com
D000328:Adult; D001291:Attitude of Health Personnel; D003657:Decision Making; D004511:Education, Nursing, Graduate; D055318:Evidence-Based Nursing / Q000193:education / Q000458:organization & administration; D022143:Family Nursing / Q000458:organization & administration / Q000523:psychology*; D005260:Female; D019983:Guideline Adherence; D007722:Health Knowledge, Attitudes, Practice; D006301:Health Services Needs and Demand; D006801:Humans; D006973:Hypertension / Q000209:etiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009722:Nurse Practitioners / Q000193:education / Q000458:organization & administration / Q000523:psychology*; D024802:Nurse's Role / Q000523:psychology; D015404:Nursing Methodology Research; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D011231:Preceptorship; D011320:Primary Health Care; D013338:Students, Nursing / Q000523:psychology*; D011795:Surveys and Questionnaires