title: Factors influencing adherence to an emergency department national protocol.
abstract: The objective of this study was to identify factors that influence emergency nurses' adherence to an emergency department national protocol (EDNP). A survey of emergency nurses (n=200) and physicians with medical end responsibility on an emergency department (n=103) was carried out. Emergency nurses' self-reported adherence to the EDNP was 38%, 55% of the nurses and 44% of the physicians were aware of the protocol. Interference with professional autonomy, insufficient organizational support and the EDNP's applicability were indicated as barriers for adherence. The main influencing factor seems awareness. Other factors related to the individual, the organization and to protocol characteristics. Solely disseminating the EDNP is not enough to get the protocol used in clinical practice.
authors.affiliation: Department of Critical Care, Faculty of Health and Social Studies, HAN University of Applied Sciences, Nijmegen, The Netherlands. Remco.Ebben@han.nl
authors.forename: Remco H A
authors.initials: RH
authors.lastname: Ebben
authors.forename: Lilian C M
authors.initials: LC
authors.lastname: Vloet
authors.forename: Joke Mintjes
authors.initials: JM
authors.lastname: de Groot
authors.forename: Theo
authors.initials: T
authors.lastname: van Achterberg
mesh_terms: D000328:Adult; D000465:Algorithms; D001364:Awareness; D002985:Clinical Protocols; D016529:Emergency Nursing / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D009741:Nursing Staff, Hospital / Q000706:statistics & numerical data*; D015279:Organizational Culture; D026684:Personal Autonomy; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012307:Risk Factors; D057566:Self Report; D012944:Social Support; D011795:Surveys and Questionnaires; D055815:Young Adult