Facilitators and barriers to clinical practice guideline use among nurses.
BACKGROUND
Clinical practice guidelines, which are designed to encourage consistent, efficient applications of scientific evidence in the daily practice of clinicians, are often underutilized. The majority of research concerning their implementation and use has focused on the work of physicians; more research concerning their use by nurses is needed.


OBJECTIVE
We sought to learn more about nurses' perceptions of facilitators and barriers to the use of clinical practice guidelines.


METHODS
This study examined free-text responses to two open-ended survey questions provided by 575 RNs working at 134 Veterans Affairs medical centers nationwide. We performed conventional content analysis on these data, which allowed thematic categories and subcategories of responses to emerge.


RESULTS
A majority of identified facilitators and barriers to nurses' use of clinical practice guidelines were external (outside the individual nurse's control). The most frequently mentioned facilitators and barriers were in the categories of communication, education/orientation/training, and time/staffing/workload.


CONCLUSIONS
Social and organizational factors appear to play critical roles in nurses' adoption and use of guidelines. Health care leaders seeking to improve clinical practice guideline use among nurses should ensure that facilitators and barriers-particularly those that are social and organizational-are considered and addressed.
Department of Public Health, Western Kentucky University, Bowling Green, KY, USA. kathleen.abrahamson@wku.edu
Kathleen A
KA
Abrahamson
Rebekah L
RL
Fox
Bradley N
BN
Doebbeling
D019983:Guideline Adherence; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D017410:Practice Guidelines as Topic; D057184:Practice Patterns, Nurses'; D014481:United States; D014493:United States Department of Veterans Affairs