title: Factors influencing critical care nurses' adoption of the AACN practice alert on verification of feeding tube placement.
abstract: BACKGROUND
  Clinical practice guidelines are intended to bridge the research-practice gap, yet little is known about how critical care nurses adopt guidelines. Feeding tube verification practices remain variable and have led to patient harm and death.
  
  
  OBJECTIVE
  To examine factors influencing critical care nurses' adoption of the American Association of Critical-Care Nurses (AACN) practice alert on verification of feeding tube placement and its 4 recommended clinical practices.
  
  
  METHODS
  Critical care nurses were invited to participate in a national, online questionnaire, guided by Rogers' diffusion of innovation framework. Descriptive statistics and logistic regression were used for data analysis. Alpha level was set at 0.05.
  
  
  RESULTS
  Fifty-five percent of the 370 participating nurses were aware of the practice alert, and 45% had adopted it in practice. Only 29% of the adopters had also implemented all 4 clinical practices. Significant predictors of adoption included BSN or higher nursing education and guideline characteristics of observability and trialability. Predictors of implementation of the clinical practices included staff nurse/charge nurse role, academic medical center, research/web-based information sources, and perception of a policy. Policy was the only significant predictor of implementation of all 4 practices. Adoption of the practice alert was also a predictor for 2 of 4 clinical practices.
  
  
  CONCLUSIONS
  Personal and organizational factors influenced implementation of practices associated with an AACN practice alert. Although a research-practice gap exists, the practice alert was a significant source of information for 2 of the clinical practices.
authors.affiliation: Annette M. Bourgault is an assistant professor at Georgia Regents University, College of Nursing in Augusta, Georgia. Janie Heath is associate dean for academic programs and Thomas A. Saunders III Endowed Professor of Nursing at University of Virginia, School of Nursing in Charlottesville. Vallire Hooper is manager of nursing research at Mission Hospital Health System in Asheville, North Carolina. Mary Lou Sole is the Orlando Health Distinguished Professor at the University of Central Florida, College of Nursing, Orlando. Jennifer L. Waller is an associate professor in the Department of Biostatistics and Epidemiology and Elizabeth G. NeSmith is an associate professor in the College of Nursing at Georgia Regents University.
authors.forename: Annette M
authors.initials: AM
authors.lastname: Bourgault
authors.forename: Janie
authors.initials: J
authors.lastname: Heath
authors.forename: Vallire
authors.initials: V
authors.lastname: Hooper
authors.forename: Mary Lou
authors.initials: ML
authors.lastname: Sole
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Waller
authors.forename: Elizabeth G
authors.initials: EG
authors.lastname: Nesmith
mesh_terms: D000328:Adult; D000368:Aged; D064648:Critical Care Nursing / Q000379:methods / Q000592:standards* / Q000706:statistics & numerical data; D004750:Enteral Nutrition / Q000379:methods / Q000592:standards* / Q000706:statistics & numerical data; D055318:Evidence-Based Nursing / Q000592:standards*; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D012956:Societies, Nursing; D014481:United States; D055815:Young Adult