title: Perceptions of practice guidelines for people with spinal cord injury.
abstract: OBJECTIVE
  The Consortium for Spinal Cord Medicine published clinical practice guidelines (CPG) related to upper limb (UL) preservation in people with spinal cord injury (SCI) in 2005. The purpose of this qualitative research was to identify stakeholder agreement with recommendations, performance gaps, and barriers and facilitators to CPG implementation.
  
  
  METHODS
  This 6-month study focused on the perspectives of healthcare providers, veterans, and key informants. The Promoting Action on Research Implementation in Health Services (PARiHS) was used to frame the interview questions, analyze data from focus groups and interviews, and develop conclusions and recommendations.
  
  
  METHODS
  SCI Centers at the Tampa, Seattle, and Hines Veterans' hospitals participated. The purposeful sample for the focus groups included 32 healthcare providers, 21 veterans with SCI, and 3 key informants. Analysis of qualitative data netted the percent of agreement with recommendations, performance gaps, and strategies for CPG implementation.
  
  
  RESULTS
  Content analysis of focus group data revealed that healthcare providers agreed or partially agreed with 20 (57%) of the 35 CSCM CPG on UL preservation of function. Agreement ranged from 100% for assessment to 28% for equipment use. Barriers for implementation related to administrative and system issues.
  
  
  CONCLUSIONS
  Consideration of gaps, barriers, and facilitators to implementation will assist clinicians to target interventions to preserve UL function.
authors.affiliation: Center of Innovation on Disability and Rehabilitation Research VISN 8, Department of Veterans Affairs (VA), Veterans Health Administration, Tampa, FL, USA.
authors.forename: Gail
authors.initials: G
authors.lastname: Powell-Cope
authors.forename: D Helen
authors.initials: DH
authors.lastname: Moore
authors.forename: Frances M
authors.initials: FM
authors.lastname: Weaver
authors.forename: Susan
authors.initials: S
authors.lastname: Thomason
mesh_terms: D001291:Attitude of Health Personnel; D002641:Chicago; D004509:Education, Nursing, Continuing; D005431:Florida; D017144:Focus Groups; D019983:Guideline Adherence; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D017410:Practice Guidelines as Topic / Q000592:standards*; D036301:Qualitative Research; D019145:Rehabilitation Nursing / Q000458:organization & administration* / Q000592:standards*; D013119:Spinal Cord Injuries / Q000451:nursing* / Q000534:rehabilitation*; D014728:Veterans; D014861:Washington
keywords: Upper limb; clinical practice guideline; spinal cord injuries