Researchers Ask: How Do Nurses Perceive Their Use of Clinical Practice Guidelines?

By Sylvia Foley, AJN senior editor

You’ve probably heard about the “knowledge translation” gap that exists between the care that patients often receive and the evidence for best practice. Clinical practice guidelines, which can help clinicians close that gap, are often underused, and most of the existing research on guideline use has focused on physicians. Nurse researcher Kathleen A. Abrahamson and colleagues wanted to learn more about how nurses perceived their use of guidelines. Their findings are reported in this month’s original research CE, “Facilitators and Barriers to Clinical Practice Guideline Use Among Nurses.”

Abrahamson and colleagues examined free-text responses to two open-ended survey questions provided by 575 RNs at 134 Veterans Affairs medical centers: “What are the facilitators to CPG use?” and “What are the barriers to CPG use?” Conventional content analysis of the data allowed several thematic categories and subcategories of responses to emerge.

Among the findings were the following.

• A majority of both facilitators and barriers to guideline use were external (outside the nurses’ control).
• The most frequently mentioned facilitators and barriers were in the categories of communication, education/orientation/training, and time/staffing/workload.
• The common perception that inadequate funding is the main barrier to guideline implementation was not confirmed.

The researchers concluded that external factors appear to play critical roles in nurses’ adoption and use of guidelines. They stated,

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 in nature—are considered and addressed.

For more on the findings of this study, read the article (for easier reading, open the PDF). And if you’re a direct care RN (or if you’re not, but this topic resonates for you), please weigh in here—what most helps or hinders you in using clinical practice guidelines?