Barriers to Clinical Practice Guideline Implementation for Septic Patients in the Emergency Department

Abstract

Contribution to Emergency Nursing Practice •The current literature on implementation of clinical practice guidelines for sepsis indicates that more research is needed to understand the unique facilitators and barriers in the emergency department. •This article contributes to a heightened awareness that clinical practice guidelines for sepsis are associated with improved patient outcomes; compliance with interventions in guidelines is variable; multiple internal and external barriers exist; and facilitators, such as education, improve patient outcomes and increase compliance. •Key implications for emergency nursing practice found in this article are that knowledge of barriers and facilitators for use of clinical practice guidelines can assist emergency nurses and advance practice nurses to develop solutions to barriers in their workplaces through use of a toolkit such as from the Registered Nurses’ Association of Ontario. Contribution to Emergency Nursing Practice •The current literature on implementation of clinical practice guidelines for sepsis indicates that more research is needed to understand the unique facilitators and barriers in the emergency department. •This article contributes to a heightened awareness that clinical practice guidelines for sepsis are associated with improved patient outcomes; compliance with interventions in guidelines is variable; multiple internal and external barriers exist; and facilitators, such as education, improve patient outcomes and increase compliance. •Key implications for emergency nursing practice found in this article are that knowledge of barriers and facilitators for use of clinical practice guidelines can assist emergency nurses and advance practice nurses to develop solutions to barriers in their workplaces through use of a toolkit such as from the Registered Nurses’ Association of Ontario. Contribution to Emergency Nursing Practice •The current literature on implementation of clinical practice guidelines for sepsis indicates that more research is needed to understand the unique facilitators and barriers in the emergency department. •This article contributes to a heightened awareness that clinical practice guidelines for sepsis are associated with improved patient outcomes; compliance with interventions in guidelines is variable; multiple internal and external barriers exist; and facilitators, such as education, improve patient outcomes and increase compliance. •Key implications for emergency nursing practice found in this article are that knowledge of barriers and facilitators for use of clinical practice guidelines can assist emergency nurses and advance practice nurses to develop solutions to barriers in their workplaces through use of a toolkit such as from the Registered Nurses’ Association of Ontario. Elizabeth N. Reich is Graduate Programs Student, Faculty of Nursing, at University of Calgary, Calgary, Alberta, Canada. Karen L. Then is Professor, Faculty of Nursing, University of Calgary; and is Acute Care Nurse Practitioner, Alberta Health Services in Cardiac Sciences, Calgary, Alberta, Canada. James A. Rankin is Professor, Faculty of Nursing, University of Calgary; and is Acute Care Nurse Practitioner, Alberta Health Services in Rheumatology, Calgary, Alberta, Canada.