Nurses' perceived barriers to the implementation of a Fall Prevention Clinical Practice Guideline in Singapore hospitals.

Elizabeth Manias,Alison M Hutchinson,Susan Donath,Serena Sl Koh,Linda Johnston

doi:10.1186/1472-6963-8-105

Abstract

BackgroundTheories of behavior change indicate that an analysis of barriers to change is helpful when trying to influence professional practice. The aim of this study was to assess the perceived barriers to practice change by eliciting nurses' opinions with regard to barriers to, and facilitators of, implementation of a Fall Prevention clinical practice guideline in five acute care hospitals in Singapore.MethodsNurses were surveyed to identify their perceptions regarding barriers to implementation of clinical practice guidelines in their practice setting. The validated questionnaire, 'Barriers and facilitators assessment instrument', was administered to nurses (n = 1830) working in the medical, surgical, geriatric units, at five acute care hospitals in Singapore.ResultsAn 80.2% response rate was achieved. The greatest barriers to implementation of clinical practice guidelines reported included: knowledge and motivation, availability of support staff, access to facilities, health status of patients, and, education of staff and patients.ConclusionNumerous barriers to the use of the Fall Prevention Clinical Practice Guideline have been identified. This study has laid the foundation for further research into implementation of clinical practice guidelines in Singapore by identifying barriers to change in acute care settings.

Highlights

Theories of behavior change indicate that an analysis of barriers to change is helpful when trying to influence professional practice
Design A survey design was chosen to assess the perceived barriers to change by eliciting nurses' opinions with regards to barriers to implementation of clinical practice guidelines in their practice setting
The demographic characteristics of the nurse respondents were consistent throughout the five acute care hospitals in Singapore

Summary

Introduction

Theories of behavior change indicate that an analysis of barriers to change is helpful when trying to influence professional practice. The aim of this study was to assess the perceived barriers to practice change by eliciting nurses' opinions with regard to barriers to, and facilitators of, implementation of a Fall Prevention clinical practice guideline in five acute care hospitals in Singapore. The need to demonstrate clinically effective care is widely acknowledged yet research knowledge has been slow to influence practice. Barriers to implementing research in healthcare exist at many levels including the individual practitioner, the clinical team, the practice setting and the organizational context [2]. The average practitioner, nurse or clinician does not have the time or the skills to locate and appraise the large volume of research publications.

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Conclusion