Strategies for the implementation of best practice guidelines in operating theatres: An integrative literature review

Olukemi O Owolabi,Margaret Williams,Wilma Ten Ham-Baloyi,Portia J Jordan

doi:10.4102/hsag.v26i0.1488

Olukemi O Owolabi, Margaret Williams + Show 2 more

Open Access

https://doi.org/10.4102/hsag.v26i0.1488

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Abstract

Best practice guidelines (BPGs) exist for operating theatre (OT), but strategies to implement them are lacking. To address the gap, an integrative review was undertaken to identify strategies which can be used to implement BPGs in OT. This article aimed to summarise the best existing literature in order to identify and describe strategies for the implementation of BPGs in OT. An extensive search was undertaken to include relevant literature from February 2005 to March 2020 using the following databases: CINAHL, Medline, Biomed Central, Academic Search Complete and Health Source: Nursing/Academic Edition (EBSCOhost) and the Cochrane library. This integrative literature review followed the methodology proposed by Whittemore and Knafl, namely: (1) identification of the research problem, (2) search of the literature, (3) evaluation of the data, (4) analysis of the data and (5) presentation of the results. On completion of the critical appraisal, 15 (n = 15) articles met the inclusion criteria and relevant data were synthesised. The review identified six strategies facilitating implementation of BPGs in OT, namely, communication, education materials and mass media, academic detailing, opinion leaders, audit and feedback, and teamwork and collaboration. The review validated strategies for the implementation of BPGs in OT. Implementation of BPGs is essential to both provide and improve patient care and to benefit health outcomes. This review is expected to contribute to the provision of strategies to implement BPGs in OT.

Highlights

The provision, by healthcare providers, of a safe environment for patients undergoing surgical procedures is crucial
This review aims, to summarise the best existing literature in order to identify and describe strategies for the implementation of best practice guidelines (BPGs) in operating theatre (OT)
After the identification of the research problem that finding the most appropriate strategies to assist or facilitate the implementation and use of BPGs in the OT is needed, no integrative literature review has been conducted to summarise the best literature on existing strategies in this context, the following question was used for the integrative literature review: ‘What literature is existing regarding strategies for the implementation of BPGs in OT?’

Summary

Introduction

The provision, by healthcare providers, of a safe environment for patients undergoing surgical procedures is crucial. Operating theatre nurses are trained to be aware of risks related to patient mismanagement, including those related to musculoskeletal injuries, patient misidentification, surgical site infection and equipment. To reduce the risks of patient mismanagement, it is recommended that clinical practices be based on the best available evidence in the form of best practice guidelines (BPGs). The implementation of BPGs provides best available evidence to support clinical decision-making to improve quality care, good patient outcomes and cost effectiveness (Melnyk et al 2017:6). Wellwritten BPGs should be used to optimise healthcare delivery and improve patient outcomes (Ayabe et al 2017:22)

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