Attitudes toward practice guidelines among intensive care unit personnel: A cross-sectional anonymous survey

School of Nursing, Columbia University, New York, NY 10032, USA.
Heart and Lung The Journal of Acute and Critical Care (Impact Factor: 1.29). 07/2007; 36(4):287-97. DOI: 10.1016/j.hrtlng.2006.08.005
Source: PubMed

ABSTRACT The study assessed attitudes of intensive care unit (ICU) staff members toward practice guidelines in general and toward a specific guideline, The Centers for Disease Control and Prevention's Guideline for Hand Hygiene in Healthcare Settings; correlated these attitudes with staff and hospital characteristics; and examined the impact of staff attitudes toward the Hand Hygiene Guideline on self-reported implementation of the Guideline.
We performed a cross-sectional survey of staff in 70 ICUs in 39 U.S. hospitals, members of The National Nosocomial Infection Surveillance System. A survey, "Attitudes Regarding Practice Guidelines," was administered anonymously to all willing staff during a site visit at each hospital. A total of 1359 ICU personnel responded: 1003 nurses (74%), 228 physicians (17%), and 128 others (10%).
Significantly more positive attitudes toward practice guidelines were found among staff in pediatric compared with adult ICUs (P < .001). Nurses and other staff when compared with physicians had more positive attitudes toward guidelines in general but not toward the specific Hand Hygiene Guideline. Those with more positive attitudes were significantly more likely to report that they had implemented recommendations of the Guideline (P < .001) and used an alcohol product for hand hygiene (P = .002).
The majority of staff members were familiar with the Centers for Disease Control and Prevention Hand Hygiene Guideline. Staff attitudes toward practice guidelines varied by type of ICU and by profession, and more positive attitudes were associated with significantly better self-reported guideline implementation. Because differences in staff attitudes might hinder or facilitate their acceptance and adoption of evidence-based practice guidelines, these results may have important implications for the education and/or socialization of ICU staff.

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    • "Views and personal beliefs can also be associated positively or negatively with uptake of new knowledge (Estabrooks et al. 2003; Greenhalgh et al. 2005) and the use of guidelines (Alanen et al. 2009; Quiros et al. 2007). Professionals' views on guidelines have been explored mainly in studies with a quantitative design; for example, studies dealing with guidelines about smoking-cessation advice (Puffer & Rashidian 2004), hand hygiene (Quiros et al. 2007), hypertension (Alanen et al. 2009), and prevention of falls (Stenberg & Wann-Hansson 2011). It is worth noting that these studies refer to 'somatic' healthcare staff. "
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    ABSTRACT: National guidelines are released regularly, and professionals are expected to adopt and implement them. However, studies dealing with mental health-care professionals' views about guidelines are sparse. The aim of the present study was to highlight mental health-care staff's views on the Swedish national guidelines for 'psychosocial interventions for schizophrenia or schizophrenia-type symptoms' and their implementation. The study took place in the southeast parts of Sweden, and data were collected through five group interviews consisting of 16 professionals working either in the county council or in the municipalities. The transcribed text was analysed by content analysis, revealing two categories. The first category 'a challenge to the practice of care as known' reflected that the release of guidelines could be perceived as a challenge to prevailing care and culture. The second category 'anticipating change to come from above' mirrored views on how staff expected the implementation process to flow from top to bottom. To facilitate working in accordance with guidelines, we suggest that future guidelines should be accompanied by an implementation plan, where the educational needs of frontline staff are taken into account. There is also a need for policy makers and managers to assume responsibility in supporting the implementation of evidence-based practice.
    International journal of mental health nursing 06/2014; 23(3):221-231. DOI:10.1111/inm.12049 · 1.95 Impact Factor
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    • "We also chose to add together each participant's individual item scores to summated scores (Polit & Beck, 2012) to be able to present the mean summary score for the attitude scale. Although attitude scales provide ordinal data it is common to also present mean scores (Kasje et al. 2004, Quiros et al. 2007, Alanen et al. 2009) as according to Polit and Beck (2012) this enables comparisons between groups while making it possible to detect fine and important differences between the attitudes in the groups studied. As the responses to item 7 were negative, the scores were reversed so that higher scores represented a more positive attitude. "
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    ABSTRACT: The adoption of evidence-based guidelines within the mental health field has been slow. Changing inadequate practice is therefore a formidable challenge for mental health-care managers. To explore decision-makers' attitudes and awareness regarding the national guidelines for psychosocial interventions targeting people with schizophrenia. A questionnaire distributed by e-mail to 592 Swedish decision-makers was analysed using descriptive and comparative techniques. Significantly more of the top-level mental health-care managers than politicians stated that they knew about the national guidelines (i.e. their release and content) and they considered the guidelines to be a good source of support for planning and allocating resources. If those responsible for allocating resources (i.e. politicians) are unaware of the dissemination of national guidelines or their content, and they do not perceive the national guidelines to be a good source of support for planning and allocating resources, this is likely to have a negative influence on the remit of nurse managers as well as nursing practice. Top-level mental health-care managers have a vital role to play in the implementation of national guidelines. However, our findings indicate that implementing national guidelines in practice could be virtually impossible without strategic government support.
    Journal of Nursing Management 07/2013; 22(7). DOI:10.1111/jonm.12061 · 1.50 Impact Factor
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    • "Individual experience of more importance than formal education to HH behaviour ; exposure to clear vicarious experience can improve training and yield sustainable results ; theory of planned behaviour most suitable framework to aid understanding between infl uences and motivational factors to HH Quiros et al , 2007 , 78 USA "
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    ABSTRACT: Changes in the behaviour of health-care workers (HCWs) are required to improve adherence to infection prevention and control (IPC) guidelines. Despite heavy investment in strategies to change behaviour, effectiveness has not been adequately assessed. We did a systematic review to assess the effectiveness and sustainability of interventions to change IPC behaviour and assessed exploratory literature for barriers to and facilitators of behaviour change. 21 studies published from 1999 to 2011 met our inclusion criteria: seven intervention studies and 14 exploratory studies. Of the intervention studies none explicitly incorporated psychological theory and only two contained elements of social marketing in the design, although five addressed sustainability. All elicited behaviour change, reduction in infection risk, or both. The exploratory studies identified social and cultural factors that affect the IPC behaviour of HCWs. To improve the standard of research and broaden the evidence base, we recommend that quality criteria are added to existing systematic review guidelines to enable the inclusion of qualitative research and to ensure robust design, implementation, and reporting of interventions.
    The Lancet Infectious Diseases 02/2012; 12(4):318-29. DOI:10.1016/S1473-3099(11)70283-3 · 22.43 Impact Factor
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