Bridging the gap between guidelines and practice in the management of emerging infectious diseases: A qualitative study of emergency nurses
Author(s)
Author(s)
Lam, S. K. K.
Kwong, E. W. Y.
Pang, S. M. C.
Date Issued
2016
Publisher
John Wiley & Sons
Journal
Journal of Clinical Nursing
Volume
25
Issue
19-20
Start page
2895
End page
2905
Abstract
Aims and objectives
To explore the difficulties and strategies regarding guideline implementation among emergency nurses.
Background
Emerging infectious diseases remain an underlying source of global health concern. Guidelines for accident and emergency departments would require adjustments for infectious disease management. However, disparities between guidelines and nurses' practice are frequently reported, which undermines the implementation of these guidelines into practice. This article explores the experience of frontline emergency nurses regarding guideline implementation and provides an in-depth account of their strategies in bridging guideline-practice gaps.
Design
A qualitative descriptive design was used.
Methods
Semi-structured, face-to-face, individual interviews were conducted between November 2013–May 2014. A purposive sample of 12 frontline emergency nurses from five accident and emergency departments in Hong Kong were recruited. The audio-recorded interviews were transcribed verbatim and analysed with a qualitative content analysis approach.
Results
Four key categories associated with guideline-practice gaps emerged, including getting work done, adapting to accelerated infection control measures, compromising care standards and resolving competing clinical judgments across collaborating departments. The results illustrate that the guideline-practice gaps could be associated with inadequate provision of corresponding organisational supports after guidelines are established.
Conclusions
The nurses' experiences have uncovered the difficulties in the implementation of guidelines in emergency care settings and the corresponding strategies used to address these problems. The nurses' experiences reflect their endeavour in adjusting accordingly and adapting themselves to their circumstances in the face of unfeasible guidelines.
Relevance to clinical practice
It is important to customise guidelines to the needs of frontline nurses. Maintaining cross-departmental consensus on guideline interpretation and operation is also indicated as an important component for effective guideline implementation.
SFU Affiliated Publication
No
Availability at SFU Library
No database links found.