Implementing Guidelines and Changing Nursing Practice: Intentions and Outcomes

2.50
Hdl Handle:
http://hdl.handle.net/10755/152512
Type:
Presentation
Title:
Implementing Guidelines and Changing Nursing Practice: Intentions and Outcomes
Abstract:
Implementing Guidelines and Changing Nursing Practice: Intentions and Outcomes
Conference Sponsor:Sigma Theta Tau International
Conference Year:2004
Conference Date:July 21, 2004
Author:Perry, Lin, MSc, PhD, RN
P.I. Institution Name:City University
Title:Dr
Co-Authors:Susan M. McLaren, BSc, PhD, RGN
Recent policies within the UK National Health Service have flagged implementation of research evidence into clinical practice to effect improvements in quality of care. Evidence-based guidelines have been recommended as one means to achieve this. However, effecting changes in practice requires more than production of guidelines. Locally-tailored multi-method change management strategies have been recommended (1). Nursing nutritional support for vulnerable hospital patients has been a poorly-regarded aspect of nursing care (2). The deleterious effect of poor nutrition on patients’ survival and recovery has been flagged repeatedly, with little effect (3). To address this, a project was conceived to develop, implement and evaluate evidence-based guidelines for nutritional support of patients hospitalized with acute stroke. This paper considers the characteristics of the site and change management strategies employed in relation to their effectiveness in achieving intended changes in clinical practices. The study was sited in medical and elderly services of an acute Trust hospital (approximately 700 beds) in South London. A Project Co-ordinator employed formal and informal approaches at project commencement to detail local characteristics, policies and practices. These comprised interviews and questionnaires to all key professionals who cared for stroke patients; observations of managerial and clinical meetings; analysis of key Trust quality-related documentation. Audits were conducted of nutritional patient care services before and after guideline implementation (n=400 stroke patients). Findings will be presented in terms of intended changes in practice, discussed in relation to local characteristics and chosen change strategies. Major changes and benefits for patients were attained but success was not universal. Possible explanations will be considered and lessons for the future identified. (1) NHS Centre for Reviews and Dissemination 1999. Getting evidence in to practice. Effective Health Care 1999:5:1. (2) Tierney AJ. JAdv Nursing. 1996;23:2:228-236, (3) Lennard-Jones J.E. 1992. A Positive Approach to Nutrition as Treatment. King's Fund, London
Repository Posting Date:
26-Oct-2011
Date of Publication:
21-Jul-2004
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleImplementing Guidelines and Changing Nursing Practice: Intentions and Outcomesen_GB
dc.identifier.urihttp://hdl.handle.net/10755/152512-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Implementing Guidelines and Changing Nursing Practice: Intentions and Outcomes</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2004</td></tr><tr class="item-conference-date"><td class="label">Conference Date:</td><td class="value">July 21, 2004</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Perry, Lin, MSc, PhD, RN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">City University</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Dr</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">l.perry@city.ac.uk</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Susan M. McLaren, BSc, PhD, RGN</td></tr><tr><td colspan="2" class="item-abstract">Recent policies within the UK National Health Service have flagged implementation of research evidence into clinical practice to effect improvements in quality of care. Evidence-based guidelines have been recommended as one means to achieve this. However, effecting changes in practice requires more than production of guidelines. Locally-tailored multi-method change management strategies have been recommended (1). Nursing nutritional support for vulnerable hospital patients has been a poorly-regarded aspect of nursing care (2). The deleterious effect of poor nutrition on patients&rsquo; survival and recovery has been flagged repeatedly, with little effect (3). To address this, a project was conceived to develop, implement and evaluate evidence-based guidelines for nutritional support of patients hospitalized with acute stroke. This paper considers the characteristics of the site and change management strategies employed in relation to their effectiveness in achieving intended changes in clinical practices. The study was sited in medical and elderly services of an acute Trust hospital (approximately 700 beds) in South London. A Project Co-ordinator employed formal and informal approaches at project commencement to detail local characteristics, policies and practices. These comprised interviews and questionnaires to all key professionals who cared for stroke patients; observations of managerial and clinical meetings; analysis of key Trust quality-related documentation. Audits were conducted of nutritional patient care services before and after guideline implementation (n=400 stroke patients). Findings will be presented in terms of intended changes in practice, discussed in relation to local characteristics and chosen change strategies. Major changes and benefits for patients were attained but success was not universal. Possible explanations will be considered and lessons for the future identified. (1) NHS Centre for Reviews and Dissemination 1999. Getting evidence in to practice. Effective Health Care 1999:5:1. (2) Tierney AJ. JAdv Nursing. 1996;23:2:228-236, (3) Lennard-Jones J.E. 1992. A Positive Approach to Nutrition as Treatment. King's Fund, London</td></tr></table>en_GB
dc.date.available2011-10-26T11:39:04Z-
dc.date.issued2004-07-21en_GB
dc.date.accessioned2011-10-26T11:39:04Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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