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  • Preventing surgical site infections: Facilitators and barriers to nurses' adherence to clinical practice guidelinesA qualitative study

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    Author(s)
    Lin, Frances
    Gillespie, Brigid M
    Chaboyer, Wendy
    Li, Yu
    Whitelock, Karen
    Morley, Nicola
    Morrissey, Shirley
    O'Callaghan, Frances
    Marshall, Andrea P
    Griffith University Author(s)
    Lin, Frances F.
    Gillespie, Brigid M.
    Chaboyer, Wendy
    Morrissey, Shirley A.
    Marshall, Andrea
    O'Callaghan, Frances V.
    Year published
    2019
    Metadata
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    Abstract
    Aims: To identify the facilitators of and barriers to nurses’ adherence to evidence-based wound care clinical practice guidelines (CPGs) in preventing surgical site infections (SSIs) in an Australian tertiary hospital. Background: Current research suggests that up to 50% of nurses are unaware of the evidence-based recommendations to prevent SSIs and that adherence to evidence-based CPGs is suboptimal. However, little is known regarding the facilitators and barriers to adherence to evidence-based CPGs. Design: A qualitative study incorporating ethnographic data collection techniques. Methods: Data collection included ...
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    Aims: To identify the facilitators of and barriers to nurses’ adherence to evidence-based wound care clinical practice guidelines (CPGs) in preventing surgical site infections (SSIs) in an Australian tertiary hospital. Background: Current research suggests that up to 50% of nurses are unaware of the evidence-based recommendations to prevent SSIs and that adherence to evidence-based CPGs is suboptimal. However, little is known regarding the facilitators and barriers to adherence to evidence-based CPGs. Design: A qualitative study incorporating ethnographic data collection techniques. Methods: Data collection included semi-structured individual interviews and focus groups (N = 20), and examination of existing hospital policy and procedure documents. Thematic analysis using inductive and deductive approaches was conducted. This manuscript adheres to the COnsolidated criteria for REporting Qualitative research (COREQ) guidelines. Findings: Data analysis revealed four themes: adhering to aseptic technique, knowledge and information seeking, documenting wound care and educating and involving patients in wound care. Facilitators and barriers within each theme were identified. Facilitators included participants’ active information-seeking behaviour, a clear understanding of the importance of aseptic technique, and patient participation in wound care. Barriers included participants’ knowledge and skills deficits regarding application of aseptic technique principles in practice, the availability of the hospital's wound care procedure document, suboptimal wound care documentation and the timing of patient education. Conclusions: There is a need to develop interventions to improve nurses’ adherence to recommended CPGs including following aseptic technique principles, hand hygiene, documentation and patient education. Hospital procedure documents that outline wound care need to reflect current recommended CPGs. Relevance to clinical practice: Adhering to evidence-based CPGs has been found to be effective in reducing and preventing SSIs. Our study provides an in-depth understanding of the barriers and facilitators to nurses’ adherence to recommended CPGs. The findings may inform future practice improvements in wound care.
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    Journal Title
    JOURNAL OF CLINICAL NURSING
    Volume
    28
    Issue
    9-10
    DOI
    https://doi.org/10.1111/jocn.14766
    Copyright Statement
    © 2019 John Wiley & Sons Ltd. This is the peer reviewed version of the following article: Preventing surgical site infections: Facilitators and barriers to nurses’ adherence to clinical practice guidelines—A qualitative study, Journal of Clinical Nursing, Vol. 28:1643–1652, 2019, which has been published in final form at 10.1111/jocn.14. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving (http://olabout.wiley.com/WileyCDA/Section/id-828039.html)
    Subject
    Nursing
    Public Health and Health Services
    Psychology
    Publication URI
    http://hdl.handle.net/10072/384339
    Collection
    • Journal articles

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