Paper
Wednesday, July 21, 2004
9:30 AM - 10:00 AM
Wednesday, July 21, 2004
2:30 PM - 3:00 PM
This presentation is part of : Posters
An Evaluation Framework to Assess the Impact of Implementing Best-Practice Guidelines
Barbara L. Davies, RN, PhD1, Nancy Edwards, RN, PhD2, Maureen Dobbins, RN, PhD3, Pat Griffin, RN, PhD4, Jenny Ploeg, RN, PhD3, Jennifer Skelly, RN, PhD3, Barbara Helliwell, BA1, and Isabelle St Pierre, MScN1. (1) Nursing/Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada, (2) Nursing/Health Sciences, University of Ottawa, Ottawa, ON, Canada, (3) School of Nursing, McMaster University, Hamilton, ON, Canada, (4) Office of Nursing Policy, Health Policy and Communications Branch, Health Canada, Ottawa, ON, Canada
Learning Objective #1: Increase their understanding of multiple variables (generic and topic specific) that can be used to assess the impact of implementing best-practice guidelines
Learning Objective #2: Increase their understanding of the elements of a promsing intervention to transfer research results into hospital and community health settings
Objectives: To determine the effectiveness of an intervention to implement nursing best practice guidelines (BPG’s) on provider, organizational and patient outcomes. To determine factors that influence the implementation of BPG’s

Background: Since 1999, The Registered Nurses Association of Ontario, Canada has been developing nursing best practice guidelines (BPG’s). We are reporting results from the recent cluster of guidelines. Topics include: asthma; breast-feeding; delirium/dementia/depression; diabetes; smoking cessation; and venous leg ulcers

Methods: Pre and post comparisons at six-months were made using both quantitative surveys (nurses) and qualitative interviews (staff nurses, clinical resource nurse, administrators). Generic measures as well as BPG-specific measures were used. Patient data were collected using chart audits, patient in-hospital interviews and follow-up telephone calls.

Population: Overall, 11 health care organizations (hospitals, community heath) with 22 units participated. A proportionate random sample of nurses was selected with response rates of 64% (317/494) for the surveys and 88% (83/94) for interviews. For patient data, all consecutive eligible patients were enrolled for six weeks to a maximum of 50 patients on each unit.

Intervention: Clinical resource nurses were employed to implement the guidelines using multiple strategies.

Variables: Assessment of own and unit nursing practice; Quality assurance; Policies/Procedures; Familiarity and referrals to community services; and BPG specific patient outcomes

Findings: Statistically significant improvements in nursing practice and/or patient outcomes were found across all topics which ranged from minimal at some organizations to substantial at others. The most important facilitating factor was the education session while the most important barrier was the nurse’s lack of time to implement recommendations. Support from the organization and follow-up support to staff on the unit were also important factors.

Conclusions: The evaluation framework is promising. Future recommendations include a longer time frame as well as cost-effectiveness analyses.

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Sigma Theta Tau International
July 21, 2004