Clinician Engagement in Point of Care Audit

Monday, 30 July 2012: 2:40 PM

Stephanie F. Sutherns, RN, RM, MHMgt, BN, DipAppSc (NsgMgt-Distinction)1
Jacinta Lee, RN, RM, BNSc (Hons), MIS2
Jackie Doolan, RN, RM, BN, MSocSc2
Lyndel Gray, RN, RM, GradDipNurs, MIntEc&Fin2
Keppel W. Schafer, RN, RM, BN, GradDipMid, MMid3
Rebecca Kimble, MBBS, FRANZCOG, GradCertIVWT&A4
(1)Maternity and Children's Services, Nambour General Hospital, Nambour, Australia
(2)Queensland Maternity and Neonatal Clinical Guidelines Program, Queensland Health, Brisbane, Australia
(3)Nursing/Midwifery Practice Development Team, Nambour General Hospital, Nambour, Australia
(4)Queensland Maternity and Neonatal Clinical Guidelines Program & School of Medicine, Queensland Health & University of Queensland, Herston, Australia

Learning Objective 1: Recognise the importance of clinician engagement in clinical guideline implementation

Learning Objective 2: Recognise that clinical audit for clinicians by clinicians is achievable

Purpose: Disseminate learnings about the importance of clinician engagement in clinical guideline implementation.

It is generally accepted that clinical guidelines on their own do not change patient care outcomes and that additional implementation strategies are required. However, there is a paucity of detailed information on what strategies are effective in translating clinical guidelines into everyday clinical practice and increasing clinician knowledge of guideline recommendations1.

Methods: The Queensland Maternity and Neonatal Clinical Guidelines Program conducted a multifaceted implementation strategy at three Queensland maternity facilities for the clinical guideline Obesity. The strategy incorporated clinician engagement, education on guideline content, point of care clinical auditing by midwives and doctors and knowledge assessments before and after these interventions.
Low and Negligible Risk Ethics approval was received from the Queensland Health Human Research Ethics Committee.

Results: Focus groups and an evaluation survey (N=72) revealed that the vast majority of clinicians viewed the audit and education implementation strategies in a positive manner. There was a statistically significant improvement (p<0.001) in knowledge of guideline content following the education intervention. Analysis of focus group themes identified the role of the local champion as a pivotal success factor and the importance of multifaceted implementation strategies to accompany the clinical guidelines.

Conclusion: The importance of clinician leadership and engagement at all levels in increasing adherence and uptake of clinical guidelines cannot be overstated2.  Consistent clinician engagement increased the project’s credibility among midwives, nurses and doctors and assisted with change management, facilitation, education delivery, data collection and participant recruitment.

1.  Forsner T, Hansson J, Brommels M, Wistedt A, Forsell Y. Implementing clinical guidelines in psychiatry: a qualitative study of perceived facilitators and barriers. BMC Psychiatry [online]. 2010; 10(8). Available from:

2.  Patel S. Achieving quality assurance through clinical audit. Nursing Managment. 2010; 17(8):28-36.