| Factors influencing the implementation of the guideline Triage in emergency departments: a qualitative study. | |
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MedLine Citation:
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PMID: 22171544 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Aims and objectives. The objectives are: (1) to identify factors that influence the implementation of the guideline Triage in emergency departments [2004] in emergency departments in the Netherlands, and (2) to develop tailored implementation strategies for implementation of this guideline. Background. Guideline dissemination is no guarantee for guideline implementation. In 2004 the guideline Triage in Emergency Departments was disseminated in Dutch hospitals. Guideline revision was scheduled in 2008. Prior to the revision, factors which influenced the implementation of the guideline [2004] were studied to be addressed at the implementation of the revised guideline. Methods. This is an exploratory study using a qualitative design including: a questionnaire sent to all emergency departments in the Netherlands (n = 108): four focus group interviews, including nurses and ward managers and in-depth interviews with ward managers and doctors. Based on the results, tailored implementation strategies and activities were suggested which target the identified influencing factors. Results. Various factors at individual, social context and organisational level were identified as influencing the implementation of the 2004 version of the guideline, namely: level of knowledge; insight and skills; work preferences; motivation and/or commitment; support; informed doctors; preliminary work and arrangements for implementation; description of tasks and responsibilities; workload and resources. Ward managers, nurses and doctors mentioned similar as well as different factors. Consequently, tailored implementation strategies and activities related to education, maintenance of change, motivation and consensus-building, information, organisation and facilitation were suggested. Conclusion. Nurses, ward managers and doctors broadly indicated similar influencing factors, although the importance of these factors differed for the different groups. For nurses, resistance and lack of resources are most important, ward managers mentioned culture and doctors the availability of doctors at the emergency department. Relevance to clinical practice. Insight into the barriers for implementation and tailoring implementation strategies to these barriers improves the implementation. |
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Authors:
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Maaike Ap Janssen; Theo van Achterberg; Marian Jm Adriaansen; Caroline S Kampshoff; Donna Mj Schalk; Joke Mintjes-de Groot |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-12-16 |
Journal Detail:
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Title: Journal of clinical nursing Volume: - ISSN: 1365-2702 ISO Abbreviation: - Publication Date: 2011 Dec |
Date Detail:
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Created Date: 2011-12-16 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9207302 Medline TA: J Clin Nurs Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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© 2011 Blackwell Publishing Ltd. |
Affiliation:
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Authors: Maaike AP Janssen, MSc, RN, Researcher, Faculty of Health and Social Studies, Department of Critical Care, HAN University of Applied Sciences; Theo van Achterberg, PhD, RN, Professor, Scientific Institute for Quality of Healthcare, Radboud University Nijmegen Medical Centre; Marian JM Adriaansen, PhD, RN, Professor, Faculty of Health and Social Studies, Department of Chronic Care, HAN University of Applied Sciences, Nijmegen; Caroline S Kampshoff, MSc, Researcher, VU University Medical Centre, Department of Public and Occupational Health, EMGO Institute for Health and Care Research, Amsterdam; Donna MJ Schalk, MSc, Researcher, Institute Quality Assurance and Patient Safety, Radboud University Nijmegen Medical Centre; Joke Mintjes-de Groot, PhD, RN, Professor, Faculty of Health and Social Studies, Department of Critical Care, HAN University of Applied Sciences, Nijmegen, The Netherlands. |
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