Guidelines on anaemia: effect on primary-care midwives in The Netherlands.

OBJECTIVE

To assess the adherence and perceived barriers for implementation of a clinical-practice guideline on anaemia, which was the first national guideline for primary-care midwifery in The Netherlands.

DESIGN

Cross-sectional survey study.

SETTING

Primary-care midwifery in The Netherlands.

PARTICIPANTS

160 midwives (60% response rate).

MEASUREMENTS

Questionnaire on the knowledge of, and attitudes and self-reported adherence to, 14 key recommendations in the guideline; attitudes to guidelines in general; and perceived barriers to implementation.

FINDINGS

The number of midwives agreeing with and adhering to specific recommendations varied between 29 and 90%. Most midwives had a positive attitude to the guidelines. The most relevant general barriers were related to the behaviour of general practitioners and obstetricians (32% of the midwives reported this). Larger numbers of midwives mentioned barriers to specific aspects of the guideline, particularly alternative iron supplementation or dietary supplements (59%), and not prescribing iron supplementation if haemoglobin was low but mean corpuscular volume was normal (49%).

KEY CONCLUSIONS

The guideline on anaemia was well received by primary-care midwives in The Netherlands, but implementation of specific recommendations needs further attention.

IMPLICATIONS FOR PRACTICE

The study provides evidence for the national organisation of midwives to continue with the development and implementation of clinical guidelines.