Marchionni Caroline, Ritchie Judith
McGill University Health Centre, QC, Canada.
J Nurs Manag. 2008 Apr;16(3):266-74. doi: 10.1111/j.1365-2834.2007.00775.x.
The context of the healthcare setting may play a crucial role in influencing the implementation of best practice guidelines in nursing. Further study is required to understand these organizational factors. Two variables, organizational culture and leadership, are thought to influence the adoption of best practice guidelines.
A discussion of organizational factors that influence best practice guideline adoption is presented. A small pilot study is provided as an example of methods for further research.
A quantitative survey of nursing staff was conducted.
Results from the pilot study reveal variability in best practice guideline implementation despite the presence of a culture of organizational learning and transformational leadership.
There is beginning evidence in the literature that culture and leadership are key elements influencing guideline implementation. In this pilot work on two inpatient units where a nursing best practice guideline was implemented, a supportive organizational culture and key people leading change were present. Implications for further studies are offered.
Nursing leaders interested in promoting the use of best practice guidelines must pay attention to the organizational context in which nursing care occurs. A supportive culture where learning is valued coupled with transformational leadership may be key factors in the implementation and the sustainability of best practice guidelines.
医疗环境背景可能在影响护理最佳实践指南的实施方面发挥关键作用。需要进一步研究以了解这些组织因素。组织文化和领导力这两个变量被认为会影响最佳实践指南的采用。
阐述影响最佳实践指南采用的组织因素。提供一项小型试点研究作为进一步研究方法的示例。
对护理人员进行了定量调查。
试点研究结果显示,尽管存在组织学习文化和变革型领导力,但最佳实践指南的实施仍存在差异。
文献中初步有证据表明,文化和领导力是影响指南实施的关键要素。在这项针对两个实施了护理最佳实践指南的住院科室的试点工作中,存在支持性的组织文化和引领变革的关键人物。文中给出了对进一步研究的启示。
对促进最佳实践指南使用感兴趣的护理领导者必须关注护理工作开展的组织环境。重视学习的支持性文化与变革型领导力相结合,可能是最佳实践指南实施及可持续性的关键因素。