McKee Gabrielle, Kerins Mary, Hamilton Glenys, Hansen Tina, Hendriks Jeroen, Kletsiou Eleni, Lambrinou Ekaterini, Jennings Catriona, Fitzsimons Donna
1 Council on Cardiovascular Nursing and Allied Health Professionals (CCNAP), European Society of Cardiology, Sophia Antipolis, France.
2 School of Nursing & Midwifery, Trinity College Dublin, Ireland.
Eur J Cardiovasc Nurs. 2017 Dec;16(8):678-686. doi: 10.1177/1474515117710097. Epub 2017 May 12.
The European Society of Cardiology (ESC) has a comprehensive clinical guideline development programme, relevant for all clinicians. However, implementation of guidelines is not always optimal.
The aim of this study was to determine nurses' and allied professionals' awareness and barriers regarding clinical guideline implementation.
A cross-sectional survey was administrated online and in print at EuroHeartCare 2015. A questionnaire was developed which examined awareness and barriers to implementation of ESC guidelines on cardiovascular disease prevention in clinical practice (2012) and ESC guidelines in general.
Of the 298 respondents, 12% reported that the prevention guidelines were used in their practice area. Respondents identified, in order of magnitude, that lack of leadership, workload, time, resources and a perception that they were unable to influence current practice were barriers to the use of the prevention guidelines. When asked to rank barriers to use of any ESC guidelines, time (22%) and leadership (23%) were ranked highest.
Implementation of ESC guidelines by nurses, the majority responders in this survey, is a serious problem, requiring urgent improvement to ensure patients receive optimal evidence based care. Issues of leadership, workload, time and resources are significant barriers to guideline implementation. It is of concern that these professionals perceive both that they have little influence on implementation decisions and lack of leadership regarding guideline implementation. Educational and organisational strategies to improve leadership skills are imperative. These will build self-efficacy and empower nurses and allied professionals to advocate for evidence-based care in the clinical environment.
欧洲心脏病学会（ESC）拥有一个全面的临床指南制定计划，适用于所有临床医生。然而，指南的实施情况并非总是尽善尽美。
本研究旨在确定护士及相关专业人员对临床指南实施的认知情况及障碍因素。
在2015年欧洲心脏保健会议上通过网络和纸质方式进行了一项横断面调查。设计了一份问卷，调查对ESC心血管疾病预防临床实践指南（2012年）及ESC一般指南实施的认知情况和障碍因素。
在298名受访者中，12%报告其工作领域使用了预防指南。受访者按影响程度依次指出，缺乏领导力、工作量、时间、资源以及认为自己无法影响当前实践是使用预防指南的障碍。当被要求对使用任何ESC指南的障碍进行排序时，时间（22%）和领导力（23%）排在最前列。
护士（本次调查的主要受访者群体）对ESC指南的实施是一个严重问题，需要紧急改进以确保患者获得最佳的循证护理。领导力、工作量、时间和资源问题是指南实施的重大障碍。令人担忧的是，这些专业人员既认为自己对实施决策影响甚微，又觉得在指南实施方面缺乏领导力。提高领导技能的教育和组织策略势在必行。这些策略将增强自我效能感，使护士及相关专业人员有能力在临床环境中倡导循证护理。
