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Implementation strategies for guidelines at ICUs: a systematic review

Portia Jordan (Department of Nursing Science, Nelson Mandela Metropolitan University, Port Elizabeth, South Africa)
Ferestas Mpasa (Department of Nursing Science, Nelson Mandela Metropolitan University, Port Elizabeth, South Africa)
Wilma ten Ham-Baloyi (Faculty of Health Sciences, Nelson Mandela Metropolitan University, Port Elizabeth, South Africa)
Candice Bowers (Department of Nursing Science, Nelson Mandela Metropolitan University, Port Elizabeth, South Africa)

International Journal of Health Care Quality Assurance

ISSN: 0952-6862

Article publication date: 8 May 2017

679

Abstract

Purpose

The purpose of this paper is to critically analyze empirical studies related to the implementation strategies for clinical practice guidelines (CPGs) in intensive care units (ICUs).

Design/methodology/approach

A systematic review with a narrative synthesis adapted from Popay et al.’s method for a narrative synthesis was conducted. A search using CINAHL, Google Scholar, Academic search complete, Cochrane Register for Randomized Controlled Trials, MEDLINE via PUBMED and grey literature was conducted in 2014 and updated in 2016 (August). After reading the abstracts, titles and full-text articles, 11 (n=11) research studies met the inclusion criteria.

Findings

After critical appraisal, using the Joanna Briggs Critical Appraisal Tools, eight randomized controlled trials conducted in adult and neonatal ICUs using implementation strategies remained. Popay et al.’s method for narrative synthesis was adapted and used to analyze and synthesize the data and formulate concluding statements. Included studies found that multi-faceted strategies appear to be more effective than single strategies. Strategies mostly used were printed educational materials, information/ sessions, audit, feedback, use of champion leaders, educational outreach visits, and computer or internet usage. Practical training, monitoring visits and grand rounds were less used.

Practical implications

Findings can be used by clinicians to implement the best combination of multi-faceted implementation strategies in the ICUs in order to enhance the optimal use of CPGs.

Originality/value

No systematic review was previously done on the implementation strategies that should be used best for optimal CPG implementation in the ICU.

Keywords

Citation

Jordan, P., Mpasa, F., ten Ham-Baloyi, W. and Bowers, C. (2017), "Implementation strategies for guidelines at ICUs: a systematic review", International Journal of Health Care Quality Assurance, Vol. 30 No. 4, pp. 358-372. https://doi.org/10.1108/IJHCQA-08-2016-0119

Publisher

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Emerald Publishing Limited

Copyright © 2017, Emerald Publishing Limited

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