The study was intended to figure out issues that enable or bar the adoption guidelines when taking care of patients with cardiovascular risks in the primary care setting. Clinical guidelines are critical in the efforts to improve healthcare outcomes as well as ensuring the provision of quality healthcare with minimal cost (McKillop, Crisp & Walsh, 2012). Despite the known benefits of clinical guidelines, it is not clear why the implementation seems complicated and unpredictable.
The study was carried out on participants in primary health care working in different regions of New Zealand (McKillop et al., 2012). There were thirty-two participants including twenty nurses in primary health care practice, five managers, four general practitioners and three planners. Participants were included on the basis of working in an environment where guidelines were implemented in the management of patients with cardiovascular risks. McKillop et al. (2012), states that the study participants were nominated by their colleagues and later all those who confirmed their participation were included in the study.
The design of the study was qualitative in nature with some participants taking part in focused groups discussions and others taking part in interviews for six months. The question guides included open-ended questions on areas such as the development of clinical guidelines and factors that influence the adoption of clinical guidelines. Study participants were allowed to choose the time and venue (McKillop et al., 2012). The structured interviews were meant for the primary care planners. The participants were grouped into five focused groups for nurses, one for the managers as well as one for the general practitioners (McKillop et al., 2012). The focused group discussions were conducted by an individual researcher, and they lasted between sixty-five to thirty minutes.
McKillop et al. (2012), argue that most health care workers rely on their clinical experience when managing patients with cardiovascular risks hence hindering the adoption of evidence-based care. Most clinicians have a preference for clinical guidelines supported by data obtained from their country. Hospital management that has a role in setting the entire culture of the organization through its leadership plays a role in the implementation of evidence-based guidelines (McKillop et al., 2012). Most clinicians cite that the implementation of guidelines is not regularly evaluated and as such it is relatively difficult to figure out the effectiveness of the new guidelines. Current clinical leaders are not keen on adopting clinical guidelines in the primary care settings and as such the entire process does not receive the necessary support.
The situation in the United States differs from the one presented in the New Zealand study. Clinical care in the US is keen on implementing new evidence as long as the developed guidelines are supported by credible data. Given that there are many malpractice suits, most clinicians and practitioners are keen to support their clinical decision with research evidence (Stevens, 2013). Organization culture does influence the adoption of new guidelines but only to a limited extent as practitioners are aware of the individual responsibility during nursing practice. On the other hand, US patients are open to receiving new care as long as it has been shown to be effective. According to Stevens (2013), the training received during initiation into clinical practice also tends to encourage the application of evidence-based practice. Clinical leadership in the US is keen on supporting the advancement of healthcare and as such enough resources are set aside for the implementation of newly developed guidelines.
McKillop, A., Crisp, J., & Walsh, K. (2012). Barriers and enablers to implementation of a New Zealand-wide guideline for assessment and management of cardiovascular risk in primary health care: A template analysis. Worldviews on Evidence-Based Nursing, 9(3), 159-171.
Stevens, K. (2013). The impact of evidence-based practice in nursing and the next big ideas. The Online Journal of Issues in Nursing, 18 (2), 4.