August 21, 2007Critical Care Medicine
Facilitating clinician adherence to guidelines in the intensive care unit: A multicenter, qualitative study*
Authors
Discussion
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Implication
Qualitative study identifies leadership and interprofessional culture as key drivers of guideline adherence in intensive care units, highlighting the need for tailored multidisciplinary strategies.
Key Points
- To determine perceived facilitators and barriers to clinical practice guideline implementation and clinician adherence in the intensive care unit.
- Conducted semistructured qualitative interviews with 44 intensive care clinicians across three university-affiliated ICUs in Canada.
- Sample included 12 intensivists, two physician directors, 12 nurses, three nurse educators, three nurse managers, nine respiratory therapists, and three respiratory therapist educators.
- Transcribed and analyzed all interview data in duplicate using grounded theory to identify thematic categories and conceptual models.
- Identified that an enabling ICU culture—underpinned by strong clinical leadership, interprofessional collaboration, and shared belief that guidelines minimize practice variation—is essential for adherence.
- Identified core facilitators to overcome implementation barriers, including tailored education by profession, repeated reminders, audit and feedback, simplified formats, and electronic media delivery.
Cite This Study
Sinuff et al. (2007) studied this question.