Background:Evidence-based professional guidelines must help to safeguard quality in the health service. Earlier research shows a gap between the guidelines' recommendations and clinical practice. Few studies have examined hospital health personnel's compliance with the guidelines following their implementation. This study is based on the 'Caesarean section project' , a project intended to improve quality in a maternity/postnatal unit in which ten new and nine revised guidelines related to the patient care pathway for caesarean sections were introduced in 2014 at the same time as a bundle of interventions. The project was initiated due to the persistent high incidence of surgical site infections following a caesarean section.Objective:The study investigates the experiences of clinical health personnel in complying with the professional guidelines three years after the implementation of the caesarean section project. Method:The study has a qualitative descriptive exploratory research design. A strategic sample of six informants from the maternity/postnatal unit were included in two interdisciplinary focus group interviews, each including a doctor, midwife and paediatric nurse. We analysed the results using Tjora's stepwise deductive-inductive method in addition to Fixsen et al.'s implementation framework. Results:The informants stated that they found the guidelines difficult to follow if they did not regard them as professionally sound, logical and relevant or in accordance with their own clinical experiences and feelings. Recommendations that competed with the department's professional traditions and values also represented barriers. The informants often explained away non-conformities in relation to the guidelines as an oversight or shortcut. They found it challenging both to give colleagues corrective feedback and to receive feedback when non-conformities were observed, especially in the case of colleagues with a different professional affiliation. When there was doubt about recommended practice, the doctors mainly used the guidelines, while midwives and paediatric nurses often asked a trusted experienced colleague. Conclusion:The informants' interpretation of guidelines, understanding and handling of non-conformities as well as competing professional traditions and values served as barriers to compliance with the guidelines. The informants wished to be more involved and to have regular active dialogue about guidelines, practical exercises and feedback on their own practice. Studies with a larger sample should be conducted in order to shed more light on the findings of this study.Evidence-based professional guidelines should quality assure patient treatment, reduce unwanted variations and limit unnecessary or erroneous use of resources in the health service 1 . However, research shows that up to 70 per cent of implemented guidelines are not followed 2 . Consequently, there may be a gap between professional recommendations and clinical practice.

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