Barriers and enablers for implementation of clinical practice guidelines in maternity and neonatal settings: A rapid review

Abstract

Background Maternity and neonatal services are rapidly changing in Australia because of evolving needs of the community and patient population. Clinical practice guidelines focused on early interventions and prevention strategies can decrease risk for preventable negative health outcomes in this population. However, despite the existence of several clinical practice guidelines, their translation into practice remains problematic for healthcare services. Aim To identify barriers and enablers for the implementation and adoption of clinical practice guidelines in maternal and neonatal settings. Methods A rapid review was conducted according to Cochrane and World Health Organization guidelines. Systematic reviews, qualitative, quantitative and mixed-methods studies related to clinical guidelines in maternal and neonatal settings published in English Language between 2010 and 2023 meeting study eligibility criteria were identified using PubMed, Cochrane CENTRAL, EMBASE, and CINAHL databases. Findings Forty-eight studies originating from 35 countries were reviewed, representing practice guidelines associated with maternal and neonatal care. Identified barriers and enablers aligned to five main themes related to the contextual level of impact: (i) healthcare system and systemic factors, (ii) patient and population, (iii) guidelines and standards, (iv) organisational capacity, and (v) health professional practice. Discussion and conclusion Findings from this review shed light on the challenges and opportunities associated with introducing clinical practice guidelines in maternal and neonatal care settings. Implementation of guidelines into practice is complex, with different factors affecting their adoption and their use within healthcare settings. Addressing the multifaceted challenges associated with the implementation of clinical practice guidelines in maternal and neonatal care demands a comprehensive and collaborative strategy. Successful adoption of guidelines requires the involvement of stakeholders at all levels, supported by ongoing evaluation, feedback, and dedication to evidence-based practices.