Implementation strategies for guidelines at ICUs: a systematic review

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.

Neonatal resuscitation guideline adherence: simulation study and framework for improvement

“…Our search strategy yielded the following results: 925 hits, four studies selected: 2 systematic meta-reviews [ 24 , 25 ], 1 systematic review [ 26 ], 1 qualitative focus group study [ 27 ]. 190 hits, four studies selected: 3 randomized controlled trials [ 28 – 30 ], 1 retrospective cohort study [ 31 ].…”

“…925 hits, four studies selected: 2 systematic meta-reviews [ 24 , 25 ], 1 systematic review [ 26 ], 1 qualitative focus group study [ 27 ].…”

COVID-19-Pandemie: Präferenzen und Barrieren für die Disseminierung von Evidenzsynthesen

“…Bemerkenswert ist der deutliche Wunsch nach Weiterbildung direkt am Arbeitsplatz. Eine maßgeschneidertes Implementierungskonzept [ 8 ] gilt bekanntermaßen als vorteilhaft und sollte im weiteren Verlauf evaluiert werden. Insbesondere Webinare als interaktive Plattform zur Vermittlung komplexer Inhalte und als Alternative zu Präsenzveranstaltungen aufgrund der Kontaktbeschränkungen stoßen bei der Mehrheit der Befragten auf Akzeptanz und wurden zuvor schon als effektives Mittel der Evidenzvermittlung in der Pandemie beschrieben [ 9 ].…”

The effectiveness of multicomponent pressure injury prevention programs in adult intensive care patients: A systematic review

“…The multicomponent programs were associated with decreased pressure injury incidence in critically ill patients. A review of strategies used in implementing clinical practice guides in ICU suggested that multi-faceted interventions such as care bundles were more effective than single component interventions (Jordan et al, 2017). However, a recent systematic review found that research evidence on the effectiveness of care bundles were mostly of low quality (Lavallee et al, 2017).…”

“…The benefits of new roles or clarified roles can be three-fold. Firstly, staff in these roles can be champions, which has been found to be an effective strategy to enhance CPG implementation in ICU (Jordan et al, 2017) and to lead and reinforce research evidence uptake and improve compliance to protocols (Miech et al, 2018). Secondly, this helps to build capacity in promoting evidence-based practice.…”