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Title: Barriers to ESC guideline implementation: results of a survey from the European Council on Cardiovascular Nursing and Allied Professions (CCNAP)
Authors: McKee, Gabrielle 
Kerins, Mary 
Hamilton, Glenys 
Hansen, Tina 
Hendriks, Jeroen 
Kletsiou, Eleni 
Lambrinou, Ekaterini 
Jennings, Catriona 
Fitzsimons, Donna 
Major Field of Science: Medical and Health Sciences
Field Category: Clinical Medicine
Keywords: Barriers;Cardiac patients;Clinical guidelines;Implementation;Prevention
Issue Date: 1-Dec-2017
Source: European Journal of Cardiovascular Nursing, 2017, vol. 16, no. 8, pp. 678-686
Volume: 16
Issue: 8
Start page: 678
End page: 686
Journal: European Journal of Cardiovascular Nursing 
Abstract: Background: The European Society of Cardiology (ESC) has a comprehensive clinical guideline development programme, relevant for all clinicians. However, implementation of guidelines is not always optimal. Aim: The aim of this study was to determine nurses’ and allied professionals’ awareness and barriers regarding clinical guideline implementation. Methods: A cross-sectional survey was administrated online and in print at EuroHeartCare 2015. A questionnaire was developed which examined awareness and barriers to implementation of ESC guidelines on cardiovascular disease prevention in clinical practice (2012) and ESC guidelines in general. Results: Of the 298 respondents, 12% reported that the prevention guidelines were used in their practice area. Respondents identified, in order of magnitude, that lack of leadership, workload, time, resources and a perception that they were unable to influence current practice were barriers to the use of the prevention guidelines. When asked to rank barriers to use of any ESC guidelines, time (22%) and leadership (23%) were ranked highest. Conclusions: Implementation of ESC guidelines by nurses, the majority responders in this survey, is a serious problem, requiring urgent improvement to ensure patients receive optimal evidence based care. Issues of leadership, workload, time and resources are significant barriers to guideline implementation. It is of concern that these professionals perceive both that they have little influence on implementation decisions and lack of leadership regarding guideline implementation. Educational and organisational strategies to improve leadership skills are imperative. These will build self-efficacy and empower nurses and allied professionals to advocate for evidence-based care in the clinical environment.
ISSN: 1474-5151
DOI: 10.1177/1474515117710097
Rights: © The European Society of Cardiology
Type: Article
Affiliation : European Society of Cardiology 
Trinity College Dublin 
St. James's Hospital 
Massachusetts General Hospital 
Zealand University Hospital 
South Australian Health and Medical Research Institute 
Linköping University 
Attikon University Hospital 
Cyprus University of Technology 
National Heart and Lung Institute 
Queens University 
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