Understanding practice nurses’ suboptimal adherence to guidelines

Published on May 21 2017 – In Dutch general practice, practice nurses sub-optimally adhere to evidence-based smoking cessation treatment guidelines. Understanding the factors explaining their sub-optimal adherence is important to develop interventions that can improve their adherence and patients’ subsequent cessation success. Therefore, ACHC-researcher Eline Smit and colleagues explored the association between different socio-cognitive and predisposing factors, and practice nurses’ adherence to smoking cessation guidelines in general (i.e. overall adherence) and to each of the guideline steps individually (i.e. step-based adherence). A cross-sectional study was conducted among 157 practice nurses using web-based questionnaires. On average, five out of nine steps were completely adhered to, and step-based adherence ranged from 34% to 75%. It was found that overall guideline adherence was associated with high levels of self-efficacy to use a guideline, whereas step-based adherence was additionally associated with spending more time on counselling. Moreover, positive associations were found between self-efficacy (8/9 steps) and perceived advantages (7/9 steps), and step-based adherence. To conclude, this study confirmed practice nurses’ sub-optimal guideline adherence and found associations between socio-cognitive (self-efficacy and perceived advantages) and predisposing factors (time spent on counselling), and guideline adherence. Detailed insights in these factors offer preliminary directions for intervention development to improve practice nurses’ adherence to evidence-based smoking cessation guidelines.

The project this study is part of is funded by the Dutch Cancer Society.

Read more? De Ruijter D, Smit ES, De Vries H, & Hoving C. (in press). Dutch practice nurses’ adherence to evidence-based smoking cessation treatment guidelines. Family Practice

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