Hypertension guideline implementation: experiences of Finnish primary care nurses
Article first published online: 2 MAY 2008
© 2008 The Authors. Journal compilation © 2008 Blackwell Publishing Ltd
Journal of Evaluation in Clinical Practice
Special Issue: Evidence Based Medicine
Volume 14, Issue 5, pages 830–835, October 2008
How to Cite
Alanen, S., Ijäs, J., Kaila, M., Mäkelä, M. and Välimäki, M. (2008), Hypertension guideline implementation: experiences of Finnish primary care nurses. Journal of Evaluation in Clinical Practice, 14: 830–835. doi: 10.1111/j.1365-2753.2007.00909.x
- Issue published online: 31 OCT 2008
- Article first published online: 2 MAY 2008
- Accepted for publication: 10 May 2007
- evidence-based guidelines;
- primary care nursing
Rationale, aims and objectives Evidence-based guidelines on hypertension have been developed in many western countries. Yet, there is little evidence of their impact on the clinical practices of primary care nurses.
Method We assessed the style of implementation and adoption of the national Hypertension Guideline (HT Guideline) in 32 Finnish health centres classified in a previous study as ‘disseminators’ (n = 13) or ‘implementers’ (n = 19). A postal questionnaire was sent to all nurses (n = 409) working in the outpatient services in these health centres. Additionally, senior nursing officers were telephoned to enquire if the implementation of the HT Guideline had led to a new division of labour between nurses and doctors.
Results Questionnaires were returned from 327 nurses (80.0%), while all senior nursing officers (n = 32) were contacted. The majority of nurses were of the opinion that the HT Guideline has been adopted into clinical practice. The recommendations in the HT Guideline were adopted in clinical practice with varying success, and slightly more often in implementer health centres than in disseminator health centres. Nurses in implementer health centres more often agreed that multiple channels had been used in the implementation (P < 0.001). According to senior nursing officers the implementation of the HT Guideline had led to a new division of labour between nurses and doctors in about a half of the health centres, clearly more often in implementer health centres (P < 0.001).
Conclusions The HT Guideline was well adopted into clinical practice in Finland. The implementation of the HT Guideline had an impact on clinical practices, and on creating a new division of labour between nurses and doctors.