Multi-level barriers analysis to promote guideline based nursing care: a leadership strategy from home health care.

摘要: Background Understanding the types of barriers that exist when implementing change can assist healthcare managers to tailor implementation strategies for optimal patient outcomes. Aim The aim this paper is present an organising framework, Barriers Assessment Taxonomy, understanding nurses' use clinical practice guideline recommendations. recommendations are illustrated using Taxonomy and insights discussed. Method As part a pilot study, semi-structured interviews (n = 26) were conducted understand nine diabetic foot ulcers. Content analysis verbatim transcripts included thematic coding categorising Taxonomy. Results Nineteen associated with recommendations, crossing five levels health care delivery system. The revealed all had individual organisational level barriers, one recommendation having at levels. Individual most frequent lack knowledge skills was only barrier crossed recommendations. Implications nursing management The provides framework complexity exist, in choosing intervention support improved quality outcomes.