20 Chapter 2 Introduction Nurses are increasingly expected to provide evidence-based care intended to enhance quality of care [1]. Therefore, an increasing number of nursing guidelines are being published. A guideline in general contains evidence-based recommendations for healthcare providers, policy makers, and patients about health interventions intended to optimize patient care. Guidelines are published with the aim of reducing unwarranted variation in healthcare delivery [2-4]. Still, healthcare providers’ adherence to guideline recommendations has proven suboptimal [5-8]. Publishing or disseminating a guideline alone will not ensure adequate use of a guideline in practice. An essential second step is to apply strategies to effectively implement the guideline [9). Using a theory, model or framework, is expected to increase the probability of success of the implementation [10]. This also holds for performing a barrier assessment and tailoring strategies [11], which are often elements in theories, models or frameworks. As nursing and medical care, as well as the associated guidelines, differ in nature, other strategies may be needed to anchor nursing guidelines in practice. Previous reviews about nursing guideline implementation considered studies addressing a single implementation strategy, such as education [12] or facilitation [13], or a specific setting, such as nursing homes [14]. More and more implementation studies in the field of nursing are being conducted [15]. However, to the best of our knowledge, the implementation strategies of nursing guidelines, independent of type or setting, have not been systematically reviewed to this date. A systematic review could provide insights useful in all areas of nursing. The objective of this review was to provide an overview of strategies used to implement nursing guidelines in all nursing fields, as well as the effects of these strategies on patient-related nursing outcomes and guideline adherence. Ideally, the findings would help guideline developers, healthcare professionals and organizations in implementing nursing guidelines in practice. Methods Design This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines [16]; the research protocol was registered on PROSPERO (registration number: CRD42018104615).
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