FACTORS INFLUENCING CRITICAL CARE NURSES' ADOPTION OF THE AACN PRACTICE ALERT ON VERIFICATION OF FEEDING TUBE PLACEMENT

    Authors

    A. M. Bourgault; J. Heath; V. Hooper; M. L. Sole; J. L. Waller;E. G. NeSmith

    Comments

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    Abbreviated Journal Title

    Am. J. Crit. Care

    Keywords

    CLINICAL-PRACTICE GUIDELINES; NURSING PRACTICE; PSYCHOMETRIC PROPERTIES; NUTRITION SUPPORT; ENTERAL NUTRITION; NATIONAL-SURVEY; HEALTH-CARE; IMPLEMENTATION; UNIT; BARRIERS; Critical Care Medicine; Nursing

    Abstract

    Background Clinical practice guidelines are intended to bridge the research-practice gap, yet little is known about how critical care nurses adopt guidelines. Feeding tube verification practices remain variable and have led to patient harm and death. Objectives To examine factors influencing critical care nurses' adoption of the American Association of Critical-Care Nurses (AACN) practice alert on verification of feeding tube placement and its 4 recommended clinical practices. Methods Critical care nurses were invited to participate in a national, online questionnaire, guided by Rogers' diffusion of innovation framework. Descriptive statistics and logistic regression were used for data analysis. Alpha level was set at 0.05. Results Fifty-five percent of the 370 participating nurses were aware of the practice alert, and 45% had adopted it in practice. Only 29% of the adopters had also implemented all 4 clinical practices. Significant predictors of adoption included BSN or higher nursing education and guideline characteristics of observability and trialability. Predictors of implementation of the clinical practices included staff nurse/charge nurse role, academic medical center, research/web-based information sources, and perception of a policy. Policy was the only significant predictor of implementation of all 4 practices. Adoption of the practice alert was also a predictor for 2 of 4 clinical practices. Conclusions Personal and organizational factors influenced implementation of practices associated with an AACN practice alert. Although a research-practice gap exists, the practice alert was a significant source of information for 2 of the clinical practices.

    Journal Title

    American Journal of Critical Care

    Volume

    23

    Issue/Number

    2

    Publication Date

    1-1-2014

    Document Type

    Article

    Language

    English

    First Page

    134

    Last Page

    143

    WOS Identifier

    WOS:000338930400006

    ISSN

    1062-3264

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