dc.contributor.author |
McKillop, Ann |
en |
dc.contributor.editor |
Howe, A |
en |
dc.contributor.editor |
Steel, N |
en |
dc.coverage.spatial |
Norwich, UK |
en |
dc.date.accessioned |
2012-04-10T23:39:30Z |
en |
dc.date.issued |
2010-11-05 |
en |
dc.identifier.citation |
Society for Academic Primary Care Annual Scientific Meeting, Norwich, UK, 07 Jul 2010 - 09 Jul 2010. Editors: Howe A, Steel N. Primary Health Care Research and Development. Cambridge University Press, Cambridge. 11: 1-174. 05 Nov 2010 |
en |
dc.identifier.uri |
http://hdl.handle.net/2292/16942 |
en |
dc.description.abstract |
The implementation of evidence-based clinical practice guidelines in primary health care can substantially improve health promotion, early disease detection and reduce the burden of chronic disease. However, the implementation of evidence into clinical practice is a highly complex endeavour that has been said to occur in a ‘black box’, defying easily reached explanations of how it happens in practice. The aim of this study was to explore the ‘black box’ of guideline implementation associated with primary health care nurses’ use of a guideline that targets high health need populations in a region of New Zealand. The potential for improvement of cardiovascular health overall and the reduction of the marked disparities between Maori (indigenous people of New Zealand) and non-Maori drives the imperative to enact the recommendations of the Assessment and Management of Cardiovascular Risk guideline. The New Zealand Guidelines Group has developed a guideline for the Assessment and Management of Cardiovascular Risk (AMCVR) that, if fully implemented, has the potential to prevent 55% of future cardiovascular disease events and reduce marked inequity in cardiovascular health between Maori and non-Maori, especially evident in rural areas. Primary health care nurses are well positioned at the frontline of healthcare to act on the recommendations of the AMCVR guideline and an effective implementation strategy is required. Primary health care nurses, doctors, health planners and managers participated in focus groups and interviews to discuss the implementation of the guideline. Data were analysed using a general inductive approach to generate themes that represented the perceptions and experiences of implementing the guideline. A rich description of implementing the guideline reduced to four themes: 1) enhancing client self management, 2) evidence in everyday practice, 3 ) communication and ways of working within the health team and 4) healthcare system factors that impact on guideline implementation. Successful guideline implementation in rural primary health care demands multidisciplinary, transformational practice development to develop an effective workplace culture and systems that optimise primary health care nurses’ uptake of evidence into practice in order to reduce high levels of cardiovascular risk, chronic illness and health inequity. |
en |
dc.publisher |
Cambridge University Press |
en |
dc.relation.ispartof |
Society for Academic Primary Care Annual Scientific Meeting |
en |
dc.relation.ispartofseries |
Primary Health Care Research and Development |
en |
dc.rights |
Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. |
en |
dc.rights.uri |
https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm |
en |
dc.title |
Opening the Black Box: Primary health care nurses’ use of a guideline for cardiovascular risk |
en |
dc.type |
Conference Item |
en |
dc.identifier.doi |
10.1017/S1463423610000447 |
en |
pubs.issue |
S1 |
en |
pubs.begin-page |
1 |
en |
pubs.volume |
11 |
en |
dc.rights.holder |
Copyright: Cambridge University Press |
en |
pubs.author-url |
http://journals.cambridge.org/action/displayAbstract |
en |
pubs.end-page |
174 |
en |
pubs.finish-date |
2010-07-09 |
en |
pubs.place-of-publication |
Cambridge |
en |
pubs.publication-status |
Published |
en |
pubs.start-date |
2010-07-07 |
en |
dc.rights.accessrights |
http://purl.org/eprint/accessRights/RestrictedAccess |
en |
pubs.subtype |
Abstract |
en |
pubs.elements-id |
205431 |
en |
dc.relation.isnodouble |
21124 |
* |
pubs.org-id |
Medical and Health Sciences |
en |
pubs.org-id |
Nursing |
en |
pubs.record-created-at-source-date |
2011-02-08 |
en |