Article Critique: Barriers and Enablers to Implementation of a New Zealand-Wide Guideline for Assessment and Management of Cardiovascular Risk in Primary Health Care: A Template Analysis
Learning Activity #1 (LA #1): Go to your Course Content page and read the qualitative research study by Mckillop, Crisp, and Walsh (2012) “ Barriers and Enablers to Implementation of a New Zealand-Wide Guideline for Assessment and Management of Cardiovascular Risk in Primary Health Care: A Template Analysis.” Then appraise and critique the article following the components of Synopsis (textbook pages 399-400). For this Learning Activity, you will only do Synopsis. This is a 2-3 page paper, 500 words. No title page, abstract or reference page are needed.
Title your page with the following heading (if you had to do a reference page in APA format, this is how your reference on the reference page would look; page 401 of your textbook provides you with another example. Please note APA style regarding how initials and authors’ last names are placed, where periods are placed, where commas are placed, how journal name and volume are italicized, how the issue number is not italicized but instead is placed in parentheses, and the listing of the doi number ):
Citation: McKillop, A., Crisp, J., & Walsh, K. (2012). Barriers and Enablers to Implementation of a New Zealand-Wide Guideline for Assessment and Management of Cardiovascular Risk in Primary Health Care: A Template Analysis. Worldviews on Evidence-Based Nursing, 9 (3), 159-171. doi: 10.1111/j.1741-6787.2011.00233.x.
Use the following subheadings from Synopsis, pages 401-402, and write a critique of the study, using your own words, and answering the following items in your paper.:
- What was the purpose of the study?
Address the research questions, and/or study purposes; these will be used in a qualitative study, but unlike a descriptive non-experimental quantitative study or a quasi-experimental quantitative study, there usually will not be a hypothesis in a qualitative research study - Who participated or contributed data?
Address items such as target population, how sample was obtained, inclusion criteria, demographics or clinical profile, dropout rate; provide as much information as you can find in the article as to who were the sample participants and what was the final sample size - What methods were used to collect data?
Address items such as sequence of events, timing of data collection, types of data assessed, types of data measures that were collected - What were the main findings?
Report and address the main findings of the study
Conclusion: End your paper by comparing the study findings to your own clinical practice experience in relation to implementation of evidence-based practice guidelines. In your own experience, do you find the results from New Zealand nurses to be similar to what happens in your own USA-based clinical practice setting?
The Synopsis Questions Are
What does the guideline address?
What population of patients is the guideline intended to address?
Did the panel use existing SRs or did they conduct their own?
What clinical outcomes was the guideline designed to achieve?
What group or groups produced the guideline?
What is the date on it and how recent are the cited evidence sources?
What are the main recommendations?
Solution
Article Analysis: Barriers and Enablers to Implementation of a New Zealand-Wide Guideline for Assessment and Management of Cardiovascular Risk in Primary Health Care: A Template Analysis
Introduction
Increased literature has been developed towards ascertaining the impact of evidence-based healthcare. Nevertheless, for such evidence to be included in the day to day practices of nurses, proper guidelines have to be developed and put in place to facilitate implementation. McKillop, Crisp, and Walsh engaged in a study that identified the various factors that enabled or barred implementation of such guidelines in the healthcare environment.
Purpose of the study
The main purpose of the study was to identify the barriers and enablers to implementation of evidence-based practice guidelines in the health care setting using the Promoting Action on Research Implementation in Health Services (PARIHS) to analyze and interpret data (McKillop, Crisp, & Walsh, 2012). At this point, it is without doubt that guidelines to clinical practice are key to improving the outcomes of healthcare. Nevertheless, the authors insists that implementation of such guidelines is highly unpredictable and complex (McKillop, Crisp, & Walsh, 2012). Identification of the barriers and enablers is important as it is meant to allow the healthcare organizations to promote implementation enablers and minimize the barriers, in view of enhancing disease outcomes.
Participants
The authors covered a wide scope of participants in the study, representing most of the professionals in the health care setting, who employ evidence-based practice in their day-to-day practice (McKillop, Crisp, & Walsh, 2012). To get an accurate verdict of the factors that inhibit or enhance implementation of evidence-based guidelines, the authors thus involved 4 general practitioners, 20 nurses from the primary healthcare setting, and 5 managers in focus groups. The research also involved 3 planners as participants, who were involved in interviews, in which they discussed how they contributed towards employment of evidence-based guidelines in cardiovascular risk assessment and management (McKillop, Crisp, & Walsh, 2012).
Methodology
The authors employed a descriptive qualitative study, in which the primary healthcare professionals in New Zealand provided a description of their experiences in the implementation of the AMCVR guideline (McKillop, Crisp, & Walsh, 2012). The authors chose the primary health care setting as the location of the study considering the level of health need in this area and the deprivation experienced. Data was collected using interviews and focus groups. The venues and timing of collection of data remained at the participants’ discretion, with the authors carrying out such meeting at venues convenient to the schedules and the workplaces of the participants. The nurse focus groups were taken through 65-minute sessions, while those involving general practitioners and managers involved 30-minute sessions (McKillop, Crisp, & Walsh, 2012).
Findings
According to the findings of the study, all the participants presented various complex contextual influences, which mapped low and high leadership and culture sub-element indicators, and low evaluation indicators. (McKillop, Crisp, & Walsh, 2012) Both the interviews and focus groups portrayed their work in a manner that showed how committed they were to minimizing cases of cardiovascular disease and related deaths. It was also clear from the participant responses that the healthcare model in place was not as suitable for management of cardiovascular conditions as it was for the management of other acute cases (McKillop, Crisp, & Walsh, 2012).
Conclusion
It is clear from the
findings of the researchers that the implementation of guidelines in the
healthcare setting is highly influenced by the context in which it is
implemented. This is the case in my organization, where the guidelines would be
easily adopted if they were specific to their area of application. Case in
point, the cardiovascular health unit would easily adopt cardiovascular disease
management guidelines. The culture of evidence-based practice defines how
committed individuals would be in implementing guidelines in their daily
practice (Brown, 2014). Lastly, it is clear
in my organization that leadership provides individuals with the direction in
application of evidence-based practices and the related guidelines.
References
Brown, S. J. (2014). Evidence-Based Nursing: The Research-Practice Connection (3rd ed.). Burlington, MA: Jones & Bartlett Learning.
McKillop, A., Crisp, J., & Walsh, K. (2012). Barriers and Enablers to Implementation of a New Zealand-Wide Guideline for Assessment and Management of Cardiovascular Risk in Primary Health Care: A Template Analysis. Worldviews on Evidence-Based Nursing, 9(3), 159-171.