| Summary: | Clinical practice guidelines (CPGs) have been developed to support knowledge
transfer in health care settings. Rigorous evaluations assessing the effectiveness of
methods to disseminate and implement CPGs into nursing practice are scarce. A quasiexperimental,
pretest, post-test design was conducted to examine the effect of a
dissemination intervention on nurse adherence to CPGs on tobacco reduction and selfefficacy
in treating tobacco use and dependence. A sample of 138 hospital-based
registered nurses who provided routine pregnancy and postpartum care was recruited
from two hospitals in one urban Regional Health Authority in mid-western Canada.
Following randomisation of hospitals, the dissemination intervention consisting of
academic detailing visits supplemented with a self-study package of print materials, a
video, and a Smoking Cessation Interventions Record form, was administered to nurses
in one hospital. Data were collected from self-administered, baseline and follow-up
questionnaires and nurse documentation of their use of the CPGs during the 10-week
intervention period. At three weeks post intervention, quantitative results indicated the
dissemination intervention positively and significantly enhanced nurse adherence to the
CPGs and boosted self-efficacy beliefs in treating tobacco use and dependence.
Although nurses' perceptions of autonomy modified the effect of the dissemination
intervention on change in beliefs in treating tobacco use and dependence, the
intervention group demonstrated significantly improved self-efficacy scores in
comparison to the control group. Multiple regression analyses revealed three significant
predictors of nurse adherence to CPGs: receiving the intervention (p<0.001); baseline
perceptions about using CPGs (p=0.05); and resource adequacy (p=0.04) and three
significant predictors of self-efficacy: receiving the intervention (p<0.001); working fulltime
(p=0.01); and own value of research (p=0.05). This study demonstrated the
efficacy of a multifaceted intervention on enhancing nurses' use of the CPGs in a
hospital-based maternal child practice setting. Receiving the intervention was clearly
the strongest predictor of self-efficacy beliefs in treating tobacco use and dependence
and nurse adherence to the CPGs on tobacco reduction. The findings broaden our
understanding of how to support hospital-based nurses in using the CPGs on tobacco
reduction and provide direction for improving future dissemination strategies. === Applied Science, Faculty of === Nursing, School of === Graduate
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