Impact of advanced practice nurses in hospital units on compliance with clinical practice guidelines: a quasi-experimental study

• Published in: BMC nursing 2022-11, Vol.21 (1), p.331-331, Article 331
• Main Authors: Pol-Castañeda, Sandra, Rodriguez-Calero, Miguel Angel, Villafáfila-Gomila, Carlos Javier, Blanco-Mavillard, Ian, Zaforteza-Lallemand, Concepción, Ferrer-Cruz, Francisco, De Pedro-Gómez, Joan Ernest
• Format: Article
• Language: English
• Subjects: Advanced practice nurses; Advanced practice nursing; Clinical outcomes; Clinical practice guidelines; Data collection; Evidence-based practice; Hospitalization; Hospitals; Intervention; Nurses; Nursing care; Patients; Practice guideline; Pressure ulcer; Pressure ulcers; Quasi-experimental methods; Vascular access devices; Venous access
• ISSN: 1472-6955; 1472-6955
• DOI: 10.1186/s12912-022-01110-x

Incorporating the best available evidence into clinical practice is a determining challenge for healthcare professionals and organisations. The role of advanced practice nurses is viewed as a facilitator to adapt guideline recommendations to suit specific contexts and to overcome barriers to implementation. In this study, we evaluate the impact of advanced practice nurses on clinical indicators of hospitalised patients and on adherence to recommendations derived from two clinical practice guidelines (pressure ulcer prevention and treatment and vascular access device management). Quasi-experimental study in five intervention (IU) and five control (CU) hospital units at three hospitals in Spain (period 2018-19). Five advanced practice nurses were incorporated into IU, with the intention that would produce attitudinal changes and enhance the skills and knowledge of the nursing team regarding 18 clinical practice recommendations. In this study, 41 indicators were evaluated through direct observation of all patients admitted, at monthly intervals for 1 year. Outcomes were assessed by means of a descriptive, multi-line regression and association analysis. The study population was composed of 3742 inpatients admitted for pressure ulcer assessment and 2631 fitted with vascular access devices. By the end of the study period, all variables had improved in the IU, where average compliance with recommendations was statistically significantly higher (pressure ulcer guidance 7.9 ± 1.9 vs 6.0 ± 1.7. OR 1.86, 95% CI 1.67-2.05; vascular access devices guidance 5.4 ± 1.4 vs 4.4 ± 1,6. OR 1.06, 95% CI 0.95-1.17). The prevalence of pressure lesions and catheter-related adverse events decreased statistically significantly in the IU compared to the CU. The prevalence of pressure ulcers decreases (5.7% in IU vs 8.7% in CU p