Nurses' perceived barriers to the implementation of a Fall Prevention Clinical Practice Guideline in Singapore hospitals

BackgroundTheories of behavior change indicate that an analysis of barriers to change is helpful when trying to influence professional practice. The aim of this study was to assess the perceived barriers to practice change by eliciting nurses\u27 opinions with regard to barriers to, and facilitators of, implementation of a Fall Prevention clinical practice guideline in five acute care hospitals in Singapore.MethodsNurses were surveyed to identify their perceptions regarding barriers to implementation of clinical practice guidelines in their practice setting. The validated questionnaire, \u27Barriers and facilitators assessment instrument\u27, was administered to nurses (n = 1830) working in the medical, surgical, geriatric units, at five acute care hospitals in Singapore.ResultsAn 80.2% response rate was achieved. The greatest barriers to implementation of clinical practice guidelines reported included: knowledge and motivation, availability of support staff, access to facilities, health status of patients, and, education of staff and patients.ConclusionNumerous barriers to the use of the Fall Prevention Clinical Practice Guideline have been identified. This study has laid the foundation for further research into implementation of clinical practice guidelines in Singapore by identifying barriers to change in acute care settings.<br /

Amniocentesis due to advanced maternal age: The role of marital intimacy in couples’ decision-making process

Due to the risk of fetal anomaly, pregnant women of advanced maternal age are given the option to undergo amniocentesis. In our study we aimed to describe couples’ decision-making process regarding amniocentesis, and assess whether it is influenced by marital intimacy and men’s participation in genetic counseling. During pregnancy, 112 couples answered the Personal Assessment of Intimacy in Relationships questionnaire and scales regarding the decision to undergo amniocentesis. Most couples shared and reached an agreement regarding this decision. Higher levels of marital engagement and communication, but not men’s participation, were associated with higher agreement, influence, and decision-sharing. Clinical implications are discussed