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Developing leadership capacity for guideline use: a pilot cluster randomized control trial.
Wendy A Gifford1, Barbara L Davies, Ian D Graham
1School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada. wgifford@uottawa.ca
Worldviews on Evidence-Based Nursing
|June 1, 2012
Summary
A pilot leadership intervention showed potential for influencing nurses' adherence to clinical guidelines for diabetic foot ulcers. Further research is needed to refine the intervention and outcome measures for improved guideline use.
Area of Science:
- Nursing
- Healthcare Management
- Clinical Practice Guidelines
Background:
- Leadership significantly impacts nurses' adoption of clinical guidelines.
- Developing and evaluating leadership interventions for guideline use requires further investigation.
Purpose of the Study:
- To pilot a leadership intervention aimed at increasing nurses' use of guideline recommendations for diabetic foot ulcer care in home health.
- To assess the feasibility of the study protocol, evaluate nursing process outcomes, and examine leadership behaviors.
Main Methods:
- Mixed-methods pilot study employing a post-only cluster randomized controlled trial and qualitative interviews.
- Four home care units were randomized; intervention group received a 12-week leadership program.
- Feasibility assessed via protocol design, intervention, measures, and data collection; trial used chart audits for nursing process outcomes.
Main Results:
- The pilot demonstrated feasibility in some protocol aspects, with others needing refinement.
- No significant difference was found in the primary outcome measure.
- A significant increase in a secondary outcome measure (5-item score) was observed in the intervention group (p = 0.02).
- Relations-oriented leadership behaviors, audit, and feedback were identified as key strategies in the experimental group.
Conclusions:
- The leadership intervention shows promise for influencing nurses' guideline use, but requires refinement.
- Further development of the intervention and outcome measures is necessary.
- A proposed taxonomy of leadership behaviors aims to guide future research in this area.
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