Diffusion of a Distress Management Guideline into practice

Area of Science:

• Oncology Nursing
• Healthcare Quality Improvement
• Evidence-Based Practice Implementation

Background:

• Patient distress is a significant concern in oncology care.
• The National Comprehensive Cancer Network Distress Management Guideline (DMG) provides a framework for addressing distress.
• Barriers to guideline adoption can impede effective distress management in outpatient oncology settings.

Purpose of the Study:

• To identify system and clinician-related barriers to adopting the DMG in oncology outpatient practice.
• To determine predictors of DMG adoption among oncology nurses.
• To inform interventions aimed at improving DMG implementation.

Main Methods:

• A descriptive, correlational study design was employed.
• A national sample of 409 oncology nurses in outpatient settings was surveyed.
• Surveys were administered electronically or via mail.

Main Results:

• Only 17% of surveyed nurses used the DMG, with time, staff uncertainties, and ambiguous accountability cited as major barriers.
• Nurses using the DMG reported greater comfort discussing distress, longer tenure, higher colleague valuation of distress screening, and more supportive organizational processes.
• Key predictors of DMG use included increased familiarity with the guideline, lower perceived barriers, non-profit hospital status, and urban/rural work settings.

Conclusions:

• Barriers and predictors for DMG adoption were identified, suggesting targets for intervention.
• Interventions enhancing familiarity with the DMG and clarifying team responsibilities in distress screening and management are recommended.
• Further research is needed to evaluate the impact of such interventions on patient care outcomes.