Feasibility of a nursing rehabilitation guideline for patients with stroke: evaluating the use by nurses

Abstract

Purpose: To determine the feasibility of the Clinical Nursing Rehabilitation Stroke-guideline (CNRS-guideline) in the care of stroke patients in terms of the experiences, views and attitudes of nurses towards the guideline and their adoption of the guideline and how often the recommendations were used.

Method: A four phase cross sectional design was used. Demographic data were collected from nurses (n=30) and patients (n=105). After each test phase the nurses received questionnaires about their experiences of the guideline including questions about their attitude towards the guideline and adoption of the guideline. Also, how often the recommendations were used was registered.

Results: The nurses’ general impression of the recommendations scored a median of 6.0. A majority of the nurses indicated that the aims of the guideline were clear, that it provided new insights into stroke care. Among the challenges experienced were lack of knowledge and skills and organizational difficulties. Half of the nurses adopted the guideline and the nurses’ attitude towards the guideline scored a median of 6.0.

Conclusion: The guideline provides nurses with an important means for evidence based care for patients with stroke. The guideline was feasible for nurses to use but various challenges need ongoing attention when planning implementation.

Implication for Rehabilitation

• The CNRGS-guideline was found to be feasible for nurses to use in the daily care of patients with stroke, but various challenges, need an ongoing attention.

• The CNRGS-guideline is an important step in the stimulation of quality improvement and efficiency and may result in better outcome and satisfaction of patients with stroke.

• The CNRGS-guideline provides nurses with an important means to provide evidence based care for patients with stroke.

Keywords::

• Clinical practice guidelines
• stroke
• nursing
• rehabilitation nursing
• evidence-based care
• feasibility study

Declaration of Interest: The authors report no conflict of interest. The authors are alone responsible for the content of the paper and did not receive any funding for conducting this study.

Appendix. Members of the Rehabilitation Guideline Stroke Working Group

Thóra B. Hafsteinsdóttir, Rudi Varekamp, Marijke Rensink, Eline Lindeman and Marieke Schuurmans,

Other members:

Dórothea Bergs, RN, MSc, Department of Rehabilitation, Grensás, Landspítali University Hospital, Reykjavík, Iceland

Katrín Björgvinsdóttir, RN, MSc, Department of Neurology (at the time of the study), Landspítali University Hospital, Reykjavík, Iceland

Floor Gooskens, RN, MSc, Division of Neuroscience, Rudolf Magnus Institute University Medical Center Utrecht, Netherlands

Marianne Klinke, RN, MSc, PhD Student, Department of Neurology, Landspítali University Hospital, Reykjavík, Iceland

Janneke de Man-van Ginkel, RN, PhD, Division of Neuroscience, Rudolf Magnus Institute University Medical Center Utrecht, Netherlands

Irina Poslawsky, RN, MSc, PhD Student, Division of Neuroscience, Rudolf Magnus Institute University Medical Center Utrecht, Netherlands

Marijke Rensink, MD, Faculty chair Care for Older People, University of Applied Sciences Utrecht, Faculty of Nursing,

Svanhildur Sigurjónsdóttir, RN, BSc, Department of Neurology, Landspítali University Hospital, Reykjavík, Iceland.

Rudi Varekamp, RN, MSc, Division of Neuroscience, Rudolf Magnus Institute University Medical Center Utrecht, Netherlands

Martine Vergunst, RN, MSc, Division of Neuroscience, Rudolf Magnus Institute University Medical Center Utrecht, Netherlands