Organizational factors that support the implementation of a nursing best practice guideline

J Nurs Manag. 2008 Apr;16(3):266-74. doi: 10.1111/j.1365-2834.2007.00775.x.


Background: The context of the healthcare setting may play a crucial role in influencing the implementation of best practice guidelines in nursing. Further study is required to understand these organizational factors. Two variables, organizational culture and leadership, are thought to influence the adoption of best practice guidelines.

Aim: A discussion of organizational factors that influence best practice guideline adoption is presented. A small pilot study is provided as an example of methods for further research.

Methods: A quantitative survey of nursing staff was conducted.

Results: Results from the pilot study reveal variability in best practice guideline implementation despite the presence of a culture of organizational learning and transformational leadership.

Conclusions: There is beginning evidence in the literature that culture and leadership are key elements influencing guideline implementation. In this pilot work on two inpatient units where a nursing best practice guideline was implemented, a supportive organizational culture and key people leading change were present. Implications for further studies are offered.

Implications for nursing management: Nursing leaders interested in promoting the use of best practice guidelines must pay attention to the organizational context in which nursing care occurs. A supportive culture where learning is valued coupled with transformational leadership may be key factors in the implementation and the sustainability of best practice guidelines.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Attitude of Health Personnel
  • Benchmarking / organization & administration*
  • Diffusion of Innovation*
  • Evidence-Based Medicine
  • Guideline Adherence / organization & administration*
  • Humans
  • Leadership
  • Models, Nursing
  • Models, Psychological
  • Nurse's Role / psychology
  • Nursing Evaluation Research
  • Nursing Staff, Hospital / education
  • Nursing Staff, Hospital / organization & administration*
  • Nursing Staff, Hospital / psychology
  • Organizational Culture
  • Organizational Innovation
  • Pilot Projects
  • Practice Guidelines as Topic*
  • Pressure Ulcer / prevention & control
  • Social Support
  • Surveys and Questionnaires