Exploring implementation of clinical practice guidelines in burn care among nurses in emergency and critical care departments: a mixed methods study

Method

Using an explanatory mixed-methods approach.<br>Results: The study surveyed ED and CCU nurses across two hospitals in Saudi Arabia. In the quantitative phase, 171 nurses responded to a questionnaire testing knowledge of burn care guideline content, motivation to use them, and influencing factors, guided by the Theory of Planned Behaviour (TPB). The findings revealed low knowledge of guideline content, with ED nurses scoring significantly lower than CCU nurses.

However, prior training, whether during studies or at work, was positively associated with better knowledge. Nurses displayed moderate levels of motivation and perceived behavioural control regarding CPG use, with no significant difference between ED and CCU groups. In the qualitative phase, 25 nurses participated in interviews, which revealed three major themes influencing CPG implementation: ‘Nurses’ attitudes that impact the implementation of burn care guidelines’, ‘Key relationships’, and ‘External factors.

Finally, data from both phases were integrated and aligned with the overarching theoretical framework of TPB. The analysis of qualitative data almost supported and expanded upon the findings from the quantitative phase. <br>Conclusion: Overall, the study underscores a gap between positive perceptions of burn care CPGs and actual knowledge. Addressing barriers like training deficits and access issues while leveraging facilitators such as team support and positive attitudes could significantly improve the uptake of CPGs, ultimately enhancing patient care in ED and CCU settings.<br><br><i>Thesis is embargoed until 31 July 2029.</i>