Clinical practice guidelines in the nursing home

UMMS Affiliation

Department of Quantitative Health Sciences

Publication Date


Document Type



Diffusion of Innovation; Guideline Adherence; Health Care Surveys; Health Personnel; Humans; Neoplasms; Nursing Homes; Pain; Palliative Care; *Practice Guidelines as Topic; Pressure Ulcer; Quality Assurance, Health Care; Stroke; United States; United States Department of Veterans Affairs; Urinary Incontinence


Biostatistics | Epidemiology | Health Services Research


Clinical practice guidelines are an important tool for improving quality of care. This study determined whether and how guidelines are being used in nursing homes. We surveyed staff at 36 Department of Veterans Affairs (VA) nursing homes. Employees were asked whether they were familiar with guidelines as well as whether 5 specific guidelines had been read, were available, and had been adopted. Among 1065 respondents (60% of those surveyed), 79% reported familiarity with guidelines. The proportion of staff at a facility reporting adoption was generally less than 50%. Those nursing homes in which a high percentage of the staff reported adoption of one guideline were more likely to have adopted other guidelines. However, staff were not more likely to report adoption of a specific guideline when the nurse manager stated that it was adopted. We conclude that staff at VA nursing homes are familiar with guidelines. Guideline adoption at individual nursing homes, however, is not a systematic process involving the entire staff.


Am J Med Qual. 2001 Nov-Dec;16(6):189-95. Link to article on publisher's site

Journal/Book/Conference Title

American journal of medical quality : the official journal of the American College of Medical Quality

PubMed ID


Related Resources

Link to Article in PubMed