Lessons learned in implementing SCI clinical practice guidelines.

Maylou Guihan*, Helen T. Bosshart, Audrey Nelson

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

24 Scopus citations


While clinical practice guidelines (CPGs) were designed as a tool to improve patient outcomes, decrease practice variation, and optimize resource utilization, providers often encounter significant barriers to integrating these into clinical practice. A study was conducted at six spinal cord injury (SCI) centers in the Department of Veterans Affairs (VA) to improve provider adherence and patient outcomes of two CPGs: Prevention of Thromboembolism in Spinal Cord Injury and Neurogenic Bowel Management in Adults With Spinal Cord Injury. To design effective implementation strategies, focus groups were conducted to identify provider-perceived barriers and facilitators to implementing recommendations for each of the SCI guidelines. Based on this information, four guideline implementation strategies were designed: (a) use of local opinion leaders ("clinical champions"), (b) patient-mediated interventions, (c) standardized documentation template/standing orders, and (d) social marketing/outreach visits. These strategies were implemented at each site. This article identifies "lessons learned" during the process of trying to get these CPGs embedded into clinical practice.

Original languageEnglish (US)
Pages (from-to)136-142
Number of pages7
JournalSCI nursing : a publication of the American Association of Spinal Cord Injury Nurses
Issue number3
StatePublished - Jan 1 2004

ASJC Scopus subject areas

  • General Medicine


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