• Caroline Marchionni and Judith Ritchie.
• McGill University Health Centre, QC, Canada.
• J Nurs Manag. 2008 Apr 1;16(3):266-74.

BackgroundThe 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.AimA 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.MethodsA quantitative survey of nursing staff was conducted.ResultsResults from the pilot study reveal variability in best practice guideline implementation despite the presence of a culture of organizational learning and transformational leadership.ConclusionsThere 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 ManagementNursing 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.

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