Provider attitudes and beliefs about clinical practice guidelines.

The goals of clinical practice guidelines (CPG) are to improve the process and outcomes of health care, decrease practice variation, and optimize resource utilization. The objectives of this study were to (a) describe overall provider attitudes and beliefs about CPG, and (b) describe provider attitudes and acceptance of two specific spinal cord injury (SCI) CPG. A total of 152 health care providers responsible for implementation of the CPG at participating Veterans Health Administration (VHA) SCI sites responded to a survey (response rate of 35%). Overall, SCI care providers expressed positive attitudes towards CPG, including the two SCI guidelines included in this study. A comparison of responses revealed relatively few areas in which differences existed among SCI facilities and provider groups. Nurses represented the largest provider group participating in this survey and consistently expressed the most positive responses. In particular, nurses were more positive about guidelines, recognized the benefits of the guidelines, and were more willing to support the development of guidelines, compared to other providers in the study. The results of this study suggest that negative attitudes and beliefs about guidelines might be less of an obstacle to guideline implementation in VHA SCI Centers. Nurses are in a position to play a key role in their implementation.