Evidence map›Paper›PMID 38644671›Full record

ArticleJournal of advanced nursing2025

First-line managers' experience of guideline implementation during the COVID-19 pandemic.

Erika Fjordkvist, Ann Catrine Eldh, Madeleine Winberg, Eva Joelsson-Alm, Maria Hälleberg Nyman

Open access · hybridAbstract read
In one paragraph

Article in Journal of advanced nursing, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.8field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 3 institutions in 1 country.

Erika FjordkvistFaculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden.ORCID https://orcid.org/0000-0002-8577-9951
Ann Catrine EldhFaculty of Medicine and Health Sciences, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
Madeleine WinbergFaculty of Medicine and Health Sciences, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
Eva Joelsson-AlmDepartment of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.ORCID https://orcid.org/0000-0002-9041-2468
Maria Hälleberg NymanFaculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden.ORCID https://orcid.org/0000-0003-0460-3864
Linköping University · SEÖrebro University · SEKarolinska Institutet · SE

Funding

Forskningsrådet om Hälsa, Arbetsliv och Välfärd STYA-2020/0002Nyckelfonden
6 · The paper itself

Abstract

AIM(S): To explore first-line managers' experience of guideline implementation in orthopaedic care during the COVID-19 pandemic.

designA descriptive, qualitative study.

methodsSemi-structured interviews with 30 first-line nursing and rehabilitation managers in orthopaedic healthcare at university, regional and local hospitals. The interviews were analysed by thematic analysis.

resultsFirst-line managers described the implementation of guidelines related to the pandemic as different from everyday knowledge translation, with a swifter uptake and time freed from routine meetings in order to support staff in adoption and adherence. The urgent need to address the crisis facilitated guideline implementation, even though there were specific pandemic-related barriers such as staffing and communication issues. An overarching theme, Hanging on to guidelines for dear life, is substantiated by three themes: Adapting to facilitate change, Anchoring safety through guidelines and Embracing COVID guidelines.

conclusionA health crisis such as the COVID-19 pandemic can generate enabling elements for guideline implementation in healthcare, despite prevailing or new hindering components. The experience of guideline implementation during the COVID-19 pandemic can improve understanding of context aspects that can benefit organizations in everyday translation of evidence into practice. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Recognizing what enabled guideline implementation in a health crisis can help first-line managers to identify local enabling context elements and processes. This can facilitate future guideline implementation. IMPACT: During the COVID-19 pandemic, the healthcare context and staff's motivation for guideline recognition and adoption changed. Resources and ways to bridge barriers in guideline implementation emerged, although specific challenges arose. Nursing managers can draw on experiences from the COVID-19 pandemic to support implementation of new evidence-based practices in the future. REPORTING

methodThis study adheres to the EQUATOR guidelines by using Standards for Reporting Qualitative Research (SRQR). No Patient or Public Contribution.

Indexed as

COVID-19Guideline AdherenceOrthopedicsPractice Guidelines as TopicAdultFemaleHumansMaleMiddle AgedPandemicsQualitative ResearchSARS-CoV-2clinical practiceCOVID‐19 pandemicfirst‐line managerguidelinesimplementation leadershipknowledge implementation

Identifiers

PMID38644671
PMCPMC12535347
OpenAlexW4395009492

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.