article · F1000Research
A survey of 169 healthcare professionals across two district teaching hospitals in South Africa's Eastern Cape Province assessed how clinical practice guidelines are accessed and utilised. Most respondents, predominantly nurses, reported that guidelines were available in their workplaces and aligned with the local disease burden. Usage rates and confidence in applying the guidelines were high, with overwhelming agreement that they improve patient outcomes and care quality whilst reducing clinical errors. However, less than half believed the materials were updated regularly, and access was largely restricted to printed paper copies, with digital tools and mobile applications rarely used. Major operational barriers included severe shortages of physical resources, staffing constraints, and insufficient professional training. Expanding digital access, ensuring regular updates, and providing structured training could address these implementation bottlenecks in resource-constrained public hospital environments.
Clinical practice guidelines help hospital staff deliver safe, consistent, and evidence-based care. Understanding how healthcare workers access and use these guidelines highlights practical weaknesses in everyday clinical operations. In resource-constrained settings, identifying problems such as out-of-date printed manuals and low training coverage is vital for health authorities seeking to reduce clinical errors and improve patient care standards.
The survey identifies a clear operational gap in digital guideline delivery and mobile application use among hospital staff, indicating an opportunity for health technology developers and education providers. Potential applications include mobile clinical decision-support tools, digital guideline updating platforms, and remote professional development software for healthcare workers. Because this study is an observational survey assessing current hospital conditions, such digital interventions remain at an early concept stage requiring active development and testing.
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Background Clinical practice guidelines (CPGs) are essential evidence-based tools for safe, effective, high-quality healthcare, yet evidence on their availability, accessibility, implementation, and perceived effectiveness in South African district teaching hospitals remains limited. This study evaluated these domains and barriers to CPG use among healthcare professionals in two district teaching hospitals in the Eastern Cape Province, South Africa. Methods A facility-based cross-sectional survey was conducted using a structured, self-administered questionnaire assessing CPG availability, accessibility, implementation, perceived effectiveness, and implementation barriers. Descriptive statistics summarized participant characteristics and responses, while independent-samples t-tests and one-way ANOVA examined differences in composite domain scores across participant characteristics. Results A total of 169 healthcare professionals participated (response rate: 73.8%); 76.3% were female and 79.9% were nurses. Overall, 71.0% reported that CPGs were available in their facilities and 72.2% considered them relevant to the local disease burden, but only 44.3% believed guidelines were updated regularly. Printed hard copies (30.2%) and multiple access methods (26.7%) predominated, whereas digital resources (8.1%) and mobile applications (9.3%) were infrequently used; 7.0% reported no access. Frequent CPG use (80.5%) and confidence in applying guidelines (88.8%) were high, although only 53.9% reported adequate training. Participants perceived CPGs as highly effective in improving patient outcomes (98.8%), reducing clinical errors (97.0%), and enhancing quality of care (95.3%). Principal implementation barriers were inadequate resources (85.8%), staff shortages (76.9%), and insufficient training (72.2%). Conclusions CPGs were generally available, widely used, and perceived as highly effective in supporting evidence-based care in district teaching hospitals. However, gaps remain in guideline updating, equitable access, digital availability, and healthcare worker training. Strengthening institutional support through regular revision, expanded digital access, adequate resourcing, and continuous professional development may enhance CPG implementation and sustainability in resource-constrained settings.
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DOI: 10.12688/f1000research.188193.1
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