DOI: 10.12688/f1000research.188193.1 ISSN: 2046-1402

Availability, Accessibility, Implementation, and Perceived Effectiveness of Clinical Practice Guidelines Among Healthcare Professionals in District Teaching Hospitals in the Eastern Cape Province, South Africa

Bomkazi Majeke, Linda Sobekwa, Thokoe Vincent Makola, Siyonela Mlonyeni, Ntandazo Dlatu, G.A. Pulido Estrada, Mirabel Nanjoh
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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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