A Model of Facilitation for Evidence-Based Practice

Harvey, Gill; Kitson, Alison

doi:10.4324/9780203557334-4

Cited by 85 publications

(245 citation statements)

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“…This may be achieved by engaging individuals who have particular impact on their colleagues, such as opinion leaders, champions and boundary spanners [28]. This ties in with the concept of facilitation, that is, enablement of implementation of evidence into practice, which requires an individual with the appropriate roles, skills, knowledge and authority to apply evidence in practice [29, 33]. Nurses in the current study highlighted the need for a designated person to drive implementation of the PUPCB for successful adoption.…”

Section: Discussionmentioning

confidence: 99%

Nurses’ perceptions of a pressure ulcer prevention care bundle: a qualitative descriptive study

et al. 2016

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BackgroundPressure ulcer prevention is a critical patient safety indicator for acute care hospitals. An innovative pressure ulcer prevention care bundle targeting patient participation in their care was recently tested in a cluster randomised trial in eight Australian hospitals. Understanding nurses’ perspectives of such an intervention is imperative when interpreting results and translating evidence into practice. As part of a process evaluation for the main trial, this study assessed nurses’ perceptions of the usefulness and impact of a pressure ulcer prevention care bundle intervention on clinical practice.MethodsThis qualitative descriptive study involved semi-structured interviews with nursing staff at four Australian hospitals that were intervention sites for a cluster randomised trial testing a pressure ulcer prevention care bundle. Four to five participants were purposively sampled at each site. A trained interviewer used a semi-structured interview guide to question participants about their perceptions of the care bundle. Interviews were digitally recorded, transcribed and analysed using thematic analysis.ResultsEighteen nurses from four hospitals participated in the study. Nurses’ perceptions of the intervention are described in five themes: 1) Awareness of the pressure ulcer prevention care bundle and its similarity to current practice; 2) Improving awareness, communication and participation with the pressure ulcer prevention care bundle; 3) Appreciating the positive aspects of patient participation in care; 4) Perceived barriers to engaging patients in the pressure ulcer prevention care bundle; and 5) Partnering with nursing staff to facilitate pressure ulcer prevention care bundle implementation.ConclusionsOverall, nurses found the care bundle feasible and acceptable. They identified a number of benefits from the bundle, including improved communication, awareness and participation in pressure ulcer prevention care among patients and staff. However, nurses thought the care bundle was not appropriate or effective for all patients, such as those who were cognitively impaired. Perceived enablers to implementation of the bundle included facilitation through effective communication and dissemination of evidence about the care bundle; strong leadership and ability to influence staff behaviour; and simplicity of the care bundle.

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Section: Discussionmentioning

confidence: 99%

Nurses’ perceptions of a pressure ulcer prevention care bundle: a qualitative descriptive study

et al. 2016

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“…Fellow nursing staff were also identified as strong referents in regard to managing residents with deteriorating health. This finding was significant because peers not only influence behaviour but also the uptake of new programs at both individual and group levels (Harvey & Kitson, ). The expectations of peers and the perception that others are engaged in a behaviour strengthen intention and are therefore needed when introducing an intervention (Sassen, Kok, & Vanhees, ).…”

Section: Discussionmentioning

confidence: 99%

Nursing staff intentions towards managing deteriorating health in nursing homes: A convergent parallel mixed‐methods study using the theory of planned behaviour

O’Neill

Dwyer

Reid‐Searl

et al. 2018

Journal of Clinical Nursing

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“…It is important to note that researchers working with a facilitation continuum recently have developed their understanding of facilitation, suggesting that facilitators are categorised according to their experience: novice, experienced, and expert facilitators. In this scheme the novice is not capable of performing all facilitation approaches or roles and needs supervision by more experienced facilitators [ 5 ]. This differentiated understanding of facilitation is supported by the findings from this study where most of the facilitators could be perceived as novices, and therefore not yet skilled in mastering a wider range of roles.…”

Section: Discussionmentioning

confidence: 99%

“…Further, since each of these activities can be associated with particular competences, the diversity of potential facilitator roles appears to place heavy demands on the competence span of facilitators. Combined with the lack of a clear and consistent operational definition of facilitation [ 2 , 5 , 7 ] this diversity of potential roles opens up the question of how facilitation is actually enacted in specific interventions where a broad understanding of facilitation is adopted. This line of enquiry also fits well with previous calls for more qualitative research aimed at improving our understanding of facilitation as an implementation approach [ 13 , 15 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

Role enactment of facilitation in primary care – a qualitative study

Due

Thorsen

Waldorff

et al. 2017

BMC Health Serv Res

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BackgroundFacilitation is a widely used implementation method in quality improvement. Reviews reveal a variety of understandings of facilitation and facilitator roles. Research suggests that facilitation interventions should be flexible and tailored to the needs and circumstances of the receiving organisations. The complexity of the facilitation field and diversity of potential facilitator roles fosters a need to investigate in detail how facilitation is enacted. Hence, the purpose of this study was to explore the enactment of external peer facilitation in general practice in order to create a stronger basis for discussing and refining facilitation as an implementation method.MethodsThe facilitation intervention under study was conducted in general practice in the Capital Region of Denmark in order to support an overall strategy for implementing chronic disease management programmes. We observed 30 facilitation visits in 13 practice settings and had interviews and focus groups with facilitators. We applied an explorative approach in data collection and analysis, and conducted an inductive thematic analysis.ResultsThe facilitators mainly enacted four facilitator roles: teacher, super user, peer and process manager. Thus, apart from trying to keep the process structured and focused the facilitators were engaged in didactic presentations and hands-on learning as they tried to pass on factual information and experienced based knowledge as well as their own enthusiasm towards implementing practice changes. While occasional challenges were observed with enacting these roles, more importantly we found that a coaching based role which was also envisioned in the intervention design was only sparsely enacted meaning that the facilitators did not enable substantial internal group discussions during their facilitation visits.ConclusionFacilitation is a complex phenomenon both conceptually and in practice. This study complements existing research by showing how facilitation can be enacted in various ways and by suggesting that some facilitator roles are more likely to be enacted than others, depending on the context and intervention design and the professional background of the facilitators. This complexity requires caution when comparing and evaluating facilitation studies and highlights a need for precision and clarity about goals, roles, and competences when designing, conducting, and reporting facilitation interventions.

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A Model of Facilitation for Evidence-Based Practice

Cited by 85 publications

References 0 publications

Nurses’ perceptions of a pressure ulcer prevention care bundle: a qualitative descriptive study

Nurses’ perceptions of a pressure ulcer prevention care bundle: a qualitative descriptive study

Nursing staff intentions towards managing deteriorating health in nursing homes: A convergent parallel mixed‐methods study using the theory of planned behaviour

Role enactment of facilitation in primary care – a qualitative study

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