Implementation science in maternity care: a scoping review

Abstract

Background Despite wide recognition that clinical care should be informed by the best available evidence, this does not always occur. Despite a myriad of theories, models and frameworks to promote evidence-based population health, there is still a long way to go, particularly in maternity care. The aim of this study is to appraise the scientific study of methods to promote the systematic uptake of evidence-based interventions in maternity care. This is achieved by clarifying if and how implementation science theories, models, and frameworks are used. Methods To map relevant literature, a scoping review was conducted of articles published between January 2005 and December 2019, guided by Peters and colleagues’ (2015) approach. Specifically, the following academic databases were systematically searched to identify publications that presented findings on implementation science or the implementation process (rather than just the intervention effect): Business Source Complete; CINAHL Plus with Full Text; Health Business Elite; Health Source: Nursing/Academic Edition; Medline; PsycARTICLES; PsycINFO; and PubMed. Information about each study was extracted using a purposely designed data extraction form. Results Of the 1181 publications identified, 158 were included in this review. Most of these reported on factors that enabled implementation, including knowledge, training, service provider motivation, effective multilevel coordination, leadership and effective communication—yet there was limited expressed use of a theory, model or framework to guide implementation. Of the 158 publications, 144 solely reported on factors that helped and/or hindered implementation, while only 14 reported the use of a theory, model and/or framework. When a theory, model or framework was used, it typically guided data analysis or, to a lesser extent, the development of data collection tools—rather than for instance, the design of the study. Conclusion Given that models and frameworks can help to describe phenomenon, and theories can help to both describe and explain it, evidence-based maternity care might be promoted via the greater expressed use of these to ultimately inform implementation science. Specifically, advancing evidence-based maternity care, worldwide, will require the academic community to make greater explicit and judicious use of theories, models, and frameworks. Registration Registered with the Joanna Briggs Institute (registration number not provided).

Client Independence Development Model in Wound Treatment Self-Based Treatment and Telenursing Nursing as Visible: A Study Literature (Paradigm of Nursing 21st century)

“…The criteria for the inclusion of articles on phenomena related to the title, define: the population of interest, namely care that is carried out independently at home, regardless of geographical location with interesting phenomena, using implementation science in nursing care provided and results adjusted to theory, model, and framework work used to inform research; related effects; and factors that help or hinder implementation. (Dadich et al, 2021). Journal topics published in 2017 to 2021,: writings included in empirical research, using full names and in English and PRISMA, with study eligibility from title, abstract, methodology, results and full text.…”

Protocol of a Single-Blind Two-Arm (Waitlist Control) Parallel-Group Randomised Controlled Pilot Feasibility Study for mHealth App among Incontinent Pregnant Women

“…Successful implementation of PFMT in maternity care is influenced by three crucial factors: (1) personal factors, (2) organisational factors, and (3) contextual factors [24]. Personal factors include the motivation of the pregnant woman, her perception towards the value of the new behaviour, and PFMT skill development [24].…”

“…Successful implementation of PFMT in maternity care is influenced by three crucial factors: (1) personal factors, (2) organisational factors, and (3) contextual factors [24]. Personal factors include the motivation of the pregnant woman, her perception towards the value of the new behaviour, and PFMT skill development [24]. Organisational factors involve stakeholder engagement in adopting the intervention and service provider involvement in the design and development of the intervention [24].…”

“…Personal factors include the motivation of the pregnant woman, her perception towards the value of the new behaviour, and PFMT skill development [24]. Organisational factors involve stakeholder engagement in adopting the intervention and service provider involvement in the design and development of the intervention [24]. Meanwhile, the contextual factors consist of adapting the intervention to fit into the current maternity service provision and the capacity to accommodate for changes [24].…”

“…Organisational factors involve stakeholder engagement in adopting the intervention and service provider involvement in the design and development of the intervention [24]. Meanwhile, the contextual factors consist of adapting the intervention to fit into the current maternity service provision and the capacity to accommodate for changes [24]. Subsequently, a pilot study should be able to investigate any barriers or issues from these three factors.…”