The Role of Nursing Best Practice Champions in Diffusing Practice Guidelines: A Mixed Methods Study

Ploeg, Jenny; Skelly, Jennifer; Rowan, Margo; Edwards, Nancy; Davies, Barbara; Grinspun, Doris; Bajnok, Irmajean; Downey, Angela

doi:10.1111/j.1741-6787.2010.00202.x

Cited by 105 publications

(99 citation statements)

References 38 publications

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“…One of the key facilitators of spread in this study, leading with passion and commitment, is consistent with other studies that have found leadership to be critically important for implementing and sustaining innovations [37-39,51]. This finding is consistent with studies inside and outside of health care settings that have shown that the commitment and attitude of leaders has a significant association with the acceptance and use of new innovations [52,53].…”

Section: Discussionsupporting

confidence: 91%

Spreading and sustaining best practices for home care of older adults: a grounded theory study

et al. 2014

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BackgroundImproving health care quality requires effective and timely spread of innovations that support evidence-based practices. However, there is limited rigorous research on the process of spread, factors influencing spread, and models of spread. It is particularly important to study spread within the home care sector given the aging of the population, expansion of home care services internationally, the high proportion of older adult users of home care services, and the vulnerability of this group who are frail and live with multiple chronic conditions. The purpose of this study was to understand how best practices related to older adults are spread within home care organizations.MethodsFour home care organizations in Ontario, Canada that had implemented best practices related to older adults (falls prevention, pain management, management of venous leg ulcers) participated. Using a qualitative grounded theory design, interviews were conducted with frontline providers, managers, and directors at baseline (n =44) and 1 year later (n =40). Open, axial, and selective coding and constant comparison analysis were used.ResultsA model of the process of spread of best practices within home care organizations was developed. The phases of spread included (1) committing to change, (2) implementing on a small scale, (3) adapting locally, (4) spreading internally to multiple users and sites, and (5) disseminating externally. Factors that facilitated progression through these phases were (1) leading with passion and commitment, (2) sustaining strategies, and (3) seeing the benefits. Project leads, champions, managers, and steering committees played vital roles in leading the spread process. Strategies such as educating/coaching and evaluating and feedback were key to sustaining the change. Spread occurred within the home care context of high staff and manager turnover and time and resource constraints.ConclusionsSpread of best practices is optimized through the application of the phases of spread, allocation of resources to support spread, and implementing strategies for ongoing sustainability that address potential barriers. Further research will help to understand how best practices are spread externally to other organizations.

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Section: Discussionsupporting

confidence: 91%

Spreading and sustaining best practices for home care of older adults: a grounded theory study

et al. 2014

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“…Existing ‘nursing champions’ should also be empowered to help diffuse best practice within existing generalist nurses [22], [70].…”

Section: Discussionmentioning

confidence: 99%

Developing an Internationally-Applicable Service Specification for Continence Care: Systematic Review, Evidence Synthesis and Expert Consensus

et al. 2014

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BackgroundGlobal demographic trends suggest that the incidence of both urinary and faecal incontinence will rise in the coming years, bringing significant health and economic implications for both patients and payers. There is limited organisational evidence to guide payers and providers about service configuration which will deliver efficient guideline-compliant, high-quality patient care.ObjectivesTo create, using evidence from a systematic review, qualitative data and expert consensus an internationally applicable service specification for continence care.MethodEvidence was obtained from a systematic and grey literature review of published randomised controlled trials and quasi-experimental studies reporting efficacy of continence service design at the level of the community dwelling patient with either bladder or bowel incontinence, governmental reports and policy frameworks supplemented by data from 47 semi-structured interviews with clinicians, patients, patient-representatives and policy experts from four geographies broadly representative of different healthcare systems.ResultsA number of themes related to current and potential future organisation of continence care were identified from the data. A modular service specification with eight core components was created including case detection, initial assessment and treatment, case co-ordination, caregiver support, community-based support, specialist assessment and treatment, use of containment products, and use of technology. Within this framework important key recommendations are: ensure robust referral pathways, shift assessment for case coordination to nurses specializing in continence care, promote self-management and technology, use comprehensive assessment tools and service performance targets based on outcome and operational measures.ConclusionsThis study has defined practice gaps in the provision of continence services and described eight core components of a service specification for incontinence that commissioners and payers of health and social care could consider using to provide high-quality continence care. A shift towards a community-delivered, nurse-led model appears to be associated with clinical and cost-effective care for people with bladder and bowel incontinence.

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“…Poudarjena pa je tudi potreba po zadostni premišljenosti pri načinu integracije kvantitativne in kvalitativne metodologije oziroma izbor ustreznega raziskovalnega načrta integracije metod glede na raziskovalni problem, upravičena uporaba kvalitativne raziskovalne faze ter zadostna upravičenost uporabe integracije metod glede na raziskovalni problem. 21 raziskav poudarja pomen nadaljnjega raziskovanja, in sicer v obliki priporočil za ponovitev raziskave na sorodnih ali kontrastnih populacijah (18), nadaljnje raziskovanje integracije metod v spletnem raziskovanju (36), uvedbo integracije metod v postopku evalvacije kakovosti novega merskega instrumenta (30), nadaljnja raziskovanja uporabe integracije metod pri sistematični evalvaciji promocijskih zdravstvenih programov (12,15,42,43) in razširitev možnosti uvedbe integracije metod v klinično prakso kot podpore pri razvoju na dokazih podprte prakse (44,38,34,41,39,37,48,45). Mortenson in Oliffe (31) izpostavljata potrebo po nadaljnjem raziskovanju integracije metod na področju delovne terapije, Andrew in Halcomb (10) na področju patronažnega zdravstvenega varstva in Bushy (13) na področju raziskovanja zdravja in zdravstvene nege na podeželju.…”

Section: Razpravljanjeunclassified

Integracija Kvantitativne In Kvalitativne Metodologije V Raziskavah V Zdravstvu: Sistematična Pregledna Študija / Integrating Quantitative and Qualitative Methodology in Health Science Research: A Systematic Review

Zurc¹

2013

Slovenian Journal of Public Health

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The Role of Nursing Best Practice Champions in Diffusing Practice Guidelines: A Mixed Methods Study

Cited by 105 publications

References 38 publications

Spreading and sustaining best practices for home care of older adults: a grounded theory study

Spreading and sustaining best practices for home care of older adults: a grounded theory study

Developing an Internationally-Applicable Service Specification for Continence Care: Systematic Review, Evidence Synthesis and Expert Consensus

Integracija Kvantitativne In Kvalitativne Metodologije V Raziskavah V Zdravstvu: Sistematična Pregledna Študija / Integrating Quantitative and Qualitative Methodology in Health Science Research: A Systematic Review

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