Indicators to measure implementation and sustainability of nursing best practice guidelines: A mixed methods analysis.

Autor:	Aloisio LD; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada., Graham N; University of Ottawa, Faculty of Health Sciences, School of Nursing, Ottawa, ON, Canada., Grinspun D; Registered Nurses' Association of Ontario, Toronto, ON, Canada., Naik S; Registered Nurses' Association of Ontario, Toronto, ON, Canada., Coughlin M; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada., Medeiros C; Registered Nurses' Association of Ontario, Toronto, ON, Canada.; Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada., McConnell H; Registered Nurses' Association of Ontario, Toronto, ON, Canada., Sales A; Sinclair School of Nursing and Department of Family and Community Medicine, University of Missouri, Columbia, MO, USA.; Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA., McNeill S; Registered Nurses' Association of Ontario, Toronto, ON, Canada., Santos WJ; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada., Squires JE; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.; University of Ottawa, Faculty of Health Sciences, School of Nursing, Ottawa, ON, Canada.
Jazyk:	angličtina
Zdroj:	Heliyon [Heliyon] 2023 Sep 09; Vol. 9 (9), pp. e19983. Date of Electronic Publication: 2023 Sep 09 (Print Publication: 2023).
DOI:	10.1016/j.heliyon.2023.e19983
Abstrakt:	Background: The use of best practice guidelines (BPGs) has the potential to decrease the gap between best evidence and nursing and healthcare practices. We conducted an exploratory mixed method study to identify strategies, processes, and indicators relevant to the implementation and sustainability of two Registered Nurses' Association of Ontario (RNAO) BPGs at Best Practice Spotlight Organizations® (BPSOs). Methods: Our study had four phases. In Phase 1, we triangulated two qualitative studies: a) secondary analysis of 126 narrative reports detailing implementation progress from 21 BPSOs spanning four sectors to identify strategies and processes used to support the implementation and sustainability of BPGs and b) interviews with 25 guideline implementers to identify additional strategies and processes. In Phase 2, we evaluated correlations between strategies and processes identified from the narrative reports and one process and one outcome indicator for each of the guideline. In Phase 3, the results from Phases 1 and 2 informed indicator development, led by an expert panel. In Phase 4, the indicators were assessed internally by RNAO staff and externally by Ontario Health Teams. A survey was used to validate proposed indicators to determine relevance, feasibility, readability, and usability with knowledge users and BPSO leaders. Results: Triangulation of the two qualitative studies revealed 46 codes of implementation and sustainability of BPGs, classified into eight overarching themes: Stakeholder Engagement, Practice Interventions, Capacity Building, Evidence-Based Culture, Leadership, Evaluation & Monitoring, Communication, and Governance. A total of 28 structure, process, or outcome indicators were developed. End users and BPSO leaders were agreeable with the indicators according to the validation survey. Conclusions: Many processes and strategies can influence the implementation and sustainability of BPGs at BPSOs. We have developed indicators that can help BPSOs promote evidence-informed practice implementation of BPGs. Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: We received ethical approval from the University of Ottawa Ethics Board (file number: H09-17-13), The Ottawa Hospital Research Institute Ethics Board (file number: 20180366-01H) and the Toronto Public Health Research Ethics Board (file number: 2018-12). Janet Elaine Squires reports financial support was provided by Registered Nurses Association of Ontario. Doris Grinspun reports a relationship with Registered Nurses Association of Ontario that includes: board membership. Shanoja Naik reports a relationship with Registered Nurses Association of Ontario that includes: employment. Christina Medeiros reports a relationship with Registered Nurses Association of Ontario that includes: employment. Heather McConnell reports a relationship with Registered Nurses Association of Ontario that includes: employment. Susan McNeill reports a relationship with Registered Nurses Association of Ontario that includes: employment. (© 2023 The Authors.)
Databáze:	MEDLINE
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