The implementation of evidence-based methods in hospital settings is difficult and complex. The aim of the present study was to highlight the implementation process concerning a new working method, i.e. a new assessment tool, based on the International Classification of Functioning Disability and Health (ICF), among psychiatric nursing staff on five participating wards at a Swedish county hospital. Descriptive, qualitative data were collected through focus group interviews pre-and post-implementation. Data were analysed using directed content analysis, guided by Normalization Process Theory (NPT). The results revealed that just one of the five participating wards met the criteria for a successful implementation process. The results confirm previous studies showing the difficulty of implementation. Although participants agreed with the intention of the model, they were reluctant to apply it in practice. The implementation process seemed to be influenced by factors such as: time pressure; heavy workload; stress; lack of routines in using the tool; lack of nursing staff; as well as cultural characteristics and resistance to change.

Background: Clear and effective communication is a prerequisite to provide help and support in healthcare situations, especially in health, and social care services for persons with intellectual disabilities, as these clients commonly experience communication difficulties. Knowledge about how to communicate effectively is integral to ensuring the quality of care. Currently, however, there is a lack of such knowledge among staff working in the disabilities sector, which is exacerbated by challenges in the competence provision in municipal health and social care services. Therefore, the aim of the study was to explore staffs' experience of web-based training in relation to their professional caring for persons with intellectual disabilities and challenging behavior. The intention is to move toward well-evaluated and proven web-based training in order to contribute to competence provision in this specific context.Methods: Fourteen semi-structured interviews were carried out with individual staff members to gather data regarding their experiences with web-based training in relation to their profession. The collected data were analyzed using qualitative content analysis with a focus on both manifest and latent content.Results: The staff's experiences with the web-based training program were presented as a single main theme: “Web-based training for staff initiates a workplace learning process by promoting reflections on and awareness of how to better care for persons with intellectual disabilities and challenging behavior.” This theme contained three categories which are based on eight sub-categories.Conclusion and clinical implications: The benefits of web-based training for workplace learning could clearly be observed in the strengthening of professional care for persons with intellectual disabilities and challenging behavior. Staff members claimed to have gained novel insights about how to better care for clients as well as about the importance of interactions in their encounters with clients. Professional teamwork is crucial to providing effective care for persons with intellectual disabilities and challenging behavior. Hence, future research aimed at investigating the views of other healthcare professionals, such as registered nurses, is recommended to improve the competence provision within municipal health and social care services and thereby enhance the quality of care.

An equal mix of organizational cultures is important for a successful implementation process. The aim of this study was to examine the implementation of a new working method in psychiatric hospital wards, representing different cultural characteristics. Descriptive quantitative data were collected at two hospitals (intervention and control). The results revealed one ward characterized by a mix of organizational cultures. This ward, compared with other intervention wards, showed the best results regarding patient assessed empowerment and participation. The result shows tentatively that organizational culture may have an impact on the implementation processes.

Background/Objective: Over the past decade, many scientific articles have focused on the importance of person-centred care (or person centredness) in the health care sector. In practice, however, person centredness is difficult to operationalise. Thus, the role of “person-centredness coach” was created in a Swedish hospital to provide information, education, and reflection on person centredness. The aim was to describe this new role of a person-centeredness coach, and how the coaches experienced the development of a person-centred working method.Methods: Qualitative semi-structured individual interviews were conducted with nine nursing staff. The data were analysed using inductive content analysis.Results: The analysis resulted in three categories with seven subcategories: an eye opener (with the subcategories of a welcome change and person centredness throughout the organisation); an obstacle with potential (with the subcategories of theoretical vs. practical development of person centredness, difficulties in developing person centredness and proposals for promoting patient participation); and a challenging role (with the subcategories of necessary but a role that takes a long time to develop and the importance of favourable conditions).Conclusions: The person-centredness coaches believed that the person-centred approach was important and that it should be the foundation of all care work within health care but, despite this, had difficulty in integrating person centredness into their practice. The person-centredness coaches found the coach training rewarding. They perceived that, from a learning perspective and through the lens of work-integrated learning, the results could be related to creating praxis, which may be seen as a development area for further research in operationalising person centredness.