Hospital-based interventions: a systematic review of staff-reported barriers and facilitators to implementation processes

Geerligs, Liesbeth; Rankin, Nicole; Shepherd, Heather L.; Butow, Phyllis

doi:10.1186/s13012-018-0726-9

Cited by 263 publications

(302 citation statements)

References 69 publications

Supporting

Mentioning

271

Contrasting

Unclassified

Order By: Relevance

“…Literature reviews addressing other patient groups confirm that staff knowledge, skills and attitudes are important factors in the implementation process [44,45]. Our results show additional dementia-specific factors: professional's individual focus of care and conflicts due to different cultures of care within the team.…”

Section: Discussionsupporting

confidence: 52%

“…In a systematic review addressing barriers and facilitators to general implementation processes in hospitals, Geerligs et al described the culture of the system as an influencing factor in combination with staff workload, lack of time, and high staff turnover. The culture of the system comprises the attitudes of employees as well as organisational readiness to change [44]. This is far beyond the culture of care as such.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

What hinders and facilitates the implementation of nurse-led interventions in dementia care? A scoping review

et al. 2020

View full text Add to dashboard Cite

Background: The implementation of evidence-based interventions for people with dementia is complex and challenging. However, successful implementation might be a key element to ensure evidence-based practice and high quality of care. There is a need to improve implementation processes in dementia care by better understanding the arising challenges. Thus, the aim of this study was to identify recent knowledge concerning barriers and facilitators to implementing nurse-led interventions in dementia care. Methods: We performed a scoping review using the methodological framework of Arksey and O'Malley. Studies explicitly reporting on the implementation process and factors influencing the implementation of a nurse-led intervention in dementia care in all settings were included. We searched eight databases from January 2015 until January 2019. Two authors independently selected the studies. For data analysis, we used an inductive approach to build domains and categories. Results: We included 26 studies in the review and identified barriers as well as facilitators in five domains: policy (e.g. financing issues, health insurance), organisation (e.g. organisational culture and vision, resources, management support), intervention/implementation (e.g. complexity of the intervention, perceived value of the intervention), staff (e.g. knowledge, experience and skills, attitude towards the intervention), and person with dementia/family (e.g. nature and stage of dementia, response of persons with dementia and their families). Conclusions: Besides general influencing factors for implementing nursing interventions, we identified dementiaspecific factors reaching beyond already known barriers and facilitators. A pre-existing person-centred culture of care as well as consistent team cultures and attitudes have a facilitating effect on implementation processes. Furthermore, there is a need for interventions that are highly flexible and sensitive to patients' condition, needs and behaviour.

show abstract

Section: Discussionsupporting

confidence: 52%

Section: Discussionmentioning

confidence: 99%

What hinders and facilitates the implementation of nurse-led interventions in dementia care? A scoping review

et al. 2020

View full text Add to dashboard Cite

show abstract

“…The emergent themes were applied to appropriate frameworks. As the themes from the in-vivo coding were largely nurses' understanding of the passport and challenges they faced in implementing it in their department, they were rst mapped to a comprehensive summary of the known barriers and facilitators taken from a systematic review on implementation of technologies in the hospital setting (13). Themes from the second phase will be discussed in relation to differences between the two groups and the group dynamics.…”

Section: Discussionmentioning

confidence: 99%

“…The themes emerging from the rst round of coding the OSN and GSN transcript were mainly barriers and facilitators of implementation such as lack of time. These themes mapped well onto categories from a systematic review of staff reported barriers and facilitators to the implementation hospital-based intervention (13). This provided a valuable framework to display the key areas reported by the nurses during the focus groups in the wider context of implementation within hospitals.…”

Section: Emergent Themesmentioning

confidence: 99%

Evaluating Implementation of the Diabetes Perioperative Passport: A qualitative focus group study

Akiboye

Page²,

Nirantharakumar

et al. 2020

Preprint

View full text Add to dashboard Cite

AimsTo examine the factors affecting implementation of an empowerment tool for patients with diabetes in two surgical groups within a single district general hospitalBackgroundA perioperative passport was developed to improve care of people with diabetes undergoing elective surgery by equipping patients with a hand-held summary of their care needs. Two surgical groups were approached to be involved in developing and piloting this novel technology with contrasting results. DesignA qualitative study using focus groups to examine factors affecting staff engagement in implementing the diabetes perioperative passport.MethodsTwo focus group were conducted in 2017 with pre-operative nurses in the departments of orthopaedics and general surgery of an NHS trust (N= 8). Audio-taped group discussions were transcribed, and the data coded and analysed to identify themes.FindingsThe general surgical nurse group generally supported each other’s views and comments. They were enthused about the passport throughout. In contrast, the orthopaedic specialist nurse group had initial reservations about implementing the passport, but as the focus group unfolded, they moved from sharing individual views to finding commonalities and became more engaged and motivated to use the passport. ConclusionFocus groups are a practical and efficient tool to conduct within the usual working environment of an NHS hospital. In addition to capturing information about the challenges to implementation they may serve as a crucial implementation tool where evidence-based practice has not been adopted. ImpactThis is the first study carried out in the NHS setting highlighting the benefit of focus groups as a practical implementation tool. Contributions to literature· Diabetes is managed in the outpatient setting with care focusing on education and patient empowerment.· Barriers for implementation of empowerment tools have not been fully explored.· This study suggests the implementation of empowerment tools may pose an additional challenge to more specialist groups.· It demonstrates that focus groups are practical and efficient and may also have utility in the implementation process beyond identifying the barriers to embedding a new technology. · These findings contribute to the small body of evidence on the implementation of empowerment tools and highlight the benefit of focus groups as a useful tool in the implementation process.

show abstract

“…In the past, midwives amongst other care providers have identified these factors as "barriers", such as workplace culture, time constraints, funding and resources and resistance to change (Barwick, 2011;Kennedy, Doig, Hackley, Leslie, & Tillman, 2012). These barriers impinge on clinicians' efforts to adopt new practice or process initiatives (Bayes et al, 2016;Darling, 2016;Geerligs, Rankin, Shepherd, & Butow, 2018;Weir, Newham, Dunlop, & Bennie, 2019). More recently, recognition of other dimensions influential to the implementation process is reported to include individual mindset, knowledge and values of EBP, clinical competence, confidence and collegial collaboration (Mariano et al, 2018).…”

Section: Is Instruments Is the Consolidated Framework For Implementationmentioning

confidence: 99%

Midwives' use of best available evidence in practice: An integrative review

Leo

Bayes

Geraghty

et al. 2019

Journal of Clinical Nursing

View full text Add to dashboard Cite

Aims and objectives To synthesise international research that relates to midwives' use of best available evidence in practice settings and identify key issues relating to the translation of latest evidence into everyday maternity care. Background Midwifery is a research‐informed profession. However, a gap persists in the translation of best available evidence into practice settings, compromising gold standard maternity care and delaying the translation of new knowledge into everyday practice. Design A five‐step integrative review approach, based on a series of articles published by the Joanna Briggs Institute (JBI) for conducting systematic reviews, was used to facilitate development of a search strategy, selection criteria and quality appraisal process, and the extraction and synthesis of data to inform an integrative review. Methods The databases CINAHL, MEDLINE, Web of Science, Implementation Science Journal and Scopus were searched for relevant articles. The screening and quality appraisal process complied with the PRISMA 2009 checklist. Narrative analysis was used to develop sub‐categories and dimensions from the data, which were then synthesised to form two major categories that together answer the review question. Results The six articles reviewed report on midwives' use of best available evidence in Australia, the UK and Asia. Two major categories emerged that confirm that although midwifery values evidence‐based practice (EBP), evidence‐informed maternity care is not always employed in clinical settings. Additionally, closure of the evidence‐to‐practice gap in maternity care requires a multidimensional approach. Conclusion Collaborative partnerships between midwives and researchers are necessary to initiate strategies that support midwives' efforts to facilitate the timely movement of best available evidence into practice. Relevance to clinical practice Understanding midwives' use of best available evidence in practice will direct future efforts towards the development of mechanisms that facilitate the timely uptake of latest evidence by all maternity care providers working in clinical settings.

show abstract

Hospital-based interventions: a systematic review of staff-reported barriers and facilitators to implementation processes

Cited by 263 publications

References 69 publications

What hinders and facilitates the implementation of nurse-led interventions in dementia care? A scoping review

What hinders and facilitates the implementation of nurse-led interventions in dementia care? A scoping review

Evaluating Implementation of the Diabetes Perioperative Passport: A qualitative focus group study

Midwives' use of best available evidence in practice: An integrative review

Contact Info

Product

Resources

About