The nursing work of hospital-based clinical practice guideline implementation: An explanatory systematic review using Normalisation Process Theory

May, Carl; Sibley, Andrew; Hunt, Katherine

doi:10.1016/j.ijnurstu.2013.06.019

Cited by 76 publications

(79 citation statements)

References 38 publications

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“…We argue that research use through EB guidelines integrated through a tool such as the huddle board might contribute to improved sustainability of guidelines through persistent routinization of action. This is consistent with other studies suggesting that routinization or normalization increases clinicians' use of guidelines and stimulate guideline sustainability (Fleiszer, Semenic, Ritchie, Richer, & Denis, 2015;May, Sibley, & Hunt, 2014).…”

Section: Standardization and Routinization May Promote Ebp At The Ssupporting

confidence: 91%

Evidence‐based practice integration in hospital wards—The complexities and challenges in achieving evidence‐based practice in clinical nursing

et al. 2019

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Aim Exploring the processes involved in two different strategies to integrate evidence‐based practice into nursing practice. Design Classical grounded theory methodology was used. Methods Data were collected through 90 hr of observation and 4 focus groups among clinical nurses in two different hospital wards. Results We identified a multidimensional evidence‐based practice integration framework that illuminates the complexities involved in the integration process. The dimensions were approaches to evidence‐based practice, positions of evidence‐based practice and levels of evidence‐based practice. The interactions between the dimensions gave five combinations; an explicit evidence‐based practice performed as a parallel to daily work at the systems level, an implicit evidence‐based practice integrated into daily work at the systems level, an explicit evidence‐based practice integrated into daily work at the individual level, an explicit evidence‐based practice integrated into daily work at the systems level and an implicit evidence‐based practice integrated into daily work at the individual level.

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Section: Standardization and Routinization May Promote Ebp At The Ssupporting

confidence: 91%

Evidence‐based practice integration in hospital wards—The complexities and challenges in achieving evidence‐based practice in clinical nursing

et al. 2019

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“…A systematic review of nursing interventions designed to normalize implementation of clinical guidelines highlighted the need to: integrate the change into the current workflow; involve and engage the relevant communities of practice and recognize the reason for that engagement; and build shared commitments across professional boundaries [31]. Another study interviewed nurses to examine factors that facilitate the effective implementation of clinical guidelines [32].…”

Section: Discussionmentioning

confidence: 99%

Changing nutrition care practices in hospital: a thematic analysis of hospital staff perspectives

Laur

Valaitis

Bell

et al. 2017

BMC Health Serv Res

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BackgroundMany patients are admitted to hospital and are already malnourished. Gaps in practice have identified that care processes for these patients can be improved. Hospital staff, including management, needs to work towards optimizing nutrition care in hospitals to improve the prevention, detection and treatment of malnutrition. The objective of this study was to understand how staff members perceived and described the necessary ingredients to support change efforts required to improve nutrition care in their hospital.MethodsA qualitative study was conducted using purposive sampling techniques to recruit participants for focus groups (FG) (n = 11) and key informant interviews (n = 40) with a variety of hospital staff and management. Discussions based on a semi-structured schedule were conducted at five diverse hospitals from four provinces in Canada as part of the More-2-Eat implementation project. One researcher conducted 2-day site visits over a two-month period to complete all interviews and FGs. Interviews were transcribed verbatim while key points and quotes were taken from FGs. Transcripts were coded line-by-line with initial thematic analysis completed by the primary author. Other authors (n = 3) confirmed the themes by reviewing a subset of transcripts and the draft themes. Themes were then refined and further detailed. Member checking of site summaries was completed with site champions.ResultsParticipants (n = 133) included nurses, physicians, food service workers, dietitians, and hospital management, among others. Discussion regarding ways to improve nutrition care in each specific site facilitated the thought process during FG and interviews. Five main themes were identified: building a reason to change; involving relevant people in the change process; embedding change into current practice; accounting for climate; and building strong relationships within the hospital team.ConclusionsHospital staff need a reason to change their nutrition care practices and a significant change driver is perceived and experienced benefit to the patient. Participants described key ingredients to support successful change and specifically engaging the interdisciplinary team to effect sustainable improvements in nutrition care.Trial registrationRetrospectively registered ClinicalTrials.gov Identifier: NCT02800304, June 7, 2016.

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“…It develops by adding many tasks not necessarily related to one another, which makes it diffi cult to remember them and leads to a lack of clarity as to who is allowed (or not allowed) to perform what task (which might explain the fi nding that sometimes nurses perform tasks that they are not authorized to do). May, Sibley & Hunt emphasized that assimilating authority in the fi eld must be associated with tasks that are already being performed and are integrated into the workfl ow [2]. When the tasks are performed sporadically and are not necessarily part of the overall work process, it is almost impossible to systematically remember everything that is permitted.…”

Section: Discussionmentioning

confidence: 99%

“…This study also found that academic education was a predictor for a nurse's attitudes. found that the physicians had greater diffi culty transferring diagnostic tasks to nurses, while some 45% of the physicians agreed that tasks such as writing prescriptions and outlining treatment could be done by specialist nurses [2].…”

Section: Discussionmentioning

confidence: 99%

“…The key characteristics examined were: nurse personalities, management processes, nurse training, certifying procedures and the implementation of the policy by the medical organizations. Successful implementations were linked to practices that were already being conducted and fi tted with the workfl ow [2], commitment from the group taking responsibility for the new task, and the actual need in the fi eld [1,11].…”

Section: Implementing Policy In Medicine and Nursingmentioning

confidence: 99%

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Nurses’ authority in Neonatal Intensive Care Units (NICUs) in Israel- The disparity between policy and Practice

Toren¹,

Tsur²,

Nirel³

et al. 2019

Arch Nursing Pract Care

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Background: Policy implementation is a fundamental aspect in management. This study examined gaps and barriers in the implementation process of governmental policy with respect to the division of responsibility and authority between physicians and nurses.In this study we aimed to examine the work processes and actual division of labor between physicians and nurses in the Neonatal Intensive Care Units (NICUs) and the disparities between them and the Israeli Ministry of Health policy (MOH) and to examine the attitudes of staff members towards the need for policy change Methods: A cross-sectional study, conducted among physicians and nurses at 22 NICUs in Israel. 432 recruited (50% rate). Results:A disparity was found between policy and actual practice. Many of the tasks permitted to RNs by law or regulations are not actually performed by them.The main barriers for authority implementation are the perceived need for approval by a local level, and a lack of nurses' knowledge regarding the tasks they are permitted to perform.Almost half of the respondents believe that the division of work between physicians and nurses requires change. Conclusions:Policy is not fully implemented due to unsuitable regulations to practice processes, lack of knowledge regarding the existed policy and local barriers. There is a need for governmental policy change.

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The nursing work of hospital-based clinical practice guideline implementation: An explanatory systematic review using Normalisation Process Theory

Cited by 76 publications

References 38 publications

Evidence‐based practice integration in hospital wards—The complexities and challenges in achieving evidence‐based practice in clinical nursing

Evidence‐based practice integration in hospital wards—The complexities and challenges in achieving evidence‐based practice in clinical nursing

Changing nutrition care practices in hospital: a thematic analysis of hospital staff perspectives

Nurses’ authority in Neonatal Intensive Care Units (NICUs) in Israel- The disparity between policy and Practice

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