Dataset Information

Strategies, facilitators and barriers to implementation of evidence-based practice in community nursing: a systematic mixed-studies review and qualitative synthesis.

ABSTRACT: AimTo appraise and synthesize empirical literature on implementation of evidence within community nursing. To explore the use of implementation theory and identify the strategies required for, and the barriers and facilitators to, successful implementation within this context.

Background

There is an international consensus that evidence-based practice can improve outcomes for people using health and social care services. However, these practices are not always translated into care delivery. Community nursing is a relatively understudied area; little is known about how innovations in practice are implemented within this setting.

Methods

Systematic mixed-studies review, synthesizing quantitative and qualitative research. The electronic databases AMED, PsycINFO, Ovid Medline, CINAHL Plus, ASSIA, British Nursing Index and EMBASE were used. Two grey literature databases were also searched: OpenGrey and EThOS. English language, peer-reviewed papers published between January 2010 and July 2017 were considered. Criteria included implementation of an innovation and change to practice within adult community nursing. An approach called Critical Interpretive Synthesis was used to integrate the evidence from across the studies into a comprehensible theoretical framework.

Results

In total, 22 papers were reviewed. Few studies discussed the use of theory when planning, guiding and evaluating the implementation of the innovation (n=6). A number of implementation strategies, facilitators and barriers were identified across the included studies, highlighting the interplay of both service context and individual factors in successful implementation.

Conclusion

Implementation is an expanding area of research; yet is challenged by a lack of consistency in terminology and limited use of theory. Implementation within community nursing is a complex process, requiring both individual and organizational adoption, and managerial support. Successful adoption of evidence-based practice however, is only possible if community nurses themselves deem it useful and there is evidence that it could have a positive impact on the patient and/or their primary carer.

SUBMITTER: Mathieson A

PROVIDER: S-EPMC6476399 | biostudies-literature | 2019 Jan

REPOSITORIES: biostudies-literature

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Publications

Strategies, facilitators and barriers to implementation of evidence-based practice in community nursing: a systematic mixed-studies review and qualitative synthesis.

Mathieson Amy A Grande Gunn G Luker Karen K

Primary health care research & development 20180802

AimTo appraise and synthesize empirical literature on implementation of evidence within community nursing. To explore the use of implementation theory and identify the strategies required for, and the barriers and facilitators to, successful implementation within this context.<h4>Background</h4>There is an international consensus that evidence-based practice can improve outcomes for people using health and social care services. However, these practices are not always translated into care deliver ...[more]

PMID: 30068402

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Project description:South Africa has implemented a community-based HIV programme (CBHP) in its primary healthcare (PHC) re-engineering strategy that aims to improve public healthcare delivery. This CBHP is delivered by ward-based outreach teams (WBOTs); provision of community HIV services comprises an important component of this programme. We conducted an exploratory study to determine the facilitators and barriers to successful implementation of this CBHP in rural Mopani District, South Africa. Focus group discussions were conducted with the community health workers (CHWs) and PHC nurses; participant interviews were conducted with community members who access these health services, community leaders, and social workers. We conducted a thematic content analysis and based on the key themes reported, we identified the Consolidated Framework for Implementation Research, consisting of five domains, as the most appropriate model to interpret our findings. First, in terms of intervention characteristics, community members generally valued the HIV services provided, but the variable needs impacted on programme implementation. Outer setting challenges include inability to meet the need of patients as a result of stigma, non-disclosure of HIV status and social factors. In terms of the inner setting, CHWs were grateful for the equipment and training received but expressed the need for better support of management and the provision of additional resources. With regard to characteristics of the implementers, the CHWs expressed the desire for further training despite reporting having sufficient knowledge to conduct their HIV work. Finally, in terms of the implementation process, the importance of relationship building between CHWs and community members was emphasised. In conclusion, these data underline the positive receipt and potential of the CBHP in this rural district and identify areas to further strengthen the programme. The success and sustainability of the CBHP requires ongoing commitment of resources, training, supervision, and organisational support in order to operate effectively and efficiently.

Dataset Information

Strategies, facilitators and barriers to implementation of evidence-based practice in community nursing: a systematic mixed-studies review and qualitative synthesis.

Background

Methods

Results

Conclusion

Publications

Strategies, facilitators and barriers to implementation of evidence-based practice in community nursing: a systematic mixed-studies review and qualitative synthesis.

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