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

2020 ◽  
Author(s):  
Melanie Karrer ◽  
Julian Hirt ◽  
Adelheid Zeller ◽  
Susi Saxer
Keyword(s):  
Scoping Review ◽  
Implementation Process ◽  
Dementia Care ◽  
Barriers And Facilitators ◽  
Successful Implementation ◽  
Evidence Based ◽  
Management Support ◽  
Implementation Processes ◽  
Culture Of Care ◽  
People With Dementia

Abstract 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 dementia-specific 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.

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

2020 ◽  
Author(s):  
Melanie Karrer ◽  
Julian Hirt ◽  
Adelheid Zeller ◽  
Susi Saxer
Keyword(s):  
Scoping Review ◽  
Implementation Process ◽  
Dementia Care ◽  
Barriers And Facilitators ◽  
Successful Implementation ◽  
Evidence Based ◽  
Management Support ◽  
Implementation Processes ◽  
Culture Of Care ◽  
People With Dementia

Abstract BackgroundThe 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.MethodsWe 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 were included. We searched eight databases until January 2019. Two authors independently selected the studies. For data analysis, we used an inductive approach to build domains and categories.ResultsWe 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). ConclusionsBesides general influencing factors for implementing nursing interventions, we identified dementia-specific 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.

Evidence-based eHealth interventions for caregivers of people with dementia (Myinlife and Partner in Balance): Evaluation of implementations in municipality contexts (Preprint)

2020 ◽  
Author(s):  
Hannah Liane Christie ◽  
Lizzy Mitzy Maria Boots ◽  
Huibert Johannes Tange ◽  
Frans Rochus Josef Verhey ◽  
Marjolein Elizabeth de Vugt
Keyword(s):  
Self Efficacy ◽  
Measurement Instrument ◽  
Implementation Process ◽  
Successful Implementation ◽  
Evidence Based ◽  
Multiple Sources ◽  
Target Groups ◽  
Face To Face ◽  
People With Dementia ◽  
Implementation Context

BACKGROUND Very few evidence-based eHealth interventions for caregivers of people with dementia are implemented into practice. Municipalities are one promising context to implement these interventions, due to their available policy and innovation incentives regarding (dementia) caregiving and prevention. In this study, two evidence-based eHealth interventions for caregivers of people with dementia (Partner in Balance and Myinlife) were implemented in eight municipalities in the Euregion Meuse-Rhine. OBJECTIVE This study’s objectives were to (1.) evaluate this implementation and (2.) investigate determinants of successful implementation. METHODS This study collected eHealth usage data, Partner in Balance coach evaluation questionnaires, and information on implementation determinants. This was done by conducting interviews with the municipality officials, based on the Measurement Instrument for Determinants of Implementation (MIDI). This data from multiple sources and perspectives was integrated and analysed to form a total picture of the municipality implementation process. RESULTS The municipality implementation of Partner in Balance and Myinlife showed varying levels of success. In the end, three municipalities planned to continue the implementation of Partner in Balance, while none planned to continue the implementation of Myinlife. The two Partner in Balance municipalities that did not consider the implementation to be successful, viewed the implementation as an external project. For Myinlife, it was clear that more face-to-face contact was needed to engage the implementing municipality and the target groups. Successful implementations were linked to implementer self-efficacy CONCLUSIONS The experiences of implementing these interventions suggested that this implementation context was feasible regarding the required budget and infrastructure. The need to foster sense of ownership and self-efficacy in implementers will be integrated into future implementation protocols, as part of standard implementation materials for municipalities and organisations implementing Myinlife and Partner in Balance.

Strategies for Successful Implementation of Innovation

2017 ◽  
Vol 8 (2) ◽  
pp. 16-28 ◽  
Author(s):  
Neeta Baporikar
Keyword(s):  
Grounded Theory ◽  
Literature Review ◽  
Implementation Process ◽  
Successful Implementation ◽  
Innovation Implementation ◽  
Implementation Processes ◽  
Innovation Processes ◽  
Multiple Causes

Innovations are vital to most organizations especially in this competitive and globalized scenario. Nevertheless, the results of innovations are in many cases far from satisfactory. Several studies have shown that an organization's failure to benefit from an adopted innovation can often be attributed to a deficient implementation process rather than to the innovation itself. Thus, the implementation process is a critical interface between the decision to adopt and the routine usage of an innovation. Ways and methods to implement innovation effectively have been under scholarship for some time now. Despite the number of studies which identify multiple causes of unsuccessful implementation processes, literature is lacking regarding the crucial aspects of innovation implementation. Building on the derived knowledge of the underlying dynamics of innovation processes, through grounded theory and in-depth literature review, the present study aims to contribute to existing implementation literature by examining the strategic facets of innovation implementation.

Staff Training Aimed at Reducing Rearrest: Probation officer attitudes and experiences

2020 ◽  
Vol 12 (3) ◽  
pp. 238-264
Author(s):  
Jill Viglione ◽  
Lucas M Alward ◽  
DeCarlos L Sheppard
Keyword(s):  
Staff Training ◽  
Implementation Process ◽  
Probation Officer ◽  
Community Supervision ◽  
Successful Implementation ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
Facilitators And Barriers ◽  
Training Programmes ◽  
Officer Attitudes

Community correction organisations have recognised the importance of implementing evidence-based practices to improve probation practice and reduce recidivism rates. Research finds when probation agencies implement evidence-based practices in line with the Risk, Need, Responsivity model with fidelity, reductions in recidivism are possible. However, challenges of implementation persist. To assist in the translation of evidence-based practices to real-world practice, researchers and practitioners developed community supervision officer training programmes. Using qualitative interview data of trained federal probation officers, this study examined the implementation of the Staff Training Aimed at Reducing Rearrest. This study explored (1) probation officer attitudes and perceptions of Staff Training Aimed at Reducing Rearrest, training and implementation process; (2) how users and coaches implement key components of Staff Training Aimed at Reducing Rearrest; and (3) the organisational facilitators and barriers associated with Staff Training Aimed at Reducing Rearrest implementation. Findings suggest positive attitudes towards Staff Training Aimed at Reducing Rearrest for improving supervision process and highlight key facilitators and barriers that can be addressed to support successful implementation efforts.

scholarly journals Cognitive stimulation therapy in dementia care: exploring the views and experiences of service providers on the barriers and facilitators to implementation in practice using Normalization Process Theory

2017 ◽  
Vol 29 (11) ◽  
pp. 1869-1878 ◽  
Author(s):  
Claire Dickinson ◽  
Grant Gibson ◽  
Zoe Gotts ◽  
Lynne Stobbart ◽  
Louise Robinson
Keyword(s):  
Psychosocial Intervention ◽  
Cost Effective ◽  
Dementia Care ◽  
Normalization Process Theory ◽  
Cognitive Stimulation ◽  
Process Theory ◽  
Evidence Based ◽  
Cognitive Stimulation Therapy ◽  
People With Dementia ◽  
Normalization Process

ABSTRACTBackground:Cognitive stimulation therapy (CST) is an evidence-based, cost-effective psychosocial intervention for people with dementia but is currently not a standard part of post-diagnostic care. This qualitative study explored the views and experiences of dementia care providers on the barriers and facilitators to its implementation in usual care.Method:Thirty four semi-structured interviews (24 participants) were conducted across four dementia care sites in the North of England; ten were follow-up interviews. Data were analyzed using thematic analysis and then mapped to the Normalization Process Theory framework.Results:Participants considered CST a “good fit” with their “preferred” ways of working and goals of dementia care namely the provision of person-centered services. For facilitators delivering the intervention, compared to other behavioral interventions, CST was seen to offer benefits to their work and was easy to understand as an intervention. Training in CST and seeing benefits for clients were important motivators. Time and resources were crucial for the successful implementation of CST. Participants were keen to objectively measure benefits to participants but unsure how to do this.Conclusions:CST is a cost-effective psychosocial intervention for people with dementia, recommended by national guidance. Despite our findings which show that, using the NPT framework, there are more facilitators than barriers to the implementation of CST, it is still not a standard part of post-diagnostic dementia care. Further research is needed to explore the reasons for this implementation gap in ensuring evidence-based care in translated into practice.

Influence of leadership on implementing Dementia Care Mapping: A multiple case study

Dementia ◽  
2017 ◽  
Vol 18 (6) ◽  
pp. 1976-1993 ◽  
Author(s):  
Tina Quasdorf ◽  
Sabine Bartholomeyczik
Keyword(s):  
Nursing Homes ◽  
Leadership Style ◽  
Qualitative Content Analysis ◽  
Dementia Care ◽  
Primary Study ◽  
Successful Implementation ◽  
People With Dementia ◽  
Care Mapping ◽  
Dementia Care Mapping

Dementia Care Mapping is an internationally applied method for enhancing person-centred care for people with dementia in nursing homes. Recent studies indicate that leadership is crucial for the successful implementation of Dementia Care Mapping; however, research on this topic is rare. This case study aimed to explore the influence of leadership on Dementia Care Mapping implementation in four nursing homes. Twenty-eight interviews with project coordinators, head nurses and staff nurses were analysed using qualitative content analysis. Nursing homes that failed to implement Dementia Care Mapping were characterised by a lack of leadership. The leaders of successful nursing homes promoted person-centred care and were actively involved in implementation. While overall leadership performance was positive in one of the successful nursing homes, conflicts related to leadership style occurred in the other successful nursing homes. Thus, it is important that leaders promote person-centred care in general and Dementia Care Mapping in particular. Furthermore, different types of leadership can promote successful implementation. Trial registration of the primary study: Current Controlled Trials ISRCTN43916381.

Exemplars Illustrating De-implementation of Tradition-Based Practices

2019 ◽  
Vol 39 (6) ◽  
pp. 64-69 ◽  
Author(s):  
Michele J. Upvall ◽  
Annette M. Bourgault ◽  
Cody Pigon ◽  
Christine A. Swartzman
Keyword(s):  
Internal Medicine ◽  
Critical Care ◽  
Clinical Practice ◽  
Cognitive Dissonance ◽  
Implementation Process ◽  
Barriers And Facilitators ◽  
Evidence Based ◽  
Implementation Barriers ◽  
Complex Process ◽  
Psychological Bias

Clinical practice must be based on evidence. When evidence suggests that a certain practice may be ineffective or even harmful, that practice should be discontinued. The Choosing Wisely campaign, an initiative of the ABIM (American Board of Internal Medicine) Foundation, is intended to bring attention to tradition-based practices, or “sacred cows,” which lack evidence to support their ongoing use. The complex process of discontinuing or reducing the use of tradition-based practices is known as “de-implementation.” Recognizing the importance of de-implementation is necessary to fully understand evidence-based practice. This article explores the de-implementation process, examining its barriers and facilitators. Three critical care exemplars of tradition-based practices are presented and examined through the lens of de-implementation. Barriers and facilitators related to de-implementing these tradition-based practices are described, with an emphasis on the roles of various stakeholders and the need to overcome cognitive dissonance and psychological bias.

scholarly journals Implementation science in maternity care: a scoping review

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Ann Dadich ◽  
Annika Piper ◽  
Dominiek Coates
Keyword(s):  
Implementation Science ◽  
Scoping Review ◽  
Maternity Care ◽  
Data Extraction ◽  
Clinical Care ◽  
Relevant Literature ◽  
Implementation Process ◽  
Theory Model ◽  
Academic Community ◽  
Evidence Based

Abstract Background Despite wide recognition that clinical care should be informed by the best available evidence, this does not always occur. Despite a myriad of theories, models and frameworks to promote evidence-based population health, there is still a long way to go, particularly in maternity care. The aim of this study is to appraise the scientific study of methods to promote the systematic uptake of evidence-based interventions in maternity care. This is achieved by clarifying if and how implementation science theories, models, and frameworks are used. Methods To map relevant literature, a scoping review was conducted of articles published between January 2005 and December 2019, guided by Peters and colleagues’ (2015) approach. Specifically, the following academic databases were systematically searched to identify publications that presented findings on implementation science or the implementation process (rather than just the intervention effect): Business Source Complete; CINAHL Plus with Full Text; Health Business Elite; Health Source: Nursing/Academic Edition; Medline; PsycARTICLES; PsycINFO; and PubMed. Information about each study was extracted using a purposely designed data extraction form. Results Of the 1181 publications identified, 158 were included in this review. Most of these reported on factors that enabled implementation, including knowledge, training, service provider motivation, effective multilevel coordination, leadership and effective communication—yet there was limited expressed use of a theory, model or framework to guide implementation. Of the 158 publications, 144 solely reported on factors that helped and/or hindered implementation, while only 14 reported the use of a theory, model and/or framework. When a theory, model or framework was used, it typically guided data analysis or, to a lesser extent, the development of data collection tools—rather than for instance, the design of the study. Conclusion Given that models and frameworks can help to describe phenomenon, and theories can help to both describe and explain it, evidence-based maternity care might be promoted via the greater expressed use of these to ultimately inform implementation science. Specifically, advancing evidence-based maternity care, worldwide, will require the academic community to make greater explicit and judicious use of theories, models, and frameworks. Registration Registered with the Joanna Briggs Institute (registration number not provided).

How Engaged are Stakeholders in Evidence-Based Treatment Implementation Projects? Results From a Scoping Review of Children’s Mental Health Treatment Projects

2021 ◽  
Author(s):  
Noah S Triplett
Keyword(s):  
Mental Health ◽  
Scoping Review ◽  
Stakeholder Engagement ◽  
Child Mental Health ◽  
The United States ◽  
Successful Implementation ◽  
Evidence Based ◽  
Implementation Phase ◽  
Evidence Based Treatment ◽  
Treatment Implementation

Engaging stakeholders in child mental health evidence-based treatment (EBT) implementation projects may increase the likelihood of successful implementation; However, little is known about the extent of stakeholder engagement to inform the implementation of EBTs. We conducted a scoping review to characterize stakeholder engagement in child mental health EBT implementation projects. We performed data extraction and synthesis to describe key study and stakeholder characteristics, stakeholder engagement methods and rationales, reported impacts of stakeholder engagement, and quality of reporting on stakeholder engagement. We identified a total of 103 unique child mental health EBT implementation projects. The largest number of projects were in the United States and conducted in community mental health settings. Most projects engaged EBT providers during the active implementation phase and with limited depth, often gathering information from stakeholders about barriers and facilitators without sharing decision-making power. Across projects, impacts of stakeholder engagement spanned all implementation outcomes. Given that stakeholder engagement is often shallow and follows initial implementation efforts, additional effort should be made to increase engagement to preempt challenges to EBT implementation and ensure implementation success. Such efforts may ensure the just distribution of power in EBT implementation efforts and could be essential in addressing mental health disparities.

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