دورية أكاديمية
Planning and implementing practice changes in Ontario maternal-newborn hospital units: a secondary qualitative analysis.
| العنوان: | Planning and implementing practice changes in Ontario maternal-newborn hospital units: a secondary qualitative analysis. |
|---|---|
| المؤلفون: | Reszel J; School of Nursing, University of Ottawa, 200 Lees Avenue, Ottawa, ON, K1N 6N5, Canada. jreszel@ohri.ca.; Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada. jreszel@ohri.ca.; Better Outcomes Registry & Network (BORN) Ontario, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada. jreszel@ohri.ca., Daub O; School of Communication Sciences and Disorders, Western University, 1201 Western Road, London, ON, N6G 1H1, Canada., Dunn SI; School of Nursing, University of Ottawa, 200 Lees Avenue, Ottawa, ON, K1N 6N5, Canada.; Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada.; Better Outcomes Registry & Network (BORN) Ontario, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada., Cassidy CE; School of Nursing, Dalhousie University, 5869 University Avenue, Halifax, NS, B3H 4R2, Canada.; IWK Health Centre, 5980 University Avenue, Halifax, NS, B3K 6R8, Canada., Hafizi K; Better Outcomes Registry & Network (BORN) Ontario, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada., Lightfoot M; Women and Children's Health Network, Orillia Soldiers' Memorial Hospital, 170 Colborne St W, Orillia, ON, L3V 2Z3, Canada., Pervez D; Parent Research Advisor, Ottawa, ON, Canada., Quosdorf A; Neonatal Intensive Care Unit, The Ottawa Hospital, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada., Wood A; Better Outcomes Registry & Network (BORN) Ontario, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada., Graham ID; School of Nursing, University of Ottawa, 200 Lees Avenue, Ottawa, ON, K1N 6N5, Canada.; Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada.; School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Ottawa, ON, K1G 5Z3, Canada. |
| المصدر: | BMC pregnancy and childbirth [BMC Pregnancy Childbirth] 2023 Oct 17; Vol. 23 (1), pp. 735. Date of Electronic Publication: 2023 Oct 17. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: BioMed Central Country of Publication: England NLM ID: 100967799 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2393 (Electronic) Linking ISSN: 14712393 NLM ISO Abbreviation: BMC Pregnancy Childbirth Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: London : BioMed Central, [2001- |
| مواضيع طبية MeSH: | Health Personnel* , Maternal Health Services*, Infant, Newborn ; Infant ; Pregnancy ; Female ; Humans ; Ontario ; Quality Improvement ; Hospital Units |
| مستخلص: | Background: Moving evidence into practice is complex, and pregnant and birthing people and their infants do not always receive care that aligns with the best available evidence. Implementation science can inform how to effectively move evidence into practice. While there are a growing number of examples of implementation science being studied in maternal-newborn care settings, it remains unknown how real-world teams of healthcare providers and leaders approach the overall implementation process when making practice changes. The purpose of this study was to describe maternal-newborn hospital teams' approaches to implementing practice changes. We aimed to identify what implementation steps teams take (or not) and identify strengths and potential areas for improvement based on best practices in implementation science. Methods: We conducted a supplementary qualitative secondary analysis of 22 interviews completed in 2014-2015 with maternal-newborn nursing leaders in Ontario, Canada. We used directed content analysis to code the data to seven steps in an implementation framework (Implementation Roadmap): identify the problem and potential best practice; assemble local evidence; select and customize best practice; discover barriers and drivers; tailor implementation strategies; field-test, plan evaluation, prepare to launch; launch, evaluate, and sustain. Frequency counts are presented for each step. Results: Participants reported completing a median of 4.5 of 7 Implementation Roadmap steps (range = 3-7), with the most common being identifying a practice problem. Other steps were described less frequently (e.g., selecting and adapting evidence, field-testing, outcome evaluation) or discussed frequently but not optimally (e.g., barriers assessment). Participants provided examples of how they engaged point-of-care staff throughout the implementation process, but provided fewer examples of engaging pregnant and birthing people and their families. Some participants stated they used a formal framework or process to guide their implementation process, with the most common being quality improvement approaches and tools. Conclusions: We identified variability across the 22 hospitals in the implementation steps taken. While we observed many strengths, we also identified areas where further support may be needed. Future work is needed to create opportunities and resources to support maternal-newborn healthcare providers and leaders to apply principles and tools from implementation science to their practice change initiatives. (© 2023. BioMed Central Ltd., part of Springer Nature.) |
| References: | Implement Sci. 2021 Feb 4;16(1):16. (PMID: 33541371) PLoS One. 2018 Mar 2;13(3):e0193579. (PMID: 29499043) Implement Sci Commun. 2021 Sep 08;2(1):99. (PMID: 34496978) Implement Sci. 2015 Apr 21;10:53. (PMID: 25895742) Qual Health Res. 2005 Nov;15(9):1277-88. (PMID: 16204405) Implement Sci. 2019 Apr 29;14(1):42. (PMID: 31036028) CMAJ Open. 2017 Jan 31;5(1):E82-E89. (PMID: 28401123) Reprod Health. 2014;11 Suppl 1:S5. (PMID: 25178110) Qual Health Res. 2020 Apr;30(5):783-792. (PMID: 31830860) Implement Sci Commun. 2022 Nov 22;3(1):121. (PMID: 36419177) BMJ Qual Saf. 2019 Aug;28(8):635-644. (PMID: 30772816) Health Soc Care Community. 2022 Nov;30(6):e3265-e3276. (PMID: 35775332) J Contin Educ Health Prof. 2006 Winter;26(1):13-24. (PMID: 16557505) Implement Sci. 2015 Feb 12;10:21. (PMID: 25889199) Implement Sci. 2022 Aug 13;17(1):55. (PMID: 35964095) Cochrane Database Syst Rev. 2015 Apr 29;(4):CD005470. (PMID: 25923419) J Pediatr Nurs. 2019 Jul - Aug;47:114-120. (PMID: 31108324) BMJ Qual Saf. 2018 Jun;27(6):425-436. (PMID: 29175856) J Health Organ Manag. 2016;30(2):258-78. (PMID: 27052625) Implement Sci. 2013 Nov 28;8:138. (PMID: 24283365) Implement Sci. 2011 Jul 13;6:72. (PMID: 21752264) BMC Pregnancy Childbirth. 2022 Feb 14;22(1):123. (PMID: 35152880) Int J Epidemiol. 2021 Nov 10;50(5):1416-1417h. (PMID: 34097034) J Oncol Pract. 2018 Jun;14(6):335-340. (PMID: 29750579) Front Public Health. 2019 Jan 22;7:3. (PMID: 30723713) J Obstet Gynaecol Can. 2013 Jan;35(1):29-38. (PMID: 23343794) J R Soc Med. 2011 Dec;104(12):510-20. (PMID: 22179294) BMJ Qual Saf. 2012 Oct;21(10):876-84. (PMID: 22543475) JMIR Form Res. 2022 Jul 29;6(7):e37243. (PMID: 35904855) Implement Sci. 2016 May 04;11:59. (PMID: 27142655) Worldviews Evid Based Nurs. 2019 Oct;16(5):332-334. (PMID: 31603625) J Nurs Scholarsh. 2020 Jan;52(1):47-54. (PMID: 31497934) Nurse Lead. 2020 Oct;18(5):497-499. (PMID: 32837348) Int J Qual Health Care. 2007 Dec;19(6):349-57. (PMID: 17872937) J Eval Clin Pract. 2022 Dec;28(6):991-1002. (PMID: 34268832) Res Nurs Health. 2010 Feb;33(1):77-84. (PMID: 20014004) Int J Gynaecol Obstet. 2017 Jan;136(1):19-28. (PMID: 28099701) CMAJ. 2022 Feb 28;194(8):E279-E296. (PMID: 35228321) Adm Policy Ment Health. 2011 Mar;38(2):65-76. (PMID: 20957426) JBI Evid Implement. 2020 Sep;18(3):278-287. (PMID: 33570317) J Behav Health Serv Res. 2022 Jan;49(1):106-116. (PMID: 34357498) BMJ. 2019 Jun 20;365:l2239. (PMID: 31221675) Implement Sci. 2013 May 08;8:49. (PMID: 23656884) Implement Sci. 2016 Oct 22;11(1):144. (PMID: 27770807) J Nurs Care Qual. 2004 Oct-Dec;19(4):297-304. (PMID: 15535533) BMJ Open. 2022 Jan 17;12(1):e053919. (PMID: 35039297) JBI Evid Implement. 2020 Sep;18(3):337-344. (PMID: 32649397) |
| معلومات مُعتمدة: | Vanier Canada Graduate Scholarship Canada CAPMC CIHR; 133576 Canada CAPMC CIHR; 143237 Canada CAPMC CIHR |
| فهرسة مساهمة: | Keywords: Implementation practice; Implementation science; Maternal-newborn care; Practice changes; Qualitative secondary analysis |
| تواريخ الأحداث: | Date Created: 20231017 Date Completed: 20231023 Latest Revision: 20231122 |
| رمز التحديث: | 20231215 |
| مُعرف محوري في PubMed: | PMC10583424 |
| DOI: | 10.1186/s12884-023-06042-1 |
| PMID: | 37848826 |
| قاعدة البيانات: | MEDLINE |
Find this article in full text from Springer Verlag. 
Full Text Finder | تدمد: | 1471-2393 |
|---|---|
| DOI: | 10.1186/s12884-023-06042-1 |