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. |
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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.) |
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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 |
تدمد: | 1471-2393 |
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DOI: | 10.1186/s12884-023-06042-1 |