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Salma I, Waelli M. Mapping research findings on change implementation in nursing practice: A scoping literature review. Nurs Open 2022; 10:450-468. [PMID: 36112719 PMCID: PMC9834520 DOI: 10.1002/nop2.1369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 07/20/2022] [Accepted: 08/30/2022] [Indexed: 01/16/2023] Open
Abstract
AIMS The aim of this study was to map the diverse factors impacting change implementation in nursing practices and investigate different implementation strategies. DESIGN Scoping literature review following PRISMA-ScR extension. METHODS Data were collected from PubMed, Ebsco, Scopus and ScienceDirect databases from 1990 onwards. Only English peer-reviewed studies reporting an implementation of change in nursing practice were included. Of 9,954 studies, 425 abstracts were scanned and 98 full-text articles were screened. Finally, 28 studies were selected. RESULTS A multifaceted approach, with a tailored intervention, was the most effective implementation strategy. Most identified factors were considered systematic, for example resource availability, leadership and knowledge. However, others related to local social and material context were identified in fewer number of studies. These seem to be operational elements for implementation processes. Both types of factors are essential and must be considered for successful implementation. CONCLUSION We advocate the development of framework including systematic factors and which capture the local context flexibility.
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Affiliation(s)
- Israa Salma
- École des Hautes Etudes en Santé PubliqueInserm U 1309‐RSMS, CNRS UMR 6051 ‐ ARENESRennesFrance
| | - Mathias Waelli
- École des Hautes Etudes en Santé PubliqueInserm U 1309‐RSMS, CNRS UMR 6051 ‐ ARENESRennesFrance,Global Health InstituteGeneva UniversityGeneveSwitzerland
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Beidas RS, Williams NJ, Becker-Haimes EM, Aarons GA, Barg FK, Evans AC, Jackson K, Jones D, Hadley T, Hoagwood K, Marcus SC, Neimark G, Rubin RM, Schoenwald SK, Adams DR, Walsh LM, Zentgraf K, Mandell DS. A repeated cross-sectional study of clinicians' use of psychotherapy techniques during 5 years of a system-wide effort to implement evidence-based practices in Philadelphia. Implement Sci 2019; 14:67. [PMID: 31226992 PMCID: PMC6588873 DOI: 10.1186/s13012-019-0912-4] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Accepted: 06/03/2019] [Indexed: 02/06/2023] Open
Abstract
Background Little work investigates the effect of behavioral health system efforts to increase use of evidence-based practices or how organizational characteristics moderate the effect of these efforts. The objective of this study was to investigate clinician practice change in a system encouraging implementation of evidence-based practices over 5 years and how organizational characteristics moderate this effect. We hypothesized that evidence-based techniques would increase over time, whereas use of non-evidence-based techniques would remain static. Method Using a repeated cross-sectional design, data were collected three times from 2013 to 2017 in Philadelphia’s public behavioral health system. Clinicians from 20 behavioral health outpatient clinics serving youth were surveyed three times over 5 years (n = 340; overall response rate = 60%). All organizations and clinicians were exposed to system-level support provided by the Evidence-based Practice Innovation Center from 2013 to 2017. Additionally, approximately half of the clinicians participated in city-funded evidence-based practice training initiatives. The main outcome included clinician self-reported use of cognitive-behavioral and psychodynamic techniques measured by the Therapy Procedures Checklist-Family Revised. Results Clinicians were 80% female and averaged 37.52 years of age (SD = 11.40); there were no significant differences in clinician characteristics across waves (all ps > .05). Controlling for organizational and clinician covariates, average use of CBT techniques increased by 6% from wave 1 (M = 3.18) to wave 3 (M = 3.37, p = .021, d = .29), compared to no change in psychodynamic techniques (p = .570). Each evidence-based practice training initiative in which clinicians participated predicted a 3% increase in CBT use (p = .019) but no change in psychodynamic technique use (p = .709). In organizations with more proficient cultures at baseline, clinicians exhibited greater increases in CBT use compared to organizations with less proficient cultures (8% increase vs. 2% decrease, p = .048). Conclusions System implementation of evidence-based practices is associated with modest changes in clinician practice; these effects are moderated by organizational characteristics. Findings identify preliminary targets to improve implementation.
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Affiliation(s)
- Rinad S Beidas
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. .,Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. .,Penn Implementation Science Center at the Leonard Davis Institute of Health Economics (PISCE@LDI), University of Pennsylvania, Hall- Mercer Community Mental Health Center, Philadelphia, PA, USA.
| | | | - Emily M Becker-Haimes
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Hall- Mercer Community Mental Health Center, Philadelphia, FL, USA
| | - Gregory A Aarons
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Frances K Barg
- Department of Family Medicine and Community Health, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | | | - Kamilah Jackson
- Community Behavioral Health, Impact Reach, LLC, Philadelphia, PA, USA
| | - David Jones
- Department of Behavioral Health, Philadelphia, PA, USA
| | - Trevor Hadley
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Kimberly Hoagwood
- Department of Child and Adolescent Psychiatry, New York University Langone Health, New York, NY, USA
| | - Steven C Marcus
- School of Social Policy and Practice, University of Pennsylvania, Philadelphia, PA, USA
| | - Geoffrey Neimark
- Community Behavioral Health, Impact Reach, LLC, Philadelphia, PA, USA
| | - Ronnie M Rubin
- Community Behavioral Health, Impact Reach, LLC, Philadelphia, PA, USA.,Impact Reach, LLC, Philadelphia, PA, USA
| | | | - Danielle R Adams
- School of Social Service Administration, University of Chicago, Chicago, IL, USA
| | - Lucia M Walsh
- Department of Psychology, University of Miami, Miami, FL, USA
| | - Kelly Zentgraf
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - David S Mandell
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Penn Implementation Science Center at the Leonard Davis Institute of Health Economics (PISCE@LDI), University of Pennsylvania, Hall- Mercer Community Mental Health Center, Philadelphia, PA, USA
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