Jansson Inger, Bahtsevani Christel, Pilhammar-Andersson Ewa, Forsberg Anna
School of Social and Health Sciences, Halmstad University, Halmstad, Sweden.
Open Nurs J. 2010 Oct 12;4:25-34. doi: 10.2174/1874434601004010025.
There is a lack of evidence about how to successfully implement standardized nursing care plans (SNCP) in various settings. The aim of this study was to use the "Promotion Action on Research Implementation in Health Services framework" (PARIHS) to explore important factors and conditions at hospital wards that had implemented SNCPs.
We employed a retrospective, cross-sectional design and recruited nurses from four units at a rural hospital and seven units at a university hospital in the western and southern region of Sweden where SNCPs had been implemented. Outcome was measured by means of a questionnaire based on the PARIHS-model.
In total, 137 nurses participated in the study. The main factors that had motivated the nurses to implement SNCPs were that they were easy to understand and follow as well as corresponding to organisational norms. The SNCPs were normally based on clinical experience, although research more frequently formed the basis of the SNCPs at the university hospital. Internal facilitators acted as important educators, who provided reminders to use the SNCP and feedback to the SNCP users. The patient experience was not considered valuable. Those who claimed that the implementation was successful were generally more positive in all measurable aspects. The use of SNCPs was rarely evaluated.
Clinical experience was considered important by the nurses, while they attributed little value to the patient experiences. Successful implementation of research based SNCPs requires internal facilitators with knowledge of evidence-based nursing.
目前缺乏关于如何在不同环境中成功实施标准化护理计划（SNCP）的证据。本研究的目的是使用“卫生服务研究实施促进行动框架”（PARIHS）来探索已实施SNCP的医院病房中的重要因素和条件。
我们采用回顾性横断面设计，从瑞典西部和南部一家乡村医院的四个科室以及一家大学医院的七个科室招募了已实施SNCP的护士。通过基于PARIHS模型的问卷来衡量结果。
共有137名护士参与了该研究。促使护士实施SNCP的主要因素是它们易于理解和遵循，并且符合组织规范。SNCP通常基于临床经验，不过在大学医院，研究更常成为SNCP的基础。内部促进者充当重要的教育者，他们提醒使用SNCP并向SNCP使用者提供反馈。患者体验未被视为有价值。那些声称实施成功的人在所有可衡量的方面通常更积极。SNCP的使用很少得到评估。
护士认为临床经验很重要，而他们对患者体验的价值评价不高。成功实施基于研究的SNCP需要具备循证护理知识的内部促进者。
