School of Nursing, University of Wisconsin - Madison, Madison, WI, USA.
J Clin Nurs. 2021 May;30(9-10):1417-1428. doi: 10.1111/jocn.15693. Epub 2021 Feb 17.
To explore registered nurses' perceptions of practice change and describe factors that influence the adoption of practice changes.
Nurses play a critical role in optimising patient outcomes. Healthcare organisations and nurses must do their part to achieve the Quadruple Aim, which requires nurses to change their practice. Nurses are ideally positioned to improve patient outcomes by changing their practice to align it with research evidence and organisational initiatives; however, this experience of practice change by nurses is grossly under-studied.
A qualitative design, inductive content analysis, was used to understand nurses' perceptions of practice change.
Eleven registered nurses, who worked in one hospital system, participated in one-on-one semi-structured interviews. The Consolidated Criteria for Reporting Qualitative Studies (COREQ) were followed.
The 11 participants described 63 distinct experiences with practice changes. Their experiences with and perceptions of practice change are categorised as (1) There is A History; (2) It's A Lot of Work; (3) It Happens to Nurses; and (4) Doing Right for the Patient.
Nurses experience practice change as a central part of the work they do; it occurs frequently and multiple practice changes may co-occur. Nurses identify strategies, such as thoughtful planning, engaging nurses, and communicating the rationale for and the outcomes of the practice change, to facilitate changing practice.
Involving nurses in practice changes could alleviate some inhibiting factors for adopting new practices. Local hospital and national policies should explore creative and practical ways to balance the competing needs of nurses providing direct care at the bedside and dedicated time to be engaged in practice change initiatives. With the ongoing focus on improving patient care and optimising patient safety, nurses should be viewed as highly valued members of the team when designing and implementing practice changes.
探索注册护士对实践变革的看法，并描述影响实践变革采用的因素。
护士在优化患者结局方面发挥着关键作用。医疗机构和护士必须尽自己的一份力量来实现四重目标，这要求护士改变他们的实践。护士通过改变实践使其与研究证据和组织倡议保持一致，从而改善患者结局，处于最有利的地位；然而，对护士实践变革的这种体验研究得还远远不够。
采用定性设计，即归纳内容分析，以了解护士对实践变革的看法。
11 名注册护士在一个医院系统工作，他们参与了一对一的半结构化访谈。遵循了定性研究报告的统一标准（COREQ）。
11 名参与者描述了 63 次不同的实践变革经历。他们对实践变革的经历和看法分为以下四个方面：（1）有历史背景；（2）这是一项艰巨的工作；（3）这是护士的事；（4）为患者做正确的事。
护士将实践变革视为其工作的重要组成部分；它经常发生，并且可能同时发生多个实践变革。护士确定了一些策略，如深思熟虑的计划、让护士参与进来、沟通变革实践的理由和结果，以促进实践变革。
让护士参与实践变革可以缓解一些采用新实践的抑制因素。当地医院和国家政策应探索有创意和实际的方法，平衡护士在床边提供直接护理和专门时间参与实践变革倡议的需求。随着对改善患者护理和优化患者安全的持续关注，在设计和实施实践变革时，应将护士视为团队中非常有价值的成员。
