养老院内的综合知识转化：探索实践发展护士的经验。

Integrated knowledge translation in nursing homes: exploring the experiences of practice development nurses.

机构信息

Western Norway University of Applied Sciences, P.O. Box 7030, N-5020, Bergen, Norway.

Norwegian Research Centre for Women's Health, Oslo University Hospital, Rikshospitalet, P.O. Box 4950 Nydalen, 0424, Oslo, Norway.

出版信息

BMC Health Serv Res. 2021 Nov 29;21(1):1283. doi: 10.1186/s12913-021-07282-7.

DOI:10.1186/s12913-021-07282-7

PMID:34844600

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8628377/

Abstract

BACKGROUND

Practice Development Nurses (PDNs) in Norwegian nursing homes (NHs) hold a specific responsibility for knowledge translation in this increasingly complex healthcare setting. They were involved as end users in an integrated knowledge translation (IKT) study, developing, testing and evaluating the IMPAKT (IMPlementation of Action to Knowledge Translation) intervention. PDNs participated in an educational programme tailored to their own defined needs. In a second intervention component, the PDNs applied their new skills with facilitation, in implementing the National Early Warning Score (NEWS2) in their respective NHs. The aim of this study was to explore 1) the PDNs' experiences of participating in an IKT educational intervention, and 2) how they applied the learning in planning, tailoring and initial implementation of the NEWS2.

METHODS

This is a qualitative exploratory study based on a phenomenological hermeneutical method. Study participants were PDNs working in the nine NHs in the intervention group of the IMPAKT trial. We conducted nine in-depth interviews and eight non-participatory observational sessions of the intervention delivery.

RESULTS

The PDNs expressed that the educational programme met their needs and enhanced their understanding about leading knowledge translation (KT). They reported a move from operating in a "big black box of implementation" to a professional and structured mode of KT. The gamechanger was a shift from KT as the PDNs' individual responsibility to KT as an organizational matter. The PDNs reported enhanced competencies in KT and in their ability to involve and collaborate with others in their facility. Organizational contextual factors challenged their KT efforts and implementation of the NEWS2.

CONCLUSIONS

This study demonstrates that an IKT approach has the potential to advance and improve staff competencies and NH readiness for KT. However, individual motivations and competencies were challenged within an organizational culture which was less receptive to this new leadership role and level of KT activity.

摘要

背景

挪威养老院的实践发展护士（PDN）在这个日益复杂的医疗保健环境中，对知识转化负有特定责任。他们作为最终用户参与了一个综合知识转化（IKT）研究，开发、测试和评估了 IMPAKT（知识转化行动的实施）干预措施。PDN 参加了一个针对他们自身特定需求定制的教育计划。在第二个干预组件中，PDN 应用他们的新技能进行促进，在各自的养老院实施国家早期预警评分（NEWS2）。本研究的目的是探讨 1）PDN 参与 IKT 教育干预的经验，以及 2）他们如何将所学知识应用于 NEWS2 的规划、定制和初步实施中。

方法

这是一项基于现象学解释学方法的定性探索性研究。研究参与者是参与 IMPAKT 试验干预组的九家养老院的 PDN。我们进行了九次深入访谈和八次非参与性观察干预交付。

结果

PDN 表示，教育计划满足了他们的需求，并增强了他们对领导知识转化（KT）的理解。他们报告说，他们已经从在“实施的大黑箱”中运作转变为专业和结构化的 KT 模式。改变的关键是将 KT 从 PDN 的个人责任转变为组织事务。PDN 报告说，他们在 KT 方面的能力以及在设施中与他人合作的能力都有所提高。组织背景因素挑战了他们的 KT 努力和 NEWS2 的实施。