Cassidy Christine E, Flynn Rachel, Campbell Alyson, Dobson Lauren, Langley Jodi, McNeil Deborah, Milne Ella, Zanoni Pilar, Churchill Megan, Benzies Karen M
School of Nursing, Faculty of Health, Dalhousie University, 5869 University Avenue, B3H 4R2, Halifax, NS, PO Box 15000, Canada.
School of Nursing and Midwifery, Brookfield Health Sciences Complex, University College of Cork, College Road, T12 AK54, Cork, Ireland.
BMC Nurs. 2024 Feb 17;23(1):125. doi: 10.1186/s12912-024-01777-4.
Sustainability of evidence-based interventions (EBIs) is suboptimal in healthcare. Evidence on how knowledge translation (KT) strategies are used for the sustainability of EBIs in practice is lacking. This study examined what and how KT strategies were used to facilitate the sustainability of Alberta Family Integrated Care (FICare)™, a psychoeducational model of care scaled and spread across 14 neonatal intensive care units, in Alberta, Canada.
First, we conducted an environmental scan of relevant documents to determine the use of KT strategies to support the sustainability of Alberta FICare™. Second, we conducted semi-structured interviews with decision makers and operational leaders to explore what and how KT strategies were used for the sustainability of Alberta FICare™, as well as barriers and facilitators to using the KT strategies for sustainability. We used the Expert Recommendations for Implementation Change (ERIC) taxonomy to code the strategies. Lastly, we facilitated consultation meetings with the Alberta FICare™ leads to share and gain insights and clarification on our findings.
We identified nine KT strategies to facilitate the sustainability of Alberta FICare™: Conduct ongoing training; Identify and prepare local champions; Research co-production; Remind clinicians; Audit and provide feedback; Change record systems; Promote adaptability; Access new funding; and Involve patients/consumers and family members. A significant barrier to the sustainability of Alberta FICare™ was a lack of clarity on who was responsible for the ongoing maintenance of the intervention. A key facilitator to sustainability of Alberta FICare was its alignment with the Maternal, Newborn, Child & Youth Strategic Clinical Network (MNCY SCN) priorities. Co-production between researchers and health system partners in the design, implementation, and scale and spread of Alberta FICare™ was critical to sustainability.
This research highlights the importance of clearly articulating who is responsible for continued championing for the sustainability of EBIs. Additionally, our research demonstrates that the adaptation of interventions must be considered from the onset of implementation so interventions can be tailored to align with contextual barriers for sustainability. Clear guidance is needed to continually support researchers and health system leaders in co-producing strategies that facilitate the long-term sustainability of effective EBIs in practice.
循证干预措施（EBIs）在医疗保健领域的可持续性并不理想。目前缺乏关于知识转化（KT）策略如何在实践中用于促进循证干预措施可持续性的证据。本研究调查了在加拿大艾伯塔省，知识转化策略被用于促进艾伯塔家庭综合护理（FICare）™可持续性的内容和方式。FICare™是一种心理教育护理模式，已在该省14个新生儿重症监护病房推广应用。
首先，我们对相关文件进行了环境扫描，以确定知识转化策略在支持艾伯塔FICare™可持续性方面的应用情况。其次，我们对决策者和运营负责人进行了半结构化访谈，以探讨知识转化策略在促进艾伯塔FICare™可持续性方面的内容和方式，以及使用这些策略促进可持续性的障碍和促进因素。我们使用实施变革专家建议（ERIC）分类法对策略进行编码。最后，我们组织了与艾伯塔FICare™负责人的咨询会议，以分享我们的研究结果，并获取见解和澄清。
我们确定了九条促进艾伯塔FICare™可持续性的知识转化策略：持续开展培训；识别并培养当地倡导者；开展研究合作；提醒临床医生；进行审核并提供反馈；更改记录系统；促进适应性；获取新资金；以及让患者/消费者和家庭成员参与。艾伯塔FICare™可持续性的一个重大障碍是，对于谁负责干预措施的持续维护缺乏明确规定。艾伯塔FICare™可持续性的一个关键促进因素是它与孕产妇、新生儿、儿童和青少年战略临床网络（MNCY SCN）的优先事项相一致。研究人员与卫生系统合作伙伴在艾伯塔FICare™的设计、实施、推广和传播方面的合作对于其可持续性至关重要。
本研究强调了明确阐明谁负责持续支持循证干预措施可持续性的重要性。此外，我们的研究表明，必须从实施开始就考虑干预措施的适应性，以便根据可持续性的背景障碍对干预措施进行调整。需要明确的指导，以持续支持研究人员和卫生系统领导者共同制定促进有效循证干预措施在实践中长期可持续性的策略。
