Karim Kesley, Trower Sommer, Segre Lisa S
College of Nursing, University of Iowa, Iowa City, Iowa, USA.
Division of Community Access and Eligibility, Iowa Department of Health and Human Services, Des Moines, Iowa, USA.
Worldviews Evid Based Nurs. 2024 Dec;21(6):644-651. doi: 10.1111/wvn.12755. Epub 2024 Nov 17.
Evidence-based practices (EBPs) are instrumental in improving patient outcomes and ensuring high-quality nursing care, yet their implementation often encounters substantial barriers. The Iowa Implementation for Sustainability Framework and the Precision Implementation Approach© offer systematic strategies for overcoming barriers and enhancing EBP implementation and sustainability in health care settings.
This project aimed to use the Iowa Implementation for Sustainability Framework and the Precision Implementation Approach© to support the use of an evidence-based maternal depression intervention within Iowa's Title V Maternal Health Program that serves mothers of young children living in poverty.
This practice-based implementation was accomplished in three steps: (1) hold intervention-focused staff meetings, (2) identify barriers to using the intervention, and (3) identify and deliver implementation strategies. Collected data included barriers identified, selected implementation strategies, and evaluation of meeting attendance and impact on confidence.
Four of the monthly virtual staff meetings focused on Listening Visits (LV) use. The 7 strategies comprising our approach to supporting LV use addressed three categories of identified barriers: lack of confidence, logistical issues, and not understanding intervention procedures. In the LV-focused meetings, representation of the 14 maternal health clinics was high, although attendance by individual staff was inconsistent. Post-meeting polls indicated that 40% to 65% of attendees felt more confident using intervention skills.
This practical nursing-implementation framework facilitated EBP adoption, and our well-structured targeted strategies effectively increased staff confidence. Nursing managers and educators should consider using this framework to enhance their organizations' capacity to implement EBPs sustainably.
循证实践(EBPs)有助于改善患者预后并确保高质量护理,但在实施过程中往往会遇到重大障碍。爱荷华州可持续性实施框架和精准实施方法©提供了系统策略,以克服障碍并加强医疗保健环境中循证实践的实施与可持续性。
本项目旨在运用爱荷华州可持续性实施框架和精准实施方法©,在爱荷华州第五章孕产妇健康项目中支持基于证据的孕产妇抑郁干预措施的使用,该项目服务于生活贫困的幼儿母亲。
这项基于实践的实施工作分三步完成:(1)召开以干预为重点的员工会议,(2)确定使用该干预措施的障碍,(3)确定并实施实施策略。收集的数据包括识别出的障碍、选定的实施策略,以及会议出席情况和对信心影响的评估。
每月举行的四次虚拟员工会议聚焦于倾听访问(LV)的使用。构成我们支持LV使用方法的7项策略解决了三类已识别的障碍:缺乏信心、后勤问题以及不理解干预程序。在以LV为重点的会议上,14家孕产妇健康诊所的代表出席率很高,尽管个别员工的出席情况不一致。会后调查显示,40%至65%的与会者在使用干预技能时更有信心。
这个实用的护理实施框架促进了循证实践的采用,我们精心构建的针对性策略有效地增强了员工的信心。护理管理者和教育工作者应考虑使用这个框架来提高其组织可持续实施循证实践的能力。