Factors and Conditions that Influence the Implementation of Standardized Nursing Care Plans

Inger Jansson,Christel Bahtsevani,Ewa Pilhammar-Andersson,Anna Forsberg

doi:10.2174/1874434601004010025

Abstract

Rationale and Aim: 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.Method: 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.Result: 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.Conclusions: 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.

Highlights

Today, there is a lack of knowledge about how to successfully implement standardized nursing care plans (SNCPs) in various settings in general and hospital wards in particular
The revised version used in the present study was not subjected to further validity tests, as we considered that an SNCP is comparable to a form of clinical guideline
The main results of this study were that the basis of SNCPs mainly involved clinical experience and research, while patient experience was rarely included

Summary

Introduction

There is a lack of knowledge about how to successfully implement standardized nursing care plans (SNCPs) in various settings in general and hospital wards in particular. Dahm and Wadensten [1] found that nurses perceived that SNCPs increased their ability to provide the same quality of care to all patients and reduced the time spent on documentation as well as unnecessary documentation. Lee and Chang [2] revealed that SNCPs enhanced the quality of care, as the nurses were reminded of care procedures and time was saved, as they did not need to write everything themselves. The SNCP could sometimes be time consuming due to the need to fill in many forms. Another problem was that the SNCP can be inflexible and difficult to apply

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