ABSTRACT
BACKGROUND: Nurses and midwives are central to the implementation and delivery of quality care through evidence-based practice (EBP). However, implementation of EBP in nursing and midwifery is under-researched with few examples of systematic and sustained change. The Registered Nurses Association of Ontario's Best-Practice Spotlight Organization (BPSO) Program was adopted in South Australia as a framework to systematically implement EBP in two diverse and complex healthcare settings. METHODS: The study was a post-implementation, mixed-method evaluation conducted at two healthcare settings in Adelaide, South Australia utilizing qualitative and quantitative data. Proctor's implementation evaluation framework guided the evaluation design. Information sources included; interviews, focus groups, questionnaires, and document review. RESULTS: Clinical and executive staff (n = 109 participants) from a broad range of stakeholder groups participated in the interviews, focus groups, and returned questionnaires. A number of facilitators directly affecting program implementation were identified; these pertained to embedding continuity into the program's implementation and delivery, a robust governance structure, and executive sponsorship. Barriers to implementation were also identified. These barriers pertained to organizational or workforce challenges; staff turnover and movement (e.g., secondment), insufficient staff to allow people to attend training, and a lack of organizational commitment to the program, especially at an executive level. As a result of successful implementation, it was observed that over three years, the BPSO program positively influenced the uptake and implementation of EBP by clinicians and the organizations into which they were introduced. CONCLUSIONS: The BPSO model can be translocated to new healthcare systems and has the potential to act as a mechanism for establishing and sustaining EBP change. This study was the first to apply an implementation evaluation framework to the BPSO program, which allowed for structured analysis of facilitating or impeding factors that affected implementation success. The findings have important implications for other health systems looking to translocate the same or similar EBP programs, as well as contributing to the growing body of implementation evaluation literature.
ABSTRACT
The Australian Nursing and Midwifery Federation (ANMF) recently published the National Aged Care Staffing and Skills Mix Project Report 2016 -- Meeting residents' care needs: A study of the requirement for nursing and personal care staff, it commissioned. Conducted over the past two years the results have been integral to building the foundation of the ANMF's national aged care campaign.
Subject(s)
Health Planning , Health Services Needs and Demand , Health Services for the Aged , Aged , Australia , Humans , Nursing Research , WorkforceABSTRACT
Introduction: The Registered Nurses' Association of Ontario's flagship Best Practice Spotlight Organization® Program is scaling up implementation around the globe. The Australian Nursing and Midwifery Federation has successfully partnered with the Registered Nurses' Association of Ontario's to become a Best Practice Spotlight Organization Host, and establish an evidence-based culture in South Australia. Australian Nursing and Midwifery Federation is the largest professional organisation and trade union for nurses, midwives and assistants in nursing in Australia with a commitment to high standards of professional practice, effective bargaining and industrial representation of members as well as a progressive, social justice based approach to policy issues facing the health system (Australian Nursing and Midwifery Federation 2017). Objective: Reflect on the experience of Australian Nursing and Midwifery Federation in implementing the Best Practice Spotlight Organization Program in nursing in South Australia. Methodology: To describe the process of scaling up the Registered Nurses' Association of Ontario's Best Practice Guidelines program in South Australia through its Best Practice Spotlight Organizations world renowned feature, barriers and opportunities to its uptake and its evaluation. Conclusions: Evaluation of the Best Practice Spotlight Organizations program demonstrates the value of practice reforms, which were implemented and improved outcomes for patients/clients, improved professional satisfaction and capacity, and created cost efficiencies in the pilot sites. [Hurley J, Dabars E, Bonner R. The Best Practice Spotlight Organizations (BPSO) Program Experience in Australia. MedUNAB 2017; 20(2): 215-223].
Introducción: La asociación de enfermeras registradas de Ontario y su programa principal de mejores prácticas de las organizaciones más destacadas está ampliando su implementación alrededor del mundo. La Federación Australiana de Enfermería y Obstetricia se ha asociado exitosamente con la asociación de enfermeras registradas de Ontario para convertirse en anfitriona de Las mejores prácticas de las organizaciones más destacadas y establecer una cultura basada en la evidencia en Australia del Sur. Federación Australiana de Enfermería y Obstetricia es el sindicato y la organización profesional más grande para enfermeras, parteras y asistentes en enfermería en Australia, con un compromiso con altos estándares de práctica profesional, negociación efectiva y representación industrial de sus miembros, así como un enfoque progresivo basado en la justicia social a los problemas políticos que enfrentan el sistema de salud (Federación Australiana de Enfermería y Obstetricia 2017). Objetivo: Reflexionar sobre la experiencia de la Federación Australiana de Enfermería y Obstetricia en la implementación del Programa Las mejores prácticas de las organizaciones más destacadas en enfermería en el sur de Australia. Metodología:Describir el proceso de escalamiento en el programa, Guía para las Buenas Prácticas de la asociación de enfermeras registradas de Ontario en el sur de Australia a través de las mejores prácticas de las organizaciones más destacadas y de renombre mundial, características, barreras y oportunidades para su adopción y su evaluación. Conclusiones: La evaluación del programa Las mejores prácticas de las organizaciones más destacadas demuestra el valor de las reformas en la práctica, las cuales fueron implementadas y los resultados para los pacientes/clientes mejoraron; al igual que la satisfacción y la capacidad profesional mejoraron, y la creación de eficiencias en los costos de los sitios piloto también. [Hurley J, Dabars E, Bonner R. Experiencia en el programa: Las mejores prácticas de las organizaciones más destacadas (BPSO) en Australia. MedUNAB 2017; 20(2): 215-223].
Introdução: A associação de enfermeiras registradas de Ontário e seu principal programa de melhores práticas das principais organizações, está expandindo sua implementação em todo o mundo. A Federação Australiana de Enfermagem e Obstetrícia fez uma parceria de sucesso com a Registered Nurses Association of Ontario para sediar as melhores práticas das organizações líderes e estabelecer uma cultura baseada em evidências, no sul da Austrália. A Federação Australiana de Enfermagem e Obstetrícia é o sindicato e a maior organização profissional para enfermeiras, parteiras e assistentes de enfermagem na Austrália, com um compromisso de altos padrões de prática profissional, de negociação eficaz e representação Industrial de seus membros, bem como uma abordagem progressiva com base na justiça social para os problemas políticos que enfrenta o sistema de saúde (Federação Australiana de Enfermagem e Obstetrícia 2017). Objetivo: Refletir sobre a experiência da Federação Australiana de Enfermagem e Obstetrícia na implementação do Programa As melhores práticas das mais destacadas organizações de enfermagem no sul da Austrália. Metodologia: Descrever o processo de encaminhamento no programa, Guia de Boas Práticas da Associação de Enfermeiras Registradas de Ontário, na Austrália do Sul, através das melhores práticas das organizações, lideres e de renome mundial, suas caraterísticas barreiras e oportunidades, para sua adoção e avaliação. Conclusões: A avaliação do programa, As melhores práticas das organizações mais destacadas, demonstra o valor das reformas na prática, as quis foram implementadas e os resultados para pacientes/ clientes melhoraram; bem como a satisfação e capacidade profissional melhorada, e a criação de eficiências nos custos dos locais piloto também. [Hurley J, Dabars E, Bonner R. Experiência no programa: Melhores práticas de organizações líderes (BPSO) na Austrália. MedUNAB 2017; 20(2): 215-223].
