Method and sample: Eight focus group interviews were conducted at four units (two intervention and two control units), including 45 nursing staff personnel.

Intervention: Monthly meetings with an external facilitator who used a group focused, democratic and enabling approach, supporting the change of clinical practice.

Findings: Establishing a change team (consisting of staff members) resulted in several activities (adaptation of KMC guidelines, release parties, education sessions, documentation guidelines, audit, etc) impacting on staffs’ behaviour. Merely disseminating the guidelines generated no effects. At the units accomplishing change, the evidence-based KMC guidelines were perceived to be of significant importance, but commonly translated to a local format. The facilitation provided to the change teams at the intervention units promoted multifaceted implementation activities and was highly appreciated by the change teams. One of the control units accomplished a similar implementation programme as the intervention units, which also resulted in similar outcomes.

Conclusions: Facilitation of change teams generated multifaceted implementation activities that affected staffs’ behaviour and was also perceived to positively impact on patients well-being. However, looking at activities performed and staff responses at one of the control units, the external facilitation seemed to be replaceable by an improvement directed organisational culture and internal support from the nurse manager.

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Sigma Theta Tau International
July 21, 2004