Implementation of Nursing Best Practice Guidelines

Monday, 22 July 2013

Laura Albornos-Muñoz, BS1
Esther Gonzalez-María, RN, MSc2
Teresa Moreno-Casbas, RN, MSc, PhD2
Carmen Fuentelsaz-Gallego, RN, MSc3
María Ruzafa-Martínez, RN, MSc, PhD4
Doris Grinspun, RN, MSN, PhD, LLD (hon), OONT5
Monique Lloyd, BScN, RN, PhD6
Eva Abad-Corpa, RN, MSc, PhD7
(1)Nursing and Healthcare Research Unit (Investén-isciii), Instituto de Salud Carlos III, Madrid, Spain
(2)Nursing and Healthcare Research Unit (Investen-isciii)., Instituto de Salud Carlos III, Madrid, Spain
(3)Investén-isciii, Madrid, Spain
(4)Nursing and Healthcare Research Unit (Investen-isciii)., University of Murcia, Murcia, Spain
(5)Registered Nurses' Association of Ontario, Registered Nurses' Association of Ontario, Toronto, ON, Canada
(6)International Affairs and Best Practice Guidelines Centre, Registered Nurses' Association of Ontario, Toronto, ON, Canada
(7)Nursing and Healthcare Research Unit (Investen-isciii)., Murcia Health Service, Murcia, Spain

Learning Objective 1: To know about the phases of a nursing best practices implementation project

Learning Objective 2: To know an implemantion project is working at national level

Introduction.There is a well-documented risk that evidence-based interventions will not be fully utilized by health care practitioners if they are not effectively introduced, supported and implemented1,2,3,4.Objective.To define the phases of project protocol to determine the effectiveness of implementation of best practices interventions included in clinical practice guidelines to improve healthcare outcomes in Spain.Methods.Investén-isciii and the Spanish Collaborating Centre of Joanna Briggs Institute, in collaboration with the Registered Nurses’ Association of Ontario (RNAO), launched in 2011 a national call for an implementation project, to create a network of centers committed with the implementation of nursing best practices in Spain and be part of the international network Best Practice Spotlight Organization.The project is based on the methodology “Toolkit for guideline implementation” developed by the RNAO5. The established phases are:(1) the identification of recommendations coming from best practices guidelines;(2) the definition of evaluation and monitoring plan;(3) the gathering of baseline measures and development of projections;(4) the engagement of healthcare professionals and training based on cascade model;(5) the development of implementation strategies;(6) the development of clinical protocols derived of the recommendations;(7) the monitoring and evaluation;(8) the reporting of conclusions and translation into clinical practice. The project will be precursor for the engagement of new centers, assuring the sustainability. Results.8 healthcare institutions have been enrolled to the project. The nursing best practices guidelines selected according to institution’ needs are related to: breastfeeding, ostomy care, prevention of falls, assessment and management of the pain, stroke assessment and assessment and management of foot ulcers for people with diabetes, totally implemented in 80 units and a community care center. One of the immediate results is the development of an online platform CarEvID that allow the comparison of nursing-sensitive indicators.Impact.To improve patient outcomes and quality of life, and to address structural, policy components and cost effectiveness of the interventions.