Paper
Saturday, July 24, 2004
This presentation is part of : Implementation of Evidence-Based Practice
Integrating an Evidence-Based Intervention: Canadian Experiences
Cheryl Forchuk, RN, PhD, Lawson Health Research Foundation, London Health Sciences Centre, London, ON, Canada, Mary- Lou Martin, RN, MScN, Centre for Mountain Health Services, St. Joseph's Healthcare, Hamilton, ON, Canada, Georgiana Beal, RN, PhD, CPMHN[C], Administration, The Center for Addiction & Mental Health, Toronto, Ontario, Canada, Elsabeth Jensen, RN, MScN, Research, University of Western Ontario/ Lawson Health Research Institute, London, ON, Canada, Susan Ouseley, MEd, Can-Voice, London, ON, Canada, and Patricia Sealy, RN, PhD, Chelsey Park Nursing Home, University of Wester Ontario, Department of Sociology, London, ON, Canada.
Objective: Explore experiences of hospital staff involved in a Randomised Controlled Trial (RCT) delivering a Transitional Discharge Model (TDM) in Canada and assessment of contextual and organisational factors affecting implementation of the model. Previous Canadian study of a TDM found clients receiving this approach were discharged from tertiary care psychiatric wards an average of 116 days sooner per person compared to those receiving usual care (Forchuk et al, 2002). The TDM consisted of 1) Hospital staff continued to see clients after discharge until a therapeutic relationship was established with a community care provider, and 2) peer support from a former client of the mental health care system

Design & Sample: Focus groups were used in this qualitative descriptive study. All members of the interdisciplinary team participating in RCT were invited to give feedback on their perceptions about and experiences of the study. Participation was voluntary.

Methods: Data was collected using focus groups at four hospital sites in Southern Ontario, Canada. Staff (n = 45) from 13 in-patient psychiatric wards participated. Data was analysed using thematic content analysis. (Miles & Huberman, 1984).

Results: Several supports and barriers to implementation were identified. Supports included availability of on-ward education and on-ward champions. Barriers included documentation systems and ambiguous support from some managers. Many specific suggestions about staff training were shared.

Conclusions/Implications: Understanding barriers and supports to implementing changes in practice is critical if nurses are to implement best practices. Specific strategies suggested by these staff could be implemented in a number of settings. These strategies will be tested through further study.

References: Forchuk, C., et al.. (2002). Therapeutic Relationships: From Hospital to Community: First Year Results. Report to the Canadian Health Services Research Foundation, Ottawa. Miles MB & Huberman AM (1984) Qualitative Data Analysis: A Sourcebook of New Methods. Newbury Park, California. Sage.

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