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A unit-level perspective on the long-term sustainability of a nursing best practice guidelines program: An embedded
Andrea R Fleiszer1, Sonia E Semenic2, Judith A Ritchie1
1Ingram School of Nursing, McGill University, Wilson Hall, 3506 University Street, Montreal, Quebec H3A 2A7, Canada.
International Journal of Nursing Studies
|October 11, 2015
Summary
Sustaining nursing best practice guidelines requires ongoing leadership efforts. Unit leaders must actively use sustainability activities, focusing on benefits, routinization, and developing unit capacity for long-term success.
Area of Science:
- Nursing Science
- Healthcare Management
- Implementation Science
Background:
- Best practice guidelines (BPGs) aim to bridge the gap between research and clinical practice, improving patient outcomes.
- While guideline implementation in nursing is studied, the long-term sustainability of these improvements remains under-explored.
- Many healthcare innovations fail to persist, highlighting the need to understand how to ensure their longevity.
Purpose of the Study:
- To investigate the sustainability of a nursing best practice guidelines program within an acute care setting.
- To identify factors influencing the long-term maintenance of guideline-based practices on nursing units.
Main Methods:
- A qualitative descriptive case study design was employed, examining an organization-wide nursing BPG program.
- Four nursing unit subcases with varying sustainability levels, an average of seven years post-implementation, were analyzed.
- Data collection involved 39 key informant interviews, site visits, and document analysis, guided by a healthcare innovation sustainability framework.
Main Results:
- Program sustainability was defined by benefits, routinization, and development.
- Key factors influencing sustainability included perceived advantages, collaboration, accountability, staffing, leadership linkage, unit leadership attributes, and leaders' use of sustainability activities.
- The extent to which unit leaders employed regular and responsive sustainability-oriented activities was crucial for long-term success.
Conclusions:
- Ensuring long-term sustainability of nursing BPG programs requires continuous leadership engagement.
- Formal unit leadership teams must persistently and adaptively orchestrate sustainability activities.
- A broad view of sustainability, encompassing unit capacity development beyond immediate benefits and routinization, is essential for adapting to changing circumstances.
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