Research nurses as practice facilitators to disseminate an asthma shared decision making intervention

Area of Science:

• Healthcare delivery research
• Implementation science
• Nursing practice

Background:

• Practice facilitation (PF) supports organizational change and evidence-based guideline implementation.
• Nurses are well-suited as PFs, but their role in complex intervention implementation needs further description.
• Shared decision-making (SDM) improves asthma patient outcomes.

Purpose of the Study:

• To describe and evaluate the practice facilitation process used in the ADAPT-NC Study.
• To assess the implementation of a complex asthma SDM toolkit in primary care practices utilizing research nurses as PFs.

Main Methods:

• A 12-week facilitator-led dissemination intervention involving an asthma SDM toolkit in 10 primary care practices.
• Research nurses were trained as PFs using a train-the-trainer model.
• Process improvement surveys measured PF engagement and outcomes.

Main Results:

• Successful implementation of the asthma SDM intervention across 4 practice-based research networks (PBRNs).
• All 10 practices engaged with PFs; 8 sustained SDM visits or clinics.
• Process improvement surveys indicated enhanced PF communication and team dynamics.

Conclusions:

• Research nurses effectively served as practice facilitators for disseminating an asthma SDM intervention.
• This study describes a successful model for large-scale implementation of complex interventions through nursing-led practice facilitation.