A framework for the implementation of certification procedures in nurse level: a mixed approach study

Area of Science:

• Healthcare Management
• Organizational Change
• Nursing Practice

Background:

• Certification procedures are crucial for healthcare systems but require context-specific adaptation.
• Previous approaches lacked precise adaptation to local contexts, hindering effective implementation.
• Local activities and socio-material contexts are essential for pragmatic recommendations.

Purpose of the Study:

• To develop a framework for implementing certification procedures at the nurse activity level.
• To identify key implementation process components.
• To integrate these components considering the local socio-material context of nurses' work.

Main Methods:

• A two-step mixed-methods approach was used.
• Inductive qualitative case study involving semi-structured interviews and observations in a French teaching hospital.
• Deductive analysis using the Quality Implementation Tool (QIT) and Translational Mobilization Theory (TMT) to construct the framework.

Main Results:

• Sixteen interviews and 83 observational hours were conducted.
• The Quality Implementation Tool (QIT) effectively captured implementation elements.
• Translational Mobilization Theory (TMT) identified context-specific interactions between actors, actions, and contexts.
• A framework was developed, adapting QIT components to the local work context using TMT, focusing on the nurse/mid-manager level.

Conclusions:

• A novel framework successfully supports the implementation of certification procedures at the activity level.
• The approach provides a broader understanding of interactions between managers, teams, and contexts during change.
• Further empirical studies are recommended to validate the framework.