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How context links to best practice use in long-term care homes: a mixed methods study.

Yinfei Duan1, Jing Wang2, Holly J Lanham3

  • 1Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, AB, Canada. yinfei1@ualberta.ca.

Implementation Science Communications
|June 7, 2024
PubMed
Summary

Implementing best practices in long-term care (LTC) depends on specific context configurations, not a universal approach. Strong leadership, education, or teamwork with communication are key for high use of evidence-based practices.

Keywords:
Best practice useCare aidesCoincidence analysisConfigurational comparative methodsContextEvidence-based practiceLong-term careNursing homesResearch utilization

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Area of Science:

  • Healthcare Management
  • Organizational Behavior
  • Nursing Practice

Background:

  • Work environment context is critical for implementing evidence-based best practices in healthcare.
  • The relationship between context and best practice use by care aides in long-term care (LTC) is understudied.
  • This study investigated interrelationships of context elements influencing best practice use by LTC care aides.

Purpose of the Study:

  • To investigate how context elements interrelate and influence best practice use by care aides in long-term care (LTC) settings.
  • To identify specific configurations of context elements linked to high and low use of best practices.
  • To deepen the understanding of the complex interplay between work environment and evidence-based practice implementation.

Main Methods:

  • Secondary analysis combining coincidence analysis and qualitative analysis of data from the Translating Research in Elder Care (TREC) program.
  • Coincidence analysis of aggregated survey data from 1,506 care aides across 36 Canadian LTC homes.
  • Qualitative analysis of ethnographic case study data from 3 LTC homes to interpret identified configurations.

Main Results:

  • Three configurations linked to high use of conceptual research use (CRU): very high leadership, frequent educational material use, or high social capital with frequent communication.
  • Two configurations linked to very low CRU involved unfavorable relationships, resources, and formal learning opportunities.
  • Qualitative analysis revealed leadership and teamwork as crucial, mitigating barriers like time constraints.

Conclusions:

  • No single, universal set of context elements universally enhances or hinders best practice use in LTC.
  • Findings highlight the importance of specific, multi-faceted context configurations for effective implementation.
  • Understanding these interrelationships is crucial for optimizing evidence-based practice in long-term care settings.