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

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.