Implementing research findings into nursing homes: A mixed-methods study

As populations age worldwide, nursing homes face increasing pressure to deliver high-quality person-centered care for residents with complex needs. Despite advancements in implementation science, a significant theory-practice gap persists in nursing homes, where evidence-based practice adoption remains particularly slow among the predominantly practically-trained nursing staff.

To identify implementation strategies currently used in nursing homes to integrate research findings into daily practice; and to explore the experiences, needs, and wishes of healthcare professionals and the experiences of implementation experts regarding research implementation.

An exploratory qualitative mixed-methods study.

Nursing homes, with primary focus on The Netherlands.

Implementation experts from Academic Networks (n = 33) and healthcare professionals from nursing homes (n = 17).

Data collection included: (1) eight focus groups and four interviews with implementation experts from the Collaborative Academic Networks for Care for Older Adults; (2) seventeen interviews with healthcare professionals; (3) analysis of 49 relevant documents from Academic Networks; and (4) a rapid review of 30 included articles. All data were systematically coded using Walter et al.'s (2003) taxonomy of implementation strategies and thematically analyzed through an iterative process. Data triangulation across sources enabled validation, while nursing home-specific adaptations emerged through constant comparison between empirical findings and the existing framework. Methodological rigor was enhanced through systematic coding by multiple researchers and regular team consensus meetings.

Nine implementation strategies were identified: dissemination, education, social influence, collaboration, incentives, evaluation, facilitation, mandating laws and regulations, and multifaceted initiatives. This study advances Walter et al.'s taxonomy by providing detailed nursing home-specific specifications of objectives, target groups, and approaches, including the valuable role of science practitioners as bridging agents and the need for facilitation approaches. Healthcare professionals expressed a need for practice-relevant research design with early stakeholder involvement, personalized feedback, accessible language, personal invitations to participate, and adequate support. Implementation wishes included dedicated internal organizational support, researcher involvement as advisors, collaborative plan development, sufficient resources, locally tailored solutions, and clear organizational communication.

This study delivers the first comprehensive overview of implementation strategies tailored to nursing home settings, providing researchers and practitioners with an expanded, evidence-based taxonomy. Three key insights emerge: implementation considerations must be embedded early in research design; multi-strategy approaches predominate and must be context-tailored; and stakeholder engagement requires reciprocal, continuous involvement throughout the research-implementation continuum, rather than one-directional consultation. This taxonomy serves as both a practical implementation tool and a foundation for advancing implementation science in nursing homes.