Evidence-Based Practice Implementation in a Pediatric Inpatient Unit: Nurses' Experiences of Organizational Change

Background: Sustained implementation of evidence-based practice (EBP) remains a challenge in complex clinical environments. Structured knowledge translation frameworks, such as the Knowledge-to-Action model (KTA), have been proposed to facilitate integration of evidence into care. However, less is known about how nurses experience the consolidation of KTA-guided implementation in clinical practice. This study aimed to explore nurses' experiences of changes in clinical practice and professional development following consolidation of KTA guided implementation in a pediatric inpatient unit. Methods: A qualitative descriptive study was conducted using two focus groups with 20 pediatric nurses who had participated in the implementation process. One year after consolidation of the implementation process, data were collected via videoconference using a semi-structured interview guide and analyzed through thematic content analysis following Bardin's methodological framework. Results: Four themes emerged: (1) contribution of the KTA to the clinical context; (2) influence on EBP competencies; (3) impact on professional development; and (4) sustainability within the organizational context. The implementation was experienced as a shift in care philosophy, with evidence becoming central to clinical reasoning, team alignment, and service structures. Conclusions: Participants perceived that the implementation of the KTA framework extended beyond competence development, influencing clinical practice, professional interactions, and organizational routines within the unit. Sustainability was associated with contextual adaptation, leadership alignment, and structural integration of evidence-based practices into care. These findings contribute to understanding mechanisms supporting durable EBP implementation in pediatric settings.