Evidence map›Paper›PMID 39085940›Full record

ArticleBMC health services research2024

First-line managers' experience of guideline implementation in orthopaedic nursing and rehabilitation: a qualitative study.

Erika Fjordkvist, Maria Hälleberg Nyman, Madeleine Winberg, Eva Joelsson-Alm, Ann Catrine Eldh

Registry-linked trialAbstract read
In one paragraph

Article in BMC health services research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04700969 (Onset PrevenTIon of Urinary Retention in Orthopaedic Nursing and Rehabilitation, OPTION - a Knowledge Implementation Study on a Facilitation Strategy for Multi-professional Clinical Champion Teams), which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04700969 naactive not recruitingnot on this map

Onset PrevenTIon of Urinary Retention in Orthopaedic Nursing and Rehabilitation, OPTION - a Knowledge Implementation Study on a Facilitation Strategy for Multi-professional Clinical Champion Teams

TypeinterventionalSponsorÖrebro University, SwedenRan2020 to 2027Enrolled20ConditionsUrinary Retention, Hip Fractures, Hip ArthritisArms: A support program to facilitate implementation of evidence-based practice for postoperative urinary retention
3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Trial
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Erika FjordkvistFaculty of Medicine and Health, School of Health Sciences, Örebro University, 701 82, Örebro, Sweden. erika.fjordkvist@oru.se.
Maria Hälleberg NymanFaculty of Medicine and Health, School of Health Sciences, Örebro University, 701 82, Örebro, Sweden.
Madeleine WinbergFaculty of Medicine and Health Sciences, Department of Health, Medicine and Caring Sciences, Linköping University, 581 83, Linköping, Sweden.
Eva Joelsson-AlmDepartment of Clinical Science and Education, 118 83Stockholm, , Södersjukhuset, Karolinska Institutet, Sweden.
Ann Catrine EldhFaculty of Medicine and Health Sciences, Department of Health, Medicine and Caring Sciences, Linköping University, 581 83, Linköping, Sweden.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFirst-line managers have a unique role and potential in encouraging the use of evidence-based clinical practice guidelines (CPGs) and thus serve the provision of safe patient care. In acute and planned hospital care, effective yet safeguarded nursing procedures are a necessity. Little is currently known about how first-line managers engage in supporting the adoption of evidence-based nursing care and about what barriers and enablers there are for implementation of CPGs in the orthopaedic care context. PURPOSE: To investigate first-line managers' experience of clinical practice guideline implementation in orthopaedic care.

methodsThis qualitative interview study included 30 first-line nursing and rehabilitation managers in 17 orthopaedic units in Sweden. A deductive content analysis, with the Ottawa Model of Implementation Leadership as a guide, was employed.

resultsTo the first-line managers, any guideline implementation required them to balance contexts, including their outer context (signified by the upper-level management and decision-makers) and their inner context, including staff and patients in their unit(s). Acting in response to these contexts, the managers described navigating the organization and its terms and conditions; using relations-, change-, and task-oriented leadership, such as involving the staff; motivating the change by emphasizing the patient benefits; and procuring resources, such as time and training. Even though they knew from past experience what worked when implementing CPGs, the first-line managers often encountered barriers within the contexts that hampered successful implementation.

conclusionsAlthough first-line managers know how to effectively implement CPGs, an organization's terms and conditions can limit their opportunities to fully do so. Organizational awareness of what supports and hinders first-line managers to offer implementation leadership can enhance opportunities to alter behaviours and conditions for the benefit of CPG implementation.

trial registrationThe study was registered as NCT04700969 with the U.S. National Institutes of Health Clinical Trials Registry on 8 January 2021.

Indexed as

Practice Guidelines as TopicQualitative ResearchAdultEvidence-Based NursingFemaleGuideline AdherenceHumansInterviews as TopicLeadershipMaleMiddle AgedOrthopedic NursingSwedenClinical practice guidelineEvidence-based health careEvidence-based nursingEvidence-based practiceFirst-line managerImplementationImplementation leadership

Identifiers

PMID39085940
PMCPMC11293162

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.