Table 4 Enablers and barriers of the PECAN implementation strategy
Categories | Enablers | Barriers |
|---|---|---|
Overall strategy | • Stepwise training of facilitators (i.e., facilitators’ workshop, peer-mentor visit, peer-mentoring via telephone) (F) | • Lack of systematic involvement of all the different stakeholders (i.e., management, social workers, relatives, and therapists) (F, R, T, SW) |
• Clear defined PECAN content (F) | • Available time period too short to complete implementation (F) | |
• Personal contact initiated by the management or the facilitators to provide the different stakeholders with information on PECAN (T, F) | • Difficulties in the implementation for residents with severe physical and cognitive impairment (F) | |
Facilitators’ workshop | • Practical elements (e.g., training on the use of technical and medical aids) (M) | • Unbalanced ratio between theory and practice (i.e., more active participation during workshop required) (F, RT) |
Information session | • Use of plain language when addressing the different participant groups (RT) | • Lack of systematic involvement of the nursing staff (e.g., no presentation within the nursing team) (F) |
• Diverse groups of participants could be reached and informed about PECAN in one session (F, SW) | • Invitation to the session (i.e., poster at the entrance area) did not reached all potential participants (F, T, R, SW, RT) | |
Peer-mentoring | • The peer-mentor visit was highlighted as a useful introduction to the implementation of PECAN (F) | • Facilitators were usually not directly available via e-mail or telephone (e.g., appointments via the head nurse were necessary) (F, PM) |
• Continuous availability of the peer-mentors via telephone (F) | ||
• Standardised procedure of peer-mentoring via telephone (F, PM) - Routines for communication and regular appointments (F, PM) - Specific objectives based on the last counselling (PM) | ||
Supportive materials | • Supportive materials tailored for the target population (F, T, SW) - Training folder for facilitators (F) - Posters for the nursing wards (T, SW, F) - Materials for nursing team training (F) - Specific leaflets for relatives, therapists and physicians (F) - Article regarding PECAN published in nursing home journal (SW) | • Lack of supportive materials with a simple and practical design (F, R) |
• Lack of supportive materials to guide the implementation (e.g., no standardised documentation forms, no overview of potential intervention measures) (F) | ||
• Leaflets should have more focus on personal tasks (R) | ||
• Supportive materials did not reach the targeted population (R, T, SW) - Posters or other reminders in the nursing wards were not noticed (R) - Leaflets were not handed out (R, T, SW) |