Table 5 Description of Implementation Processes in Two Nursing Homes
Example 1 (NH2) | Example 2 (NH11) | |
|---|---|---|
Internal project lead | INTERCARE nurse | The two INTERCARE nurses and the nursing director |
Implementation plan | A written implementation plan and process description how to use STOP&WATCH, ISBAR & role description of INTERCARE nurse were developed | No implementation plan specific for this NH was developed |
Involvement of care workers | Care workers were invited to provide feedback to adapt the processes to their needs | No involvement of care workers to adapt the processes |
General introduction of project | A single information event for relatives, residents, physicians and the staff | A single information event for staff only |
Information provision on individual units | The INTERCARE nurse was present at each unit’s team meeting to inform about the tools and own role using project educational materials | No information available |
Supervision of implementation | Each unit appointed a champion that received a 2-day training on the instruments by an INTERCARE nurse | Regularly changing daily ward supervisors (often LPN) with no specific training |
Tailoring implementation | INTERCARE nurse was fully supported by the nursing director having flexibility in implementing intervention elements and structuring clinical work | INTERCARE nurses were not supported by the nursing director and had no flexibility in implementing or structuring their clinical work |
INTERCARE nurse start | Several months before the implementation | Concurrent with implementation |
Role implementation | On units with high fluctuation, INTERCARE nurses spent additional time to maintain implementation | Due to high fluctuation on several units, INTERCARE nurses were delegated to work as registered nurses on the units, and they could not execute their roles as INTERCARE nurses |
Evaluation and adaptation of processes | The NH upper management, unit managers, and INTERCARE nurse met regularly to discuss implementation. Use of the tools was documented and evaluated continuously. Champions elicited feedback from care workers` and discussed it with INTERCARE nurse in regular meetings to adapt processes | The nursing director and INTERCARE nurses met regularly with the management of the NH group to discuss implementation, yet no adaptations of the processes were made |