Adoption and sustainability of decision support for patients facing health decisions: an implementation case study in nursing

摘要: Effective interventions prepare patients for making values-sensitive health decisions by helping them become informed and clarifying their values each of the options. However, patient decision support have not been widely implemented little is known about effective models delivering to patients. The purpose this study was describe call centre nurses' adoption a protocol into practice following exposure an implementation intervention identify factors influencing sustainable nursing changes. Exploratory case at Canadian province-wide guided Ottawa Model Research Use. Data sources included survey nurses who participated in (n = 31), 2 focus groups with nurses, interviews 4 administrators, document review. Twenty-five 31 responded measuring practice. Of 25 11 had used within one month intervention. Twenty-two intended use it next three months. Although some found challenging begin using protocol, most reported that it: a) helped recognize callers needing support; b) changed approach handling these calls; c) positive enhancement Strategies identified promote sustainability changes integration database, streamlining aids easier via telephone, administrative direction centre's program, creating length guideline specific calls, incorporating training staff development plan, informing public enhanced service. adopted coaching facing decisions, sustain changes, are required manage barriers environment integrate organization's policies, resources, routine activities.