Implementation processes and capacity-building needs in Ontario maternal-newborn care hospital settings: a cross-sectional survey

Abstract Background Maternal-newborn care does not always align with the best available evidence. Applying implementation science to change initiatives can help move evidence-informed practices into clinical settings. However, it remains unknown to what extent current implementation practices in mat...

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Main Authors: Jessica Reszel, Olivia Daub, Sandra I. Dunn, Christine E. Cassidy, Kaamel Hafizi, Marnie Lightfoot, Dahlia Pervez, Ashley Quosdorf, Allison Wood, Ian D. Graham
Format: Article
Language:English
Published: BMC 2025-01-01
Series:BMC Nursing
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Online Access:https://doi.org/10.1186/s12912-024-02643-z
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author Jessica Reszel
Olivia Daub
Sandra I. Dunn
Christine E. Cassidy
Kaamel Hafizi
Marnie Lightfoot
Dahlia Pervez
Ashley Quosdorf
Allison Wood
Ian D. Graham
author_facet Jessica Reszel
Olivia Daub
Sandra I. Dunn
Christine E. Cassidy
Kaamel Hafizi
Marnie Lightfoot
Dahlia Pervez
Ashley Quosdorf
Allison Wood
Ian D. Graham
author_sort Jessica Reszel
collection DOAJ
description Abstract Background Maternal-newborn care does not always align with the best available evidence. Applying implementation science to change initiatives can help move evidence-informed practices into clinical settings. However, it remains unknown to what extent current implementation practices in maternal-newborn care align with recommendations from implementation science, and how confident nurses, other health professionals, and leaders are completing steps in the implementation process. We aimed to understand Ontario maternal-newborn teams’ (1) approaches to implementing practice changes and the extent to which their implementation processes aligned with an implementation science planned-action framework; and (2) perceptions of importance and confidence completing implementation activities. Methods We conducted a cross-sectional survey between September–November 2023. Using purposive sampling, we invited Ontario maternal-newborn nurses, other healthcare professionals, and leaders who had experience participating in or leading implementation projects to complete an online questionnaire. The questionnaire was informed by an implementation science framework, which includes three core phases (identify issue; build solutions; implement, evaluate, sustain). The questions probed respondents’ perceptions of frequency of completion, importance, and confidence for each of the 28 implementation activities. We used descriptive statistics for the closed-ended questions and grouped the written responses into categories. Results We received 73 responses from 57 Ontario maternal-newborn hospitals, the majority being nurses in point-of-care and leadership roles. Nearly all respondents agreed that each of the 28 implementation activities were important. Respondents reported always completing a median of 8 out of 28 activities, with the number of activities completed declining from phase 1 through to 3. Most respondents indicated they were somewhat confident completing the implementation activities and agreed their teams would benefit from increasing their knowledge and skills to use an evidence-informed approach to implementing practice changes. Conclusions Despite viewing implementation activities as important, many teams are not consistently doing them and lack confidence, particularly in later phases of the implementation process. These findings inform where further capacity-building and supports may be needed to enable maternal-newborn nurses, other healthcare professionals, and leaders to apply implementation science to their change initiatives.
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spelling doaj-art-22ab166bfc3c433a88e88551c804bcb72025-01-12T12:13:48ZengBMCBMC Nursing1472-69552025-01-0124111610.1186/s12912-024-02643-zImplementation processes and capacity-building needs in Ontario maternal-newborn care hospital settings: a cross-sectional surveyJessica Reszel0Olivia Daub1Sandra I. Dunn2Christine E. Cassidy3Kaamel Hafizi4Marnie Lightfoot5Dahlia Pervez6Ashley Quosdorf7Allison Wood8Ian D. Graham9School of Nursing, University of OttawaSchool of Communication Sciences and Disorders, Western UniversitySchool of Nursing, University of OttawaSchool of Nursing, Dalhousie UniversityBetter Outcomes Registry & Network (BORN) OntarioWomen and Children’s Health Network, Orillia Soldiers’ Memorial HospitalParent Research AdvisorNeonatal Intensive Care Unit, The Ottawa HospitalBetter Outcomes Registry & Network (BORN) OntarioSchool of Nursing, University of OttawaAbstract Background Maternal-newborn care does not always align with the best available evidence. Applying implementation science to change initiatives can help move evidence-informed practices into clinical settings. However, it remains unknown to what extent current implementation practices in maternal-newborn care align with recommendations from implementation science, and how confident nurses, other health professionals, and leaders are completing steps in the implementation process. We aimed to understand Ontario maternal-newborn teams’ (1) approaches to implementing practice changes and the extent to which their implementation processes aligned with an implementation science planned-action framework; and (2) perceptions of importance and confidence completing implementation activities. Methods We conducted a cross-sectional survey between September–November 2023. Using purposive sampling, we invited Ontario maternal-newborn nurses, other healthcare professionals, and leaders who had experience participating in or leading implementation projects to complete an online questionnaire. The questionnaire was informed by an implementation science framework, which includes three core phases (identify issue; build solutions; implement, evaluate, sustain). The questions probed respondents’ perceptions of frequency of completion, importance, and confidence for each of the 28 implementation activities. We used descriptive statistics for the closed-ended questions and grouped the written responses into categories. Results We received 73 responses from 57 Ontario maternal-newborn hospitals, the majority being nurses in point-of-care and leadership roles. Nearly all respondents agreed that each of the 28 implementation activities were important. Respondents reported always completing a median of 8 out of 28 activities, with the number of activities completed declining from phase 1 through to 3. Most respondents indicated they were somewhat confident completing the implementation activities and agreed their teams would benefit from increasing their knowledge and skills to use an evidence-informed approach to implementing practice changes. Conclusions Despite viewing implementation activities as important, many teams are not consistently doing them and lack confidence, particularly in later phases of the implementation process. These findings inform where further capacity-building and supports may be needed to enable maternal-newborn nurses, other healthcare professionals, and leaders to apply implementation science to their change initiatives.https://doi.org/10.1186/s12912-024-02643-zNursingImplementation scienceImplementation practiceMaternal-newborn careEvidence-informed carePractice changes
spellingShingle Jessica Reszel
Olivia Daub
Sandra I. Dunn
Christine E. Cassidy
Kaamel Hafizi
Marnie Lightfoot
Dahlia Pervez
Ashley Quosdorf
Allison Wood
Ian D. Graham
Implementation processes and capacity-building needs in Ontario maternal-newborn care hospital settings: a cross-sectional survey
BMC Nursing
Nursing
Implementation science
Implementation practice
Maternal-newborn care
Evidence-informed care
Practice changes
title Implementation processes and capacity-building needs in Ontario maternal-newborn care hospital settings: a cross-sectional survey
title_full Implementation processes and capacity-building needs in Ontario maternal-newborn care hospital settings: a cross-sectional survey
title_fullStr Implementation processes and capacity-building needs in Ontario maternal-newborn care hospital settings: a cross-sectional survey
title_full_unstemmed Implementation processes and capacity-building needs in Ontario maternal-newborn care hospital settings: a cross-sectional survey
title_short Implementation processes and capacity-building needs in Ontario maternal-newborn care hospital settings: a cross-sectional survey
title_sort implementation processes and capacity building needs in ontario maternal newborn care hospital settings a cross sectional survey
topic Nursing
Implementation science
Implementation practice
Maternal-newborn care
Evidence-informed care
Practice changes
url https://doi.org/10.1186/s12912-024-02643-z
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