Exploring the Experience of Facilitation with Implementing Evidence-Based Practice in a Neonatal Intensive Care Unit

Abstract

Background: Literature supports that it takes approximately 17 years for 14% of original research to be translated and implemented into clinical practice. This dissemination gap requires researchers and clinicians to consider efficient and effective methods to integrate evidence-based practice (EBP) into a clinical setting. Furthermore, literature supports that EBP improves the quality of care and health outcomes, reduces healthcare cost, and improves clinician variation in practice. Despite the supporting evidence, EBPs are inconsistently implemented by nurses and other clinicians throughout the U.S. Facilitation has been described as one implementation strategy to speed adoption and implementation of evidence into clinical settings. While previous research focuses on facilitation to increase the adoption and implementation of EBP into a clinical setting, facilitation has not been described in the literature as an implementation strategy in a neonatal intensive care unit (NICU). Purpose: The purpose of this qualitative descriptive (QD) study was to categorize, describe, and discover essential features of the strategy of facilitation in the context of implementing an EBP using perspectives elicited from neonatal healthcare clinicians and external facilitators. Methods: In this QD study, one in-depth semi-structured phone interview was conducted with a purposive sample of neonatal healthcare clinicians and external facilitators. Participants’ shared their experiences related to the strategy of facilitation while implementing an EBP during the California Perinatal Quality Care (CPQCC) Antibiotic Stewardship Collaborative in their NICU. Interviews were transcribed, coded and data were analyzed using directed content analysis. Results: Five themes emerged to address facilitation as an implementation strategy in the context of integrating an EBP in a NICU. The five themes addressed: 1) facilitated change management; 2) unit and organization receptivity; 3) evaluation strategies; 4) supportive culture; and 5) facilitator stewardship. Results from this study provide insights into influencing barriers and drivers, and contextual factors that impacted the success of implementation. Study finding also add to the body of implementation science on facilitation in a NICU setting.