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Handling a challenging context: experiences of facilitating evidence-based elderly care
Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden.
2016 (English)In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 24, no 2, 201-210 p.Article in journal (Refereed) Published
Abstract [en]


To explore improvement facilitators' experiences of handling their commission to implement evidence-based practice in elderly care for frail older persons.


Improvement facilitators were put in place across Sweden in a time-limited project by the government, with one part of the project being to evaluate the model before establishing this facilitation of evidence-based practice in elderly care.


Two focus groups were interviewed twice. Each group comprised three respondents. The interviews were analysed using qualitative content analysis.


A main theme, ‘Moving forward by adjusting to the circumstances’, described how the improvement facilitators handle their commitment. Five subthemes emerged: identifying barriers, keeping focus, maintaining motivation, building bridges and finding balance.


The improvement facilitators' commitment is ambiguous because of unclear leadership of, and responsibility for the national investment. They have to handle leaders' different approaches and justify the need for evidence-based practice. The improvement facilitators did not reflect on the impact of programme adaptations on evidence-based practice.

Implications for nursing management

The findings emphasise the need for collaboration between the improvement facilitator and the nurse manager. To fully implement evidence-based practice, negotiations with current practitioners for adaptation to local conditions are necessary. Furthermore, the value of improving organisational performance needs to be rigorously communicated throughout the organisation.

Place, publisher, year, edition, pages
2016. Vol. 24, no 2, 201-210 p.
Keyword [en]
elderly care; evidence-based practice; facilitators; nurse management; quality register
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
URN: urn:nbn:se:hj:diva-28864DOI: 10.1111/jonm.12300ISI: 000372022600017PubMedID: 25882164ScopusID: 2-s2.0-84928128896OAI: diva2:890774
Available from: 2016-01-04 Created: 2016-01-04 Last updated: 2016-09-06Bibliographically approved

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