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The nursing work of hospital-based clinical practice guideline implementation: an explanatory systematic review using normalisation process theory

The nursing work of hospital-based clinical practice guideline implementation: an explanatory systematic review using normalisation process theory
The nursing work of hospital-based clinical practice guideline implementation: an explanatory systematic review using normalisation process theory
Objective: To investigate the dynamics of nurses’ work in implementing Clinical Practice Guidelines.

Design: Hybrid: systematic review techniques used to identify qualitative studies of clinical guideline implementation; theory-led and structured analysis of textual data.

Data sources: CINAHL, CSA Illumina, EMBASE, MEDLINE, PsycINFO, and Sociological Abstracts.

Methods: Systematic review of qualitative studies of the implementation of Clinical Practice Guidelines, analysed using Directed Content Analysis, and interpreted in the light of Normalisation Process Theory.

Results: Seven studies met the inclusion criteria of the review. These revealed that clinical practice guidelines are disposed to normalisation when: (a) They are associated with activities that practitioners can make workable in practice, and practitioners are able to integrate it into their collective workflow. (b) When they are differentiated from existing clinical practice by its proponents, and when claims of differentiation are regarded as legitimate by their potential users. (c) When they are associated with an emergent community of practice, and when members of that community of practice enrol each other into group processes that specify their engagement with it. (d) When they are associated with improvements in the collective knowledge of its users, and when users are able to integrate the application of that knowledge into their individual workflow. And, (e) when nurses can minimise disruption to behaviour norms and agreed professional roles, and mobilise structural and cognitive resources in ways that build shared commitments across professional boundaries.

Conclusions: This review demonstrates the feasibility and benefits of theory-led review of studies of nursing practice, and proposes a dynamic model of implementation. Normalisation Process Theory supports the analysis of nursing work. It characterises mechanisms by which work is made coherent and meaningful, is formed around sets of relational commitments, is enacted and contextualised, and is appraised and reconfigured. It facilitates such analysis from within the frame of nursing knowledge and practice itself.
0020-7489
May, Carl R.
17697f8d-98f6-40d3-9cc0-022f04009ae4
Sibley, A.
afe7cc9d-614e-4cb1-b080-8ca7df54ae40
Hunt, Katherine J.
5eab8123-1157-4d4e-a7d9-5fd817218c6e
May, Carl R.
17697f8d-98f6-40d3-9cc0-022f04009ae4
Sibley, A.
afe7cc9d-614e-4cb1-b080-8ca7df54ae40
Hunt, Katherine J.
5eab8123-1157-4d4e-a7d9-5fd817218c6e

May, Carl R., Sibley, A. and Hunt, Katherine J. (2014) The nursing work of hospital-based clinical practice guideline implementation: an explanatory systematic review using normalisation process theory. International Journal of Nursing Studies. (doi:10.1016/j.ijnurstu.2013.06.019). (PMID:23910398)

Record type: Article

Abstract

Objective: To investigate the dynamics of nurses’ work in implementing Clinical Practice Guidelines.

Design: Hybrid: systematic review techniques used to identify qualitative studies of clinical guideline implementation; theory-led and structured analysis of textual data.

Data sources: CINAHL, CSA Illumina, EMBASE, MEDLINE, PsycINFO, and Sociological Abstracts.

Methods: Systematic review of qualitative studies of the implementation of Clinical Practice Guidelines, analysed using Directed Content Analysis, and interpreted in the light of Normalisation Process Theory.

Results: Seven studies met the inclusion criteria of the review. These revealed that clinical practice guidelines are disposed to normalisation when: (a) They are associated with activities that practitioners can make workable in practice, and practitioners are able to integrate it into their collective workflow. (b) When they are differentiated from existing clinical practice by its proponents, and when claims of differentiation are regarded as legitimate by their potential users. (c) When they are associated with an emergent community of practice, and when members of that community of practice enrol each other into group processes that specify their engagement with it. (d) When they are associated with improvements in the collective knowledge of its users, and when users are able to integrate the application of that knowledge into their individual workflow. And, (e) when nurses can minimise disruption to behaviour norms and agreed professional roles, and mobilise structural and cognitive resources in ways that build shared commitments across professional boundaries.

Conclusions: This review demonstrates the feasibility and benefits of theory-led review of studies of nursing practice, and proposes a dynamic model of implementation. Normalisation Process Theory supports the analysis of nursing work. It characterises mechanisms by which work is made coherent and meaningful, is formed around sets of relational commitments, is enacted and contextualised, and is appraised and reconfigured. It facilitates such analysis from within the frame of nursing knowledge and practice itself.

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Accepted/In Press date: 30 July 2013
Published date: 2014
Organisations: Faculty of Health Sciences

Identifiers

Local EPrints ID: 358909
URI: http://eprints.soton.ac.uk/id/eprint/358909
ISSN: 0020-7489
PURE UUID: 25f63c26-1838-498a-99e2-414b9bde5ef0
ORCID for Carl R. May: ORCID iD orcid.org/0000-0002-0451-2690
ORCID for A. Sibley: ORCID iD orcid.org/0000-0002-2503-5432
ORCID for Katherine J. Hunt: ORCID iD orcid.org/0000-0002-6173-7319

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Date deposited: 29 Nov 2013 13:26
Last modified: 15 Mar 2024 03:36

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Contributors

Author: Carl R. May ORCID iD
Author: A. Sibley ORCID iD

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