This evidence brief describes implementation strategies, challenges, and lessons learned from conducting five Interdisciplinary Nursing Quality Research Initiative (INQRI) funded implementation studies, and presents two case examples of other INQRI studies to illustrate dissemination strategies.

Background

• The terms “dissemination” and “implementation” are used to indicate the process of bringing evidence into practice.
• Applying of evidence based practices (EBPs) in care delivery improves patient outcomes. Large gaps still exist, however, between recommended care and that used in practice.

Key Findings:

• Four of five implementation studies were on clinical topics (falls; delirium; pain; substance abuse screening, brief intervention and referral) and one was on professional development of nurse managers.
• The most common implementation strategies used included education, ongoing interaction with sites, use of implementation tools, and visibility of the projects on the study units.
• Major successes investigators reported were enthusiasm and engagement of site coordinators and nurses, their increased understanding about the study topic, and tools for other hospitals to use for improving practice.
• Major challenges included administrative delays with the institutional review board (IRB) approval processes, and the short length of time allocated for implementation. IRB challenges included obtaining approval for multisite implementation studies. Studies were funded for 18 months. Time spent in actual implementation ranged from 4 to 12 months with most being 4 to 6 months.
• Most common lessons learned reported by investigators included an understanding of the importance of context, as well as the complexity of implementation, and ensuring good communication with clinicians and study sites throughout implementation.
• Case examples illustrated dissemination strategies at both local and national levels, wherein findings were utilized by sites to improve care and also led to additional funded research.