Project Implement - Pilot implementation of Guidelines for District Nursing

In November 2023, there was a report in this newsletter about the IMPACT project (see news below). During this project, researchers applied a methodology in which a trial implementation of draft guidelines in practice becomes part of guideline development. With the 'Implement' project, Maud Heinen and Rosa Mennes of IQ Health are building further on guideline development and implementation within nursing. They are reapplying this methodology to five guidelines: Compression therapy, Skin tears, Psychosocial care in cancer, Working safely with cytostatics and Contaminated households.

A pilot implementation will test the five guidelines in practice. During that pilot implementation, nurses and caregivers will work according to the new guideline for a period of three months. After those three months, the researchers will make a determinant analysis for each guideline for the implementation of the guideline. They also use qualitative research methods to examine the experience of working according to the guideline. This is done with different participants and stakeholders, such as the nurses and caregivers, but also policy staff in the organization, clients and relatives and other disciplines with whom there was collaboration as a result of acting according to the guideline. As a next step, the researchers identify implementation strategies that align with practice needs. They then report these findings to the V&VN, the client of the project. An international publication is also being prepared in collaboration with V&VN.

From this project 1 guideline has now been published: Guideline Osteoporosis and Fracture Prevention (update 2024) - V&VN Knowledge Platform (venvn.nl) Below are the results of the pilot implementation from this guideline:

Use of the guideline:

• Osteoporosis and Fracture Prevention was perceived by the participating healthcare providers as important in order to contribute to fracture prevention.

• Some aspects of the guideline could be more focused on the target group of district nurses and POHs.
• The health care providers would like the word monitor in the guideline to be replaced by evaluate.

Implementation plan

The implementation of the guideline can be promoted by giving specific examples, focused on the target group of the guideline. Examples could include:

- An overview with sample exercises that people can do if they have a disability, for example, are wheelchair-dependent.

- An overview with suitable vitamin D supplements.

- An overview of calcium-rich foods (see calcium meter).

In addition, for implementation it is advised to link up with already existing fall prevention recommendations. Finally, a flow chart can help healthcare professionals understand the client's care process.

This news item was posted on our website in November 2023:

ProjectIMPACT (Implementation Activities Applied)

The national professional association Verpleegkundigen & Verzorgenden Nederland develops guidelines for the nursing and caregiving profession. V&VN has a unique step built into the development of a guideline, namely: a trial implementation. In a trial implementation, the recommendations given in the guideline are tested in practice before a guideline is finally published. A number of health care providers get to work providing care in accordance with the recommendations. By means of qualitative and quantitative research methods, the experience with the guideline will be collected, in order to better align the guideline with practice. IQ healthcare is preferred partner for both the development of guidelines and the execution of pilot implementations of V&VN. From IQ healthcare, Dr. Maud Heinen as project leader and Rosa Mennes as researcher are involved in this project.