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Barriers and Facilitators to Successful Implementation of Worksite Mindfulness Interventions for Acute Care Nurses

出版	Ohio State University, 2022
URL	http://books.google.com.hk/books?id=n4ykzwEACAAJ&hl=&source=gbs_api

註釋Effects of nurse stress and burnout on work engagement, absenteeism, and turnover are well documented as are associations with medication errors and lapses in care. Mindfulness-based interventions (MBIs) are widely recognized for reducing employee stress and improving coping and resilience. However, mechanisms of success and sustainability of MBIs are difficult to ascertain due to multiple inter-related factors including intervention features, nurse characteristics, and complexities inherent within health care environments. The purpose of this study was to determine contextual factors contributing to implementation success of worksite MBIs aimed at supporting nurse health and well-being. A multi-phase, sequential, mixed-methods design was used to explore critical aspects of the implementation process for worksite MBIs targeted to clinician groups that included acute care nurses working in academic medical centers. Guided by the Consolidated Framework for Implementation Research (CFIR), a comprehensive survey was used to obtain information from key implementation leaders related to variations in worksite mindfulness interventions and implementation processes across multiple United States (U.S.) healthcare systems. Factors associated with implementation success, defined as nurse participation in a mindfulness intervention with reported improvements in individual and/or organizational outcomes, were computed using univariate analysis. Semi-structured interviews with a subset of implementation team leaders were completed to further explore, evaluate, and clarify strategies that have led to successful implementation and described intervention, health care setting, or process-related barriers to implementation success. A predictor of implementation success within academic healthcare systems included offering paid time (p=.029) to support participation and sustainability. Validated qualitatively by implementation team leaders, this predictor of implementation success appeared to be a result of organizational leadership whose support was essential in planning, developing, implementing, and evaluating evidence-based mindfulness interventions to improve the health and well-being of clinician groups that include acute care nurses. An understanding of how and why specific development and implementation strategies for MBIs are successful for nurses may be applicable to other interventions and more broadly to all health care professionals in the acute care health care environment. This is also valuable information for health care organizations that employ interventions targeted to employee well-being, especially considering the significant psychological effect of the COVID-19 pandemic on front line health care providers, including acute care nurses. An examination of the practical application of the CFIR to support development and implementation of worksite interventions is a priority for future research.