Table 1 Description of the educational component of the IMPAKT intervention

Actors

Academic staff from Center for evidence-based practice (EBP) set up and delivered an educational KT capacity program. Learners/students were employed in intervention group NHs.

Facilitation led by members of the academic partner to Practice development nurses who led the implementation of a clinical innovation in their respective nursing homes. Facilitation was tailored to the challenges and needs that arised during an 8-month long implementation period.

Actions

To provide the NH organization with a KT capacity program tailored and adapted to the roles and needs in the organization.

To increase readiness to deal with KT by equipping learners with competencies and tools in EBP and KT.

To facilitate a real-world KT project aiming to implement NEWS2, using the knowledge-to-action model to guide the process.

Some facilitation activities were collective across the intervention NHs, including four meetings with PDNs in intervention group, to share their challenges and solutions over a common KT project. Others were specific to each NH, such as how they could achieve leadership involvement, and took place every two weeks on telephone.

Target(s) of the action

To enhance Practice Development Nurses’ (PDNs) with knowledge, skills and tools to lead KT-projects and professional development in the NH organization.

To enhance knowledge, skills and attitudes related to partaking in KT-projects in NHs.

To support newly trained PDNs in their pursuit of a KT project in the NH. Help them use the tools and frameworks provided in the educational program, and keep on track with their local Action plans for the implementation of NEWS2 in their respective NHs.

Temporality

The capacity program was the initial activity in the intervention. Preceding the intervention was a development phase of the intervention, in an IKT partnership.

The facilitation period represented a continuation of part I. This period marks the implementation period the KT project and a shift from educational to clinical setting.

Dose

The program was delivered as a 15 ECTS university led EBP/KT program, with in-house sessions over one semester in university premises. The program had three distinct modules, reflecting three advancing steps of KT competence. The modules consisted of 2 + 3 + 2 full days, with some ‘homework’ between sessions in each NH. All modules were mandatory for PDNs, but each facility was encouraged to send more staff to the program.

Educational meetings over two days in a train-the trainer fashion to develop clinical capacity in the use of NEWS2. Each NH had three members of staff on a course with clinical staff from the local emergency room.

Four physical implementation team meetings among the PDNs, over the course of 8 months.

Bi-weekly telephone facilitation meetings between PDN and facilitator from academic partner.

Implemen-tation outcomes affected

Acceptability, measured as the number of participants throughout the program modules, and work in-between modules at each nursing home.

Feasibility of program, using open-ended survey at end of each module and counting participants. Adoption of concepts of knowledge-to-action when assessing each NH action plans for implementing NEWS2.

Appropriateness of educational material developed to guide the PDNs in their work to plan, tailor, and carry out a KT project according to the steps of knowledge-to-action plan. Adoption of KT capacity, assessed by the PDNs’ ability to plan a knowledge-to-action process and then carry it out.

Uptake of NEWS2 in nursing homes, assessed as calculated penetration of its use.

Justification

Within the IKT partnership we undertook a development period where we collected input from the range of staff in the NH organization towards the current level of EBP and KT competencies.

Research was set up in an IKT partnership to enhance involvement and relevance [13, 30, 31]. Educational program underpinned by research [32] and long-standing experience in the academic team [33,34,35].

Many studies show that EBP courses change learners’ knowledge and attitudes positively, but that they struggle to change their behavior and apply EBP in clinical practice. This coincides with the academic partner’s experience [33, 34]. The facilitation period was undertaken to integrate and facilitate the transfer of learning from the educational program to the learners’ clinical setting.