Adoption and Early Implementation Evaluation of a Heart Failure Nursing Protocol in Veterans Health Clinics.

IF 1.7 4区医学 Q3 NURSING

Journal of nursing care quality Pub Date : 2026-05-22 DOI:10.1097/NCQ.0000000000000977

Christina L Wyles, Alaina K Preddie, Margeaux A Chavez, Courtney Monterusso, Teresa Damush

{"title":"Adoption and Early Implementation Evaluation of a Heart Failure Nursing Protocol in Veterans Health Clinics.","authors":"Christina L Wyles, Alaina K Preddie, Margeaux A Chavez, Courtney Monterusso, Teresa Damush","doi":"10.1097/NCQ.0000000000000977","DOIUrl":null,"url":null,"abstract":"Background: The Veterans Health Administration Office of Nursing Services developed an ambulatory care heart failure nursing protocol to standardize outpatient nursing practice and piloted it at 4 medical centers.Methods: We conducted a cross-sectional evaluation using semi-structured interviews with Likert-scale items to assess early adoption and contextual influences. Interviews were conducted with 39 nursing staff across 4 pilot sites. Data were analyzed using rapid qualitative methods informed by Reach, Effectiveness, Adoption, Implementation, Maintenance and Consolidated Framework for Implementation Research frameworks.Results: Staff described improvements in documentation standardization and communication, and increased confidence in protocol use. Time constraints, workflow integration challenges, and electronic health record barriers limited consistent implementation. Nurse educators were key facilitators.Conclusions: Early findings suggest the protocol may support standardized outpatient nursing practice. Attention to workflow integration, role clarity, and contextual variation may strengthen broader adoption.","PeriodicalId":16931,"journal":{"name":"Journal of nursing care quality","volume":" ","pages":""},"PeriodicalIF":1.7000,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of nursing care quality","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/NCQ.0000000000000977","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"NURSING","Score":null,"Total":0}

引用次数: 0

Abstract

Background: The Veterans Health Administration Office of Nursing Services developed an ambulatory care heart failure nursing protocol to standardize outpatient nursing practice and piloted it at 4 medical centers.

Methods: We conducted a cross-sectional evaluation using semi-structured interviews with Likert-scale items to assess early adoption and contextual influences. Interviews were conducted with 39 nursing staff across 4 pilot sites. Data were analyzed using rapid qualitative methods informed by Reach, Effectiveness, Adoption, Implementation, Maintenance and Consolidated Framework for Implementation Research frameworks.

Results: Staff described improvements in documentation standardization and communication, and increased confidence in protocol use. Time constraints, workflow integration challenges, and electronic health record barriers limited consistent implementation. Nurse educators were key facilitators.

Conclusions: Early findings suggest the protocol may support standardized outpatient nursing practice. Attention to workflow integration, role clarity, and contextual variation may strengthen broader adoption.

查看原文本刊更多论文

退伍军人健康诊所心力衰竭护理方案的采用及早期实施评估。

背景：退伍军人健康管理局护理服务办公室制定了门诊护理心力衰竭护理方案，以规范门诊护理实践，并在4个医疗中心进行了试点。方法：我们使用李克特量表项目的半结构化访谈进行了横断面评估，以评估早期采用和环境影响。对4个试验点的39名护理人员进行了访谈。通过Reach、有效性、采用、实施、维护和实施研究框架的统一框架，使用快速定性方法分析数据。结果：工作人员描述了文件标准化和沟通方面的改进，并增加了对方案使用的信心。时间限制、工作流集成挑战和电子健康记录障碍限制了一致性实现。护士教育者是关键的推动者。结论：早期研究结果表明，该方案可能支持标准化门诊护理实践。对工作流集成、角色清晰度和上下文变化的关注可能会加强更广泛的采用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of nursing care quality 医学-护理

CiteScore

2.40

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Journal of Nursing Care Quality (JNCQ) is a peer-reviewed journal that provides practicing nurses as well as nurses who have leadership roles in nursing care quality programs with useful information regarding the application of quality principles and concepts in the practice setting. The journal offers a forum for the scholarly discussion of “real world” implementation of quality activities.