Barriers and facilitators of implementation sustainability of evidence-based practice for peristomal irritant contact dermatitis: A descriptive qualitative study

Objectives

To investigate the barriers and facilitators influencing the sustainable implementation of evidence-based practice (EBP) for Peristomal Irritant Contact Dermatitis (PICD) based on the Consolidated Framework for Implementation Research (CFIR).

Methods

The sample consisted of 17 nurses from three urology wards at a tertiary hospital in Beijing, China, who had participated in the EBP. Guided by the CFIR, we identified constructs influencing the sustainability of implementation by conducting a directed content analysis of the 17 individual in-depth interviews. By rating, the valence and magnitude of each construct were determined.

Results

This study identified 19 factors across the five domains of the CFIR. Among these determinants, 16 were identified as barriers, while three were recognized as facilitators. Common barriers across different contexts were identified, such as delayed evidence updating, the complexity of intervention components and steps, and incompatibility between the implementation process and clinical practices. In contrast, facilitators of intervention implementation were regular communication and feedback, support and drive from principals and a positive cultural atmosphere. In addition, we identified “regular evidence updating” as an independent construct outside of the CFIR, a finding that will provide key information for updating the CFIR framework.

Conclusions

Regular evidence updating is crucial for the sustainability of EBP implementation. Researchers should receive consistent feedback from practitioners and adjust or modify the EBP as necessary. Additionally, researchers must consider the compatibility or adaptability of the EBP’s content with clinical practice in formulating it rather than adding additional complexity to the original workflow.