Facilitating an Evidence-Based Quality Improvement Learning Culture in Nursing Teams Through Coaching and Identification of Key Influencing Factors: An Action Research Approach

通过辅导和识别关键影响因素,促进护理团队中基于证据的质量改进学习文化:一种行动研究方法

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Abstract

AIMS: To explore how coaching can facilitate the development of an Evidence-Based Quality Improvement (EBQI) learning culture within nursing teams in hospital and community care settings. This study also explores the specific contextual factors that influence effective outcomes. DESIGN: Action research. METHOD: Nine teams, including 254 nurses were selected from four hospitals and two community care organisations to participate in the development of an EBQI-learning culture under the guidance of internal and external coaches. Data were gathered from 27 focus groups with 56 unique participants (of whom 31 participated multiple times) and six individual interviews with three external coaches. Transcripts of all interviews were subjected to abductive thematic analysis. RESULTS: To promote an EBQI learning culture in nursing teams, it is essential that internal coaches effectively guide their team members. The internal coaches in this study focused on enhancing readiness for EBQI by providing support, encouraging involvement and motivating team members. They deepened innovation competencies including assessing daily care, implementing well-structured changes in care practices and embedding small steps in the change process in daily routines. It was found that barriers and facilitators within the team's context can influence the development of EBQI-learning culture and therefore need to be considered when seeking to make changes. The presence of external coaches served as a valuable resource and a motivator in supporting internal coaches to apply and improve their coaching skills. CONCLUSIONS: To stimulate the development of an EBQI-learning culture, internal coaches need to focus on team readiness to work with EBQI. Priority needs to be given to enhancing the care change competencies of team members. Barriers to change must also be addressed. Internal coaches require external support and motivation to continually develop coaching skills. REPORTING METHOD: The Standards for Reporting Qualitative Research. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

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