title: Factors and conditions that have an impact in relation to the successful implementation and maintenance of individual care plans.
abstract: BACKGROUND
  The gap between what is stated in legislation about written individualized nursing care plans (ICP) and how they are used in practice is still too wide.
  
  
  OBJECTIVE
  To explore attitudes and experiences among nurses and managers in order to capture which factors and conditions impact on the successful implementation of individual care plans within hospital care, as well as the strategies that were adopted to ensure continued use.
  
  
  METHODS
  The study was carried out through directed content analysis guided by the Promoting Action on Research Implementation in Health Services framework. Interviews were conducted with 15 informants on different operational and decision levels at a hospital that is well known in Sweden for its work in the ICP area.
  
  
  RESULTS
  Important factors for implementation on the wards were clear instructions from the hospital management at the start of implementation as well as clear roles and mandates for those involved. The work of internal facilitators was crucial for the continuation of the process. Clinical experience was important as the long-term driving force.
  
  
  CONCLUSIONS
  On the basis of the findings of this study, we argue that it is important for hospital managers to recruit leaders that focus on individual nursing care and can highlight needs and instigate change. It seems also important that the organization takes advantage of the potential of skilled facilitators.
authors.affiliation: School of Social and Health Sciences, Halmstad University, Halmstad, Sweden. Inger.Jansson@hh.se
authors.forename: Inger
authors.initials: I
authors.lastname: Jansson
authors.forename: Ewa
authors.initials: E
authors.lastname: Pilhamar
authors.forename: Anna
authors.initials: A
authors.lastname: Forsberg
mesh_terms: D001291:Attitude of Health Personnel; D004506:Education, Nursing / Q000458:organization & administration; D019983:Guideline Adherence / Q000458:organization & administration; D006801:Humans; D010347:Patient Care Planning / Q000458:organization & administration*; D017410:Practice Guidelines as Topic; D011785:Quality Assurance, Health Care; D013222:State Medicine; D013548:Sweden