title: Factors and Conditions that Influence the Implementation of Standardized Nursing Care Plans.
abstract: OBJECTIVE
  There is a lack of evidence about how to successfully implement standardized nursing care plans (SNCP) in various settings. The aim of this study was to use the "Promotion Action on Research Implementation in Health Services framework" (PARIHS) to explore important factors and conditions at hospital wards that had implemented SNCPs.
  
  
  METHODS
  We employed a retrospective, cross-sectional design and recruited nurses from four units at a rural hospital and seven units at a university hospital in the western and southern region of Sweden where SNCPs had been implemented. Outcome was measured by means of a questionnaire based on the PARIHS-model.
  
  
  RESULTS
  In total, 137 nurses participated in the study. The main factors that had motivated the nurses to implement SNCPs were that they were easy to understand and follow as well as corresponding to organisational norms. The SNCPs were normally based on clinical experience, although research more frequently formed the basis of the SNCPs at the university hospital. Internal facilitators acted as important educators, who provided reminders to use the SNCP and feedback to the SNCP users. The patient experience was not considered valuable. Those who claimed that the implementation was successful were generally more positive in all measurable aspects. The use of SNCPs was rarely evaluated.
  
  
  CONCLUSIONS
  Clinical experience was considered important by the nurses, while they attributed little value to the patient experiences. Successful implementation of research based SNCPs requires internal facilitators with knowledge of evidence-based nursing.
authors.affiliation: School of Social and Health Sciences, Halmstad University, Halmstad, Sweden.
authors.forename: Inger
authors.initials: I
authors.lastname: Jansson
authors.forename: Christel
authors.initials: C
authors.lastname: Bahtsevani
authors.forename: Ewa
authors.initials: E
authors.lastname: Pilhammar-Andersson
authors.forename: Anna
authors.initials: A
authors.lastname: Forsberg