title: Management Involvement--A Decisive Condition When Implementing Evidence-Based Practice.
abstract: BACKGROUND
  Even though health professionals have a positive attitude toward evidence-based practice (EBP), they have limited skills when it comes to implementation of EBP. A postprofessional program in EPB has been offered at Bergen University College since 2004. To date, there is limited knowledge of how the graduates of the program implement and make use of the EBP principles in their working environment in different healthcare settings.
  
  
  OBJECTIVE
  The aim of the study was to explore the facilitators and strategies to successful implementation of the steps of EBP as experienced by health professionals who had completed a postgraduate program in EBP.
  
  
  METHODS
  Grounded theory was used in gathering and analyzing data from single and focus group interviews of 20 health professionals who had attended a postprofessional program in EBP. Inclusion criteria also required current clinical practice.
  
  
  RESULTS
  This study identified a specific set of activities used by health professionals when implementing EBP within their service organization. Creating an interest and understanding of EBP amongst their colleagues appeared to be a challenge, which they addressed by using the generated grounded theory of "tailoring principles." The dominant condition of this theory was management involvement.
  
  
  CONCLUSIONS
  This study highlighted the importance of middle-range managers' coordinating and supporting role as a decisive component in the process of implementing EBP to clinical settings in Norway. Moreover, the dynamic complex process of "tailoring principles" also showed how the production of a clinical protocol became an outcome of implementation effectiveness as well as input for further intervention effectiveness. Tailoring the principle of EBP to the organizational and cultural context facilitated the implementation of EBP.
authors.affiliation: Assistant Professor, Centre for Evidence-Based Practice, Bergen University College, Bergen, Norway.
authors.forename: Katrine
authors.initials: K
authors.lastname: Aasekjaer
authors.affiliation: Assistant Professor, Department of Research and Development, Haukeland University Hospital, Bergen, Norway.
authors.forename: Hilde Valen
authors.initials: HV
authors.lastname: Waehle
authors.affiliation: Professor, Centre for Evidence-Based Practice, Bergen University College, Bergen, Norway and School of Nursing, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Donna
authors.initials: D
authors.lastname: Ciliska
authors.affiliation: Professor, Centre for Evidence-Based Practice, Bergen University College, Bergen, Norway.
authors.forename: Monica Wammen
authors.initials: MW
authors.lastname: Nordtvedt
authors.affiliation: Associated Professor, Centre for Evidence-Based Practice, Bergen University College, Bergen, Norway.
authors.forename: Esther
authors.initials: E
authors.lastname: Hjälmhult
mesh_terms: D001291:Attitude of Health Personnel; D055317:Evidence-Based Practice / Q000379:methods*; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D007857:Leadership; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: evidence-based practice; grounded theory; implementation; tailoring principles