Abstract
Background:
Evidence-based health care is accepted as a quality standard of mental health practice. However, acute mental health inpatient settings internationally present significant challenges to embedding evidence-based interventions into practice. Evidence is limited on elements that can influence successful implementation of therapeutic engagement interventions in these settings. This study sought to address the evidence gap by examining factors influencing implementation of the Therapeutic Engagement Questionnaire (TEQ), an evidence-based intervention.
Aims:
To understand barriers and enablers to implementation of the TEQ in acute mental health inpatient settings.
Methods:
Qualitative methods were used in which data were collected from ethnographic field notes and documentary review, coded and thematically analysed. Theoretical framing supported data analysis and interpretation. Data were collected across fifteen acute inpatient wards in seven English mental health organisations June 2020 -October 2021.
Results:
Eight themes were identified in the implementation process experienced by study sites: philosophy of the TEQ, fit with organisational goals, therapeutic engagement know-how, Covid-19 pandemic challenges, data collection,
reflective and facilitative conversations, therapeutic engagement training and learning, ward-level agents of change.
Discussion:
The TEQ as an evidence-based intervention co-produced by service users and nurses was valued and welcomed by many nurse directors, senior clinicians and ward managers. However, a range of practical and perceptual factors impeded implementation, often magnified by the COVID-19 pandemic. Our study suggested several facilitation methods to address these barriers, brought together in a conceptual model, including encouragement of reflective, facilitative discussion meetings among stakeholders and researchers, effort put into winning nurse ‘buy in’, and identifying and supporting ward-level agents of change.
Conclusion:
Successful implementation of the TEQ into practice is feasible. However, the challenges faced in translating the intervention into a non-receptive context suggest several practice implications for others implanting the TEQ
or other interventions into the acute inpatient mental health environment.
Evidence-based health care is accepted as a quality standard of mental health practice. However, acute mental health inpatient settings internationally present significant challenges to embedding evidence-based interventions into practice. Evidence is limited on elements that can influence successful implementation of therapeutic engagement interventions in these settings. This study sought to address the evidence gap by examining factors influencing implementation of the Therapeutic Engagement Questionnaire (TEQ), an evidence-based intervention.
Aims:
To understand barriers and enablers to implementation of the TEQ in acute mental health inpatient settings.
Methods:
Qualitative methods were used in which data were collected from ethnographic field notes and documentary review, coded and thematically analysed. Theoretical framing supported data analysis and interpretation. Data were collected across fifteen acute inpatient wards in seven English mental health organisations June 2020 -October 2021.
Results:
Eight themes were identified in the implementation process experienced by study sites: philosophy of the TEQ, fit with organisational goals, therapeutic engagement know-how, Covid-19 pandemic challenges, data collection,
reflective and facilitative conversations, therapeutic engagement training and learning, ward-level agents of change.
Discussion:
The TEQ as an evidence-based intervention co-produced by service users and nurses was valued and welcomed by many nurse directors, senior clinicians and ward managers. However, a range of practical and perceptual factors impeded implementation, often magnified by the COVID-19 pandemic. Our study suggested several facilitation methods to address these barriers, brought together in a conceptual model, including encouragement of reflective, facilitative discussion meetings among stakeholders and researchers, effort put into winning nurse ‘buy in’, and identifying and supporting ward-level agents of change.
Conclusion:
Successful implementation of the TEQ into practice is feasible. However, the challenges faced in translating the intervention into a non-receptive context suggest several practice implications for others implanting the TEQ
or other interventions into the acute inpatient mental health environment.
| Original language | English |
|---|---|
| Publication status | Published - 6 Sept 2023 |
| Event | RCN International Nursing Research Conference 2023: Embedding a Culture of Research in Nursing - University of Manchester, Manchester, United Kingdom Duration: 6 Sept 2023 → 8 Sept 2023 https://www.rcn.org.uk/-/media/Royal-College-Of-Nursing/Documents/Events/2023/Research/Book-of-abstracts-v5.pdf |
Conference
| Conference | RCN International Nursing Research Conference 2023 |
|---|---|
| Country/Territory | United Kingdom |
| City | Manchester |
| Period | 6/09/23 → 8/09/23 |
| Internet address |