Using the Knowledge‐to‐Action Framework to understand experiences of breastfeeding guideline implementation: A qualitative study
Antonio Jesús Ramos‐Morcillo, David Harillo‐Acevedo, María Ruzafa‐Martínez
Abstract
AIM: To examine the perceptions and experiences of health care professionals and mothers in relation to the implementation of a breastfeeding clinical practice guideline (CPG). BACKGROUND: Breastfeeding CPG applications remain limited, and qualitative studies have indicated the need to overcome the perception by professionals of difficulties in applying recommendations. METHODS: A qualitative study was conducted in a Spanish public hospital that implemented the Registered Nurses´ Association of Ontario breastfeeding CPG from 2012 through 2015. Between May and August 2017, 27 semi-structured interviews were conducted with managers, with professionals in maternity and paediatric departments and with mothers. Deductive content analysis was performed following the stages in the Knowledge-To-Action (KTA) Framework. RESULTS: We obtained five main categories: (a) problem as opportunity; (b) adequate context and adapted recommendations; (c) extent of implementation; (d) impact of results; and (e) knowledge use normalization. CONCLUSIONS: The KTA Framework assists understanding of the participation of the main actors in breastfeeding CPG implementation. IMPLICATIONS FOR NURSING MANAGEMENT: The nature of the interventions and the participation of managers, different professionals and mothers in a multi-unit setting generate a complex implementation process that reveals key factors to be taken into account in future CPG implementations.