{
  "abstract": "Aim This study aims to identify key determinants and strategies for effectively implementing a reflection method to support adequate use of the ‘Informal Care’ guideline within community nursing. The SPARK (Self & Peer Assessment to Reflect on Quality Standards) reflection method, developed in an earlier participatory design-based study, is a structured group reflection approach designed to help nurses and nursing assistants reflect on and apply guideline recommendations in daily practice.Design A mixed method study.Setting Six community care organisations in the Netherlands.Participants and interventions This mixed-method study collected qualitative data through observations and video recordings of group meetings with community nurses, nursing assistants and a patient representative, alongside quantitative questionnaires. This project included design and test group meetings to develop and evaluate prototypes of the reflection method. Observations were discussed, and video recordings were thematically analysed. The Measurement Instrument for Determinants of Innovations questionnaire was used to identify key determinants for effective implementation. The questionnaire results were analysed descriptively, using the Tailored Implementation in Chronic Diseases (TICD) framework to present preliminary determinants for validation. Implementation strategies were then selected in a group meeting. Based on this input, the research group operationalised the selected implementation strategies.Results Twenty-nine determinants for implementing the reflection method were identified across seven TICD domains, including barriers such as limited support, knowledge and time, and facilitators such as team collaboration and prevention of caregiver overload. Based on these findings, three implementation strategies, namely knowledge enhancement, coaching development and leadership strengthening, were formulated to support integration into community nursing practice.Conclusion This study identified key determinants and strategies for implementing a reflection method in community nursing. While several determinants align with existing literature, context-specific determinants related to the heterogeneous group of registered nurses and certified nursing assistants also emerged. Strengthening guideline knowledge, coaching competencies and leadership is essential for sustainable, guideline-based reflection in practice.",
  "authors": [
    {
      "affiliations": [
        "Radboud Institute of Health Sciences, Scientific Institute for Quality of Healthcare, Radboud University Medical Center, Nijmegen, the Netherlands",
        "Faculty of Nursing Studies, HAN University of Applied Sciences Institute of Nursing Studies, Nijmegen, the Netherlands"
      ],
      "name": "Nicole Vullings"
    },
    {
      "affiliations": [
        "Radboud Institute of Health Sciences, Scientific Institute for Quality of Healthcare, Radboud University Medical Center, Nijmegen, the Netherlands",
        "Faculty of Allied Health Sciences, HAN University of Applied Sciences, Nijmegen, the Netherlands"
      ],
      "name": "Marjo Maas"
    },
    {
      "affiliations": [
        "Faculty of Nursing Studies, HAN University of Applied Sciences Institute of Nursing Studies, Nijmegen, the Netherlands"
      ],
      "name": "Marian Adriaansen"
    },
    {
      "affiliations": [
        "Radboud Institute of Health Sciences, Scientific Institute for Quality of Healthcare, Radboud University Medical Center, Nijmegen, the Netherlands"
      ],
      "name": "Hester Vermeulen"
    },
    {
      "affiliations": [
        "Radboud Institute of Health Sciences, Scientific Institute for Quality of Healthcare, Radboud University Medical Center, Nijmegen, the Netherlands"
      ],
      "name": "Philip Van der Wees"
    },
    {
      "affiliations": [
        "Radboud Institute of Health Sciences, Scientific Institute for Quality of Healthcare, Radboud University Medical Center, Nijmegen, the Netherlands"
      ],
      "name": "Maud Heinen"
    }
  ],
  "title": "Determinants and implementation strategies to implement a reflection method for guideline-based informal caregiving in community nursing in the Netherlands: a mixed-method study",
  "uid": "fa6c8772-ac03-596f-8e0f-fefa8736c02e"
}