The tailored implementation of the nursing programme ‘Coping with itch’

Abstract

The aim of the study was to implement the nursing programme 'Coping with itch'. The nursing programme 'Coping with itch' is intended to reduce itch and to help patients to cope with itch. The programme is carried out at a nurse clinic at the dermatology outpatient department. Implementation of this programme was undertaken in five hospitals in the Netherlands using the tailored implementation approach based on the contingency model of van Linge. The implementation procedure started with a diagnostic interview to gather data on the characteristics of the dermatology outpatient departments subsumed in four dimensions: structure, human resource practices, culture and politics. These characteristics were then compared with the demands of the programme. Discrepancies between the demands of the new programme and the characteristics of each organization guided the choice of the implementation strategies. Implementation strategies were mostly directed at the structure or human resource dimensions. Then, the results of the implementation were examined according to three criteria: professional adherence, continuation and barriers, using nurses' self-report forms on the consultations and the Barriers and Facilitators questionnaire. Seventy-seven self-report forms were completed by the nurses for first consultations at the itch clinic and 81 for follow-up consultations. Results concerning professional adherence show that nurses are able to carry out the programme 'Coping with itch'. All five hospitals continued the itch clinic after completion of the implementation study. Two barriers to the implementation were frequently mentioned by the nurses: the necessary time investment and the lack of extra financial compensation. The use of a tailored implementation approach has led to the reasonably successful implementation of the nursing programme 'Coping with itch'. Relevance to clinical practice. The contingency model is a useful model for the tailored implementation of a nursing programme in daily practice.