Implementing Evidence Into Everyday Practice: Midwifery Leaders’ Views About What Helps and Hinders Clinical Innovation.

Abstract BackgroundDespite the ongoing production of new scientific evidence in the field of maternity care, midwives continue to face challenges when translating latest evidence into evidence-informed care, and report uncertainty in both knowledge and confidence to implement sustained evidence-based change in clinical areas. This study aimed toexplore midwifery leaders’ views on what factors help or hinder midwives’ efforts to implement evidence-based practices, and test the usability of the Capability, Opportunity, Motivation and Behaviour model and Transtheoretical Domains Framework to analyse the barriers and facilitators of evidence-based change.MethodsThis qualitative study formed part of a larger Participatory Action Research (PAR) project designed to improve the processes by which midwives implement evidence-based practice change in clinical areas. Data were obtained by a nominal group workshop and individual face-to-face interviews between July – September 2019. Thematic analysis was used to interpret the transcribed data, which were then coded and categorised into meaningful themes.ResultsOne overarching core finding emerged from four major categories to fulfil the aim of this study: Fear can stop change and midwives lack the confidence and time to implement new evidence-based practices, however having high level midwives in leadership roles is a huge advantage.ConclusionThis study confirms what is known about the hinderances and helpers of translating latest evidence into everyday practice, and provides valuable insight into the usability of behavioural theories and context assessment tools to both diagnose and develop intervention strategies applicable to midwives initiating evidence-based practice change in clinical areas.