The perceptions of public health nurses on using standardized care plans to translate evidence-based guidelines into family home visiting practice

Objectives Public health nurse (PHN) perceptions of using standardized care plans to translate evidence-based guidelines into family home visiting practice have not been examined. The purpose of this study was to evaluate PHN experience and awareness of cognitive processes while using evidence-based care plans in family home visiting practice. Design This qualitative study used content analysis of PHN interviews. Sample A purposive sample of PHNs in a local public health agency who were experienced in the use of care plans in electronic documentation. Measures The qualitative study utilized content analysis methods. Semi-structured interviews examined their cognitive experience transitioning from usual practice care plans to evidence-based care plans. Interviews were transcribed and analyzed using a thematic analysis approach. Themes were developed and revised following several reviews of the transcripts. Results Four themes from PHN interviews revealed a complex dynamic process of knowledge management: (1) PHN thinking is separate from the care plan. (2) PHN thinking is supported by the care plan. (3) PHN thinking is stimulated by the care plan. (4) PHN documentation distress is minimized when the care plan matches PHN thinking. Conclusion While using the evidence-based FHV care plan, PHN cognitive processes were related to their own knowledge and expertise, their individual clients, and the entire client population or program. Evidence-based care plans supported and stimulated PHN thinking about evidence-based interventions and their application in practice. A good fit of the care plan knowledge schemata with a PHN's own knowledge schemata may decrease documentation distress. Further research is needed to evaluate the impact of using evidence-based care plans in other disciplines and settings.