Factors and Conditions that Influence the Implementation of Standardized Nursing Care Plans

Inger Jansson*, 1, Christel Bahtsevani2, Ewa Pilhammar-Andersson3, Anna Forsberg4
1 School of Social and Health Sciences, Halmstad University, Halmstad, Sweden
2 Faculty of Health and Society, Malmö University, Sweden
3 Gothenburg University,The Sahlgrenska Academy, Institute of Health and Care Sciences, Sweden
4 Gothenburg University,The Sahlgrenska Academy, Institute of Health and Care Sciences, and Department of Surgery, Sahlgrenska University Hospital, Sweden

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© Jansson et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the School of Social and Health Sciences, HOS, Halmstad University, Box 823, 301 18 Halmstad, Sweden; Tel: 0046-35-167458; Fax: 0046-340-676419; E-mail:


Rationale and Aim:

There is a lack of evidence about how to successfully implement standardized nursing care plans (SNCP) in various settings. The aim of this study was to use the “Promotion Action on Research Implementation in Health Services framework” (PARIHS) to explore important factors and conditions at hospital wards that had implemented SNCPs.


We employed a retrospective, cross-sectional design and recruited nurses from four units at a rural hospital and seven units at a university hospital in the western and southern region of Sweden where SNCPs had been implemented. Outcome was measured by means of a questionnaire based on the PARIHS-model.


In total, 137 nurses participated in the study. The main factors that had motivated the nurses to implement SNCPs were that they were easy to understand and follow as well as corresponding to organisational norms. The SNCPs were normally based on clinical experience, although research more frequently formed the basis of the SNCPs at the university hospital. Internal facilitators acted as important educators, who provided reminders to use the SNCP and feedback to the SNCP users. The patient experience was not considered valuable. Those who claimed that the implementation was successful were generally more positive in all measurable aspects. The use of SNCPs was rarely evaluated.


Clinical experience was considered important by the nurses, while they attributed little value to the patient experiences. Successful implementation of research based SNCPs requires internal facilitators with knowledge of evidence-based nursing.

Keywords: Implementation, standardized nursing care plans, PARIHS, questionnaire.