Introduction, adoption, and facilitation of standardized care plans in municipal healthcare services

To ensure patient safety and continuity of care, nurses need access to accurate and timely information. Standardized care plans (SCPs) were implemented in Norwegian municipalities to improve the quality of the patient record content. This study explored the information practice in which SCPs were introduced, how nurses adopted and used the SCPs and identified facilitating factors for routine use of SCPs. Data were collected from participant observations and interviews with nurses, printouts from the care plans, and workshops with nurses and nursing leaders. The study revealed that municipal healthcare is a complex context in which to introduce SCPs with several information sources in use, poor access to the patient record system at the point of care, and large differences in individual knowledge and educational background within the healthcare workforce. There were large variations in how nurses evaluated the usefulness of SCPs and in how they were used. The study also showed that well-functioning technology, engaged leaders and stakeholders, and ongoing access to training and support were important factors for SCPs to become routinely embedded in nurses’ information practice.