Page 143 - Demo

Community of Practice as implementation strategy1415implementation interventions were not in all cases targeted at care staff directly, hindering the uptake of NAF. Part of the interventions included informing intermediate disciplines, such as team leaders and CCA coaches responsible for bringing NAF further to care teams. Because the questionnaires were administered exclusively to care staff, the effects of these implementation interventions might not have surfaced. Other studies focusing on CoPs in long-term elderly care have directly assessed CoP participants and demonstrated effectiveness (Read et al., 2023). For future studies examining the effectiveness of CoPs as implementation strategy, we recommend outcome assessments should involve not only end-users but also CoP participants and intermediaries.It was anticipated that care staff would need support to understand the purpose of NAF and in learning how to apply it in clients%u2019 cases concerning involuntary care. An educational strategy seemed most successful in getting care staff to engage with NAF. Practicing with NAF under the guidance of an implementer elicited discussions about involuntary care and the importance of considering clients%u2019 perspectives. This aligns with prior research findings suggesting that care staff can derive benefits from participation in staff training programmes (Knotter et al., 2018). For future implementation plans, we recommend interventions that engage care staff in practicing with innovations. Facilitating the CoP and monitoring adherence to the work routine were important for maintaining focus in discussions aligned with the intended goals. Additionally, a facilitator can proactively manage dynamics among participants to enhance collective learning (Eldh et al., 2023). Moreover, a facilitator can remind participants not only to develop an implementation plan but also to consider sustainability strategies within their organisations, ensuring the integration of NAF into regular work processes.LimitationsMean scores on the NoMAD questionnaire for Level of Implementationwere relatively high at TP-0 for both the experimental and control groups. This may indicate a possible ceiling effect. By informing participants about the study to ask for their consent, awareness of the e-tool NAF may have