External Facilitation as an Evidence-Based Practice Implementation Strategy During an Antibiotic Stewardship Collaborative in Neonatal Intensive Care Units

Background: Despite research support, evidence-based practices (EBPs) are inconsistently implemented throughout the United States. Facilitation is one implementation strategy to speed adoption in clinical settings. Facilitation has not been previously described in the literature as an implementation strategy within neonatal care. Purpose: The purpose of this study was to categorize and describe essential features of facilitation in the context of implementing an EBP using perspectives elicited from neonatal clinicians and external facilitators (EFs). Methods: In this qualitative descriptive study, semistructured interviews were conducted with a purposive sample of neonatal clinicians and EFs. Participants shared their experiences related to the strategy of facilitation while implementing an EBP during the California Perinatal Quality Care Antibiotic Stewardship Collaborative. Interviews were transcribed, coded, and analyzed using directed content analysis. Results: Five categories emerged to address facilitation as an implementation strategy: (a) facilitated change management, (b) unit and organization receptivity, (c) evaluation strategies, (d) supportive culture, and (e) facilitator stewardship. Linking Evidence to Action: Implementing EBP is complex and multifactorial. Results from this study provide insights into influencing barriers and drivers as experienced by internal and external facilitators, and context factors that impacted the success of implementation.