Abstract：
BACKGROUND: The demand for advanced clinical care in nursing homes (NHs) is increasing. Evidence-based practices and knowledge translation (KT) initiatives are growing to bridge the gap between what is known and what is done. However, research on contextual influence on KT has primarily focused on hospital settings.
OBJECTIVE: To expand our understanding of contextual influences on KT capacity in a NH organisation.
METHODS: Lindseth and Norberg\'s phenomenological hermeneutical method was used to explore and describe practice development nurses\' experiences, perspectives and practices regarding how contextual factors influence KT capacity in NHs. Focus group interviews, participant observations, in-depth interviews and non-participant observations provided the data.
RESULTS: Two main themes and four subthemes were identified. (1) Continuous limited resources are a cultural condition that inhibits KT readiness; prioritising keeping the NH machinery running at all costs and having contrasting care philosophies undermines KT. (2) Organisational prioritisations leave KT as a missing cogwheel in the machinery; retaining a system of fragmented KT strategies and lacking a structure for collective KT effort.
CONCLUSIONS: The study showed that KT held a minor role in the fast-paced NH machinery. Contradicting values characterise the NH organisation, resulting in a lack of a common vision and priorities. Building a sustainable KT capacity and providing evidence-based practice necessitates explicit responsibilities, dedicated resources and robust organisational support. Management has a critical role in strengthening the position of KT. Incorporating KT in daily NH practice can help staff become adaptable and confident, capable of meeting the increasing challenges of advanced care that alleviates suffering and promote the health and well-being of NH patients.
OBJECTIVE: To expand our understanding of contextual influences on KT capacity in a NH organisation.
METHODS: Lindseth and Norberg\'s phenomenological hermeneutical method was used to explore and describe practice development nurses\' experiences, perspectives and practices regarding how contextual factors influence KT capacity in NHs. Focus group interviews, participant observations, in-depth interviews and non-participant observations provided the data.
RESULTS: Two main themes and four subthemes were identified. (1) Continuous limited resources are a cultural condition that inhibits KT readiness; prioritising keeping the NH machinery running at all costs and having contrasting care philosophies undermines KT. (2) Organisational prioritisations leave KT as a missing cogwheel in the machinery; retaining a system of fragmented KT strategies and lacking a structure for collective KT effort.
CONCLUSIONS: The study showed that KT held a minor role in the fast-paced NH machinery. Contradicting values characterise the NH organisation, resulting in a lack of a common vision and priorities. Building a sustainable KT capacity and providing evidence-based practice necessitates explicit responsibilities, dedicated resources and robust organisational support. Management has a critical role in strengthening the position of KT. Incorporating KT in daily NH practice can help staff become adaptable and confident, capable of meeting the increasing challenges of advanced care that alleviates suffering and promote the health and well-being of NH patients.
摘要：
背景：疗养院（NHs）对高级临床护理的需求正在增加。循证实践和知识翻译（KT）计划正在发展，以弥合已知与已完成之间的差距。然而,关于情境对KT影响的研究主要集中在医院环境上。
目的：扩大我们对NH组织中KT能力的情境影响的理解。
方法：使用Lindseth和Norberg的现象学解释方法来探索和描述实践发展护士的经验，关于环境因素如何影响NHs中KT能力的观点和实践。焦点小组访谈,参与者的观察，深入访谈和非参与者观察提供了数据.
结果：确定了两个主要主题和四个子主题。（1）持续有限的资源是抑制KT准备的文化条件；优先考虑不惜一切代价保持NH机器运行，并具有相反的护理理念破坏了KT。（2）组织优先次序使KT成为机械中缺少的齿轮；保留了分散的KT策略系统，并且缺乏集体KT努力的结构。
结论：研究表明，KT在快节奏的NH机制中起着次要作用。矛盾的价值观表征了NH组织，导致缺乏共同的愿景和优先事项。建立可持续的KT能力并提供循证实践需要明确的责任，专用资源和强大的组织支持。管理层在加强KT的地位方面发挥着关键作用。将KT纳入日常NH实践可以帮助员工变得适应性和自信，能够应对日益增加的挑战，减轻痛苦，促进NH患者的健康和福祉。
目的：扩大我们对NH组织中KT能力的情境影响的理解。
方法：使用Lindseth和Norberg的现象学解释方法来探索和描述实践发展护士的经验，关于环境因素如何影响NHs中KT能力的观点和实践。焦点小组访谈,参与者的观察，深入访谈和非参与者观察提供了数据.
结果：确定了两个主要主题和四个子主题。（1）持续有限的资源是抑制KT准备的文化条件；优先考虑不惜一切代价保持NH机器运行，并具有相反的护理理念破坏了KT。（2）组织优先次序使KT成为机械中缺少的齿轮；保留了分散的KT策略系统，并且缺乏集体KT努力的结构。
结论：研究表明，KT在快节奏的NH机制中起着次要作用。矛盾的价值观表征了NH组织，导致缺乏共同的愿景和优先事项。建立可持续的KT能力并提供循证实践需要明确的责任，专用资源和强大的组织支持。管理层在加强KT的地位方面发挥着关键作用。将KT纳入日常NH实践可以帮助员工变得适应性和自信，能够应对日益增加的挑战，减轻痛苦，促进NH患者的健康和福祉。
