Stakeholders’ experiences of the implementation of a multifactorial intervention for safe patient handling and movement: a qualitative explorative and descriptive study

Abstract Background Despite growing evidence for the effectiveness of safe patient handling and movement (PHM) interventions, there is limited insight into implementation and sustainment in routine healthcare. By focusing on stakeholders directly involved in implementation following a cluster randomised controlled trial (RCT), this study provides insight into the mechanisms through which a safe PHM intervention is enacted in practice and how the implementation processes contribute to implementation. Aim To explore stakeholders’ experiences of implementing a multifactorial intervention for safe PHM, and to examine the determinants and perceived outcomes influencing its integration and sustained use in clinical practice. Methods A qualitative explorative design was employed, using individual interviews with 25 implementation stakeholders (leaders, external facilitators, and implementation team members). The stakeholders were recruited from a cluster RCT evaluating the effectiveness and implementation of a multifactorial safe PHM intervention in Swedish regional and municipal healthcare units. Data were analysed with qualitative deductive-inductive content analysis using the Consolidated Framework for Implementation Research (CFIR) as a theoretical framework. Results The analysis resulted in five deductive categories corresponding to CFIR constructs (innovation, inner setting, individuals, implementation process, and actual implementation outcomes) and 13 inductively developed categories. Determinants influencing the implementation of a safe PHM practice were described. The implementation outcomes reflected implementation, enactment of the intervention in practice, and conditions for sustained use, manifested through perceived changes in safety culture, work routines, and use of patient handling equipment. Conclusions This study identified key determinants and perceived outcomes influencing the implementation of safe PHM practices. The interdependence between leadership, facilitation, and participants’ active engagement with knowledge shaped the implementation process, enabling translation into practice. Outcomes were reflected in the perceived integration of practices into clinical routines and changes in safety culture, indicating implementation. These findings highlight the importance of organisational and social processes in supporting the sustained use of new practices. Trial registration This study is part of a cluster randomised controlled trial, registered at ClinicalTrials.gov on 2 November 2022 (ref NCT05276180).