Background: The gap between what is stated in legislation about written individualized nursing care plans (ICP) and how they are used in practice is still too wide.
Aim: To explore attitudes and experiences among nurses and managers in order to capture which factors and conditions impact on the successful implementation of individual care plans within hospital care, as well as the strategies that were adopted to ensure continued use.
Method: The study was carried out through directed content analysis guided by the Promoting Action on Research Implementation in Health Services framework. Interviews were conducted with 15 informants on different operational and decision levels at a hospital that is well known in Sweden for its work in the ICP area.
Findings: Important factors for implementation on the wards were clear instructions from the hospital management at the start of implementation as well as clear roles and mandates for those involved. The work of internal facilitators was crucial for the continuation of the process. Clinical experience was important as the long-term driving force.
Implications: On the basis of the findings of this study, we argue that it is important for hospital managers to recruit leaders that focus on individual nursing care and can highlight needs and instigate change. It seems also important that the organization takes advantage of the potential of skilled facilitators.