11 General introduction 1 Nursing guidelines Nursing guidelines are developed and published for various reasons, one of which is to prevent complications. These guidelines are systematically designed to assist nurses in making informed decisions, ensuring the provision of appropriate care and the discontinuation of inappropriate care. Their goal is to reduce unwarranted variations in healthcare delivery and to provide evidence-based recommendations to optimize patient care [15, 16]. Several guidelines exist for preventing in-hospital falls [17, 18]. Most emphasize conducting multifactorial fall risk assessments and implementing targeted interventions based on identified risk factors, such as impaired mobility. Education for nurses, patients, and informal caregivers is also a common recommendation [19]. The European pressure ulcer guideline provides supporting evidence for effective prevention and treatment. A key recommendation is conducting risk assessments using clinical judgment, optionally combined with a validated risk assessment tool that the nurse is familiar with. Additional recommendations focus on selecting tailored preventive measures and educating patients [20]. However, despite the availability of guidelines, their mere existence does not guarantee effective implementation in practice [21]. Implementation science Implementation science is the scientific study of methods and strategies that promote the uptake of evidence-based practice and research into practice [22, 23]. Unlike clinical effectiveness trials, which aim to identify interventions that improve health outcomes, implementation science focuses on the actions, implementation strategies, needed to integrate these interventions into practice [24]. However, implementing guidelines to improve nursing care remains difficult [25]. To support researchers and quality improvement advisors, numerous frameworks, models, and theories (FMT) have been developed [26, 27]. Nilsen [26] provided an overview of how these different FMTs can be categorized and deployed at various stages of the implementation process. Determinant frameworks offer guidance in assessing contextual factors, barriers, and facilitators that may influence implementation success. Process models outline the critical steps involved in entire implementation process. Theories offer insights into the mechanisms of change and provide the theoretical basis for creating change.
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