224 Chapter 8 The aim of this thesis was to explore the impact of implementation science on improving fundamentals of nursing care. The focus was on assessing the effectiveness of implementation and de-implementation strategies. In this chapter, the key findings of the studies are described and discussed. Additionally, methodological implications and recommendations for clinical practice and future research on implementation and de-implementation are addressed. The chapter concludes with a scenario envisioning nursing in 2040. Key findings • Educational components are the most used implementing and de-implementing strategies in the implementation studies reviewed (Chapters 2, 3 and 6) • No single strategy or combination of implementation and de-implementation strategies seemed universally effective. (Chapters 2, 3 and 6) • Barriers to use technological innovations included complexity of use, perceived unreliability, and questioning of the added value. (Chapters 4 and 5) • Facilitators included availability to use technological innovations anticipated improvement of patient safety and reduced workload. (Chapters 4 and 5) • Successful integration of technological innovations among nurses requires a sense of ownership, continuous involvement of supportive staff, adaptability to the context, and promoting the added value. (Chapters 4 and 5) • Reexamining implementation and applying adaptations are necessary to respond to unexpected barriers, such as technical issues, frustration and lack of trust. (Chapters 4 and 5) • There is a knowledge gap among nurses and prescribers regarding the composition and appropriate use of intravenous fluids. (Chapter 7) • A notable proportion of patients received unnecessary intravenous fluids to keep the vein open, highlighting the potential for reducing low-value care through better-targeted infusion therapy protocols. (Chapter 7) • Future research should focus on better reporting of implementation and deimplementation strategies and process evaluations to understand the extent of the deployment of implementation strategies and increase reproducibility. (Chapters 2, 3 and 6)
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