Implementing Dementia Care Mapping to develop person‐centred care: results of a process evaluation within the Leben‐QD II trial

Tina Quasdorf, Christine Riesner, Martin Nikolaus Dichter, Olga Dortmann, Sabine Bartholomeyczik, Margareta Halek

To evaluate Dementia Care Mapping (DCM) implementation in nursing homes. DCM, an internationally applied method for supporting and enhancing person-centred care (PCC) for people with dementia, must be successfully implemented into care practice for its effective use. Various factors influence the implementation of complex interventions such as DCM; few studies have examined specific factors influencing DCM implementation. A convergent parallel mixed methods design embedded in a quasi-experimental trial was used to assess DCM implementation success and influential factors. From 2011 to 2013, nine nursing units in nine different nursing homes implemented either DCM (n=6) or a periodic quality of life measurement using the dementia-specific instrument QUALIDEM (n=3). Diverse data (interviews, n=27; questionnaires, n=112; resident records, n=81; and process documents) were collected. Each data set was separately analysed and then merged to comprehensively portray the implementation process. Four nursing units implemented the particular intervention without deviating from the pre-planned intervention. Translating DCM results into practice was challenging. Necessary organisational preconditions for DCM implementation included well-functioning networks, a dementia-friendly culture, and flexible organisational structures. Involved individuals' positive attitudes towards DCM also facilitated implementation. Precisely planning the intervention and its implementation, recruiting champions who supported DCM implementation, and having well-qualified, experienced project coordinators were essential to the implementation process. For successful DCM implementation, it must be embedded in a systematic implementation strategy considering the specific setting. Organisational preconditions may need to be developed before DCM implementation. Necessary steps may include team building, developing and realising a PCC-based mission statement, or educating staff regarding general dementia care. The implementation strategy may include attracting and involving individuals on different hierarchical levels in DCM implementation and supporting staff to translate DCM results into practice. The identified facilitating factors can guide DCM implementation strategy development. This article is protected by copyright. All rights reserved.