Influence of a Multifaceted Nursing Practice Bundle to Support Hospitalised Adults With Cognitive Impairment: A Longitudinal Qualitative Study

AIM: To explore nurses' perceptions of the influence of a multifaceted nursing practice bundle, and the factors affecting practice change over time. DESIGN: A longitudinal qualitative study with recurrent cross-sectional analysis over two timepoints. METHODS: Thematic analysis of focus groups and interviews with nurses. RESULTS: 17 nurses participated, and four themes emerged. Two described how the bundle influenced nursing practice: supporting positive nonpharmacological practices and strengthening communication, collaboration, and relationships. Two addressed the factors affecting practice change: leadership driving practice change and purpose-driven nursing. CONCLUSION: Nurses reported a positive influence of the bundle on practice. Leadership and the bundle's strong alignment with nurses' professional and personal values appeared to drive perceived practice change over time. IMPLICATIONS FOR THE PROFESSION: This study highlights the potential of a multifaceted nursing practice bundle to enhance care for adults with cognitive impairment in hospital. The multifaceted approach may facilitate adoption across health services, with ongoing practice change driven by supportive leadership and alignment with nurses' values. IMPACT: Nonpharmacological interventions are internationally recommended to support adults with cognitive impairment, but are underutilised by nurses in hospital. Nurses described enhanced practice following implementation of the bundle, with leadership and alignment to nurses' values perceived as key drivers of practice change. This study provides recommendations for organisation-led programs to support nursing practices and improve the quality of care for hospitalised adults with cognitive impairment. REPORTING METHOD: Reported in accordance with COREQ. PATIENT OR PUBLIC CONTRIBUTION: No direct patient or public contribution.