A strong public project governance structure is instrumental to ensure the effective and efficient delivery of projects in the public domain. The Norwegian State Project Model is an example of such a ...structure; a standardized classification of projects into stages, with defined decision points, where requirements regarding documentation are specified. In Iceland, the public project governance structure has been criticised. This paper investigates the Icelandic framework by comparison to the Norwegian framework, through a desk analysis of both structures. Furthermore, the features and perceived utility of the Icelandic project governance structure are assessed by interviewing selected public stakeholders who are representatives of seven important organizations in the public sector. The study indicates that there is a significant difference between the frameworks where the Icelandic framework is lacking crucial elements of what constitutes best practices in modern project governance. In view of extensive plans for investments in infrastructure in the coming years, there is an urgent need for reforming the Icelandic project governance structure.
•Best practices in project governance are based on transparency, fairness, responsibility, and accountability.•This is the case with the Norwegian framework but the Icelandic framework lacks crucial elements.•It consists of basic instructions - quality assurance is dependent on the decisions of individual institutions or ministries.•Investment in infrastructure projects in Iceland in the next 20 years will be close to 10 billion euros for over 100 projects.•To ensure that public funds are well spent, the Icelandic Project Governance Framework should be reformed.
Purpose
To report on approaches that were used to assist with implementation of family systems nursing (FSN) at a university hospital level in Northern Europe.
Design and Methods
A quasi‐experimental ...research design was used for the first phase of the study. For the second phase, a cross‐sectional research design was used. Data were collected in the first phase of the study from 457 nurses in all except one of the divisions of the hospital regarding their attitudes towards involving families into their care before and after having participated in the education and training intervention (ETI) program in FSN. Furthermore, in the second phase, data were collected from 812 nurses, after FSN had been implemented in all divisions at Landspitali University Hospital, regarding the nurses’ knowledge of FSN and their evaluation of the quality of the ETI program (i.e., theoretical lectures on FSN as well as the benefit of the skill lab training regarding applying FSN into their clinical practices). Graham and colleagues’ Knowledge to Action framework was used as the conceptual framework for the research.
Results
Nurses who had taken a course in FSN reported a significantly more positive attitude towards involving families in their care after the ETI program compared to those who had not taken such a course. Furthermore, a majority of the nurses who participated in the ETI program reported that the program was a favorable experience and indicated readiness for applying FSN in clinical practice.
Conclusions
Further research is needed regarding the benefits of offering FSN at an institutional level, but focusing international attention on effective strategies to implement FSN into nursing practice may result in better health care for individuals and families around the globe.
Clinical Relevance
Providing clinically meaningful education and training in family nursing through programs such as the ETI program for practicing nurses at a university hospital is essential in supporting nurses applying new knowledge, when providing evidence‐based health care services, to individuals and their family members. Such training can facilitate integration of new and needed information in clinical practice.
