05

05SCIENCE, PRACTICE AND EDUCATION DOI: 10.35279/jowm2022.23.03.05 Implementing seating guidelines into clinical practice and policy: A critical reflection and novel theory 168 Ray Samuriwo 1 , Melanie Stephens 2 , Carol Bartley 3 , Nikki Stubbs 4 1 Dr, PhD, School of Nursing and Healthcare Leadership, Faculty of Health Studies, University of Bradford, United Kingdom 2 PhD, School of Health and Society, Mary Seacole Building, University of Salford, UK 3 MSc, Occupational Therapist Rehab for Independence Ltd, Lancashire, United Kingdom 4 MSc, Independent Nurse Consultant Tissue Viability NCS Wound Care Consulting Ltd Correspondence: Ray Samuriwo, r.samuriwo@bradford.ac.uk Conflict of interest The Tissue Viability Society Board of Trustees supported the survey that generated the data used in this paper; however, the views and opinions expressed herein are those of the authors and do not necessarily reflect those of the Tissue Viability Society Board of Trustees or the Tissue Viability Society. No funding bodies had any role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. Nikki Stubbs and Dr Ray Samuriwo were, respectively, the Treasurer and Vice Chair of the Society of Tissue Viability Study (SoTV), formerly known as the Tissue Viability Society (TVS), when the original evaluation study was conducted in 2020. However, both of them wrote this paper in their personal capacity. Keywords: Guidelines, implementation, liminal spaces, pressure ulcers, seating, trajectory ABSTRACT Introduction A significant proportion of healthcare that is deliv- ered is wasteful, harmful and not evidence-based. There are many wound care-related guidelines, but their implementation in practice is variable. The So- ciety of Tissue Viability (SoTV) published updated seating guidelines in 2017, but there is a lack of theoretical and conceptual clarity about how these guidelines are being used to inform clinical practice. Therefore, the aim of this paper is to generate a theory that can be used to incorporate the SoTV seating guidelines into policy and clinical practice. Methods We critically reflected on data from an evaluation study using a systems thinking approach and in- formed by implementation and safety science using the wider literature and our expertise to generate a guideline-implementation theory. Discussion Factors that facilitate or hinder the incorporation of the SoTV guidelines into policy and practice were characterised. We conceptualised the implemen- tation of these guidelines into policy and practice into a Translation or Implementation into Policy or Practice (TIPP) theory with distinct stages, which we called ‘liminal spaces’. Knowledge of the guidelines, and the agency or authority to effect change, are key factors in the translation of these guidelines into clinical practice. Conclusion Our theory is that there are liminal spaces in the implementation trajectory of these guidelines into practice, and these have their own characteristics. This theory provides a framework that can be used to underpin guidelines’ strategies for embedding skin and wound care guidelines into policy and clinical practice to improve patient care. JOURNAL OF WOUND MANAGEMENT OFFICIAL JOURNAL OF THE EUROPEAN WOUND MANAGEMENT ASSOCIATIONPage 2