Worldviews on evidence-based nursing
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Worldviews Evid Based Nurs · Jan 2004
ReviewConducting translation research in the home care setting: lessons from a just-in-time reminder study.
Home care organizations are relatively isolated from academic health centers, university-based schools of nursing, and centers of health services research that have advanced the knowledge base for quality improvement. Thus limited information exists about how best to promote evidence-based practice in this setting. ⋯ The study described in this article demonstrates that rigorous translation research can be conducted in highly decentralized practice settings. It also points to the value of assessing different levels of intensity of interventions in a single study, looking at process measures and patient outcomes, and conducting a cost-effectiveness analysis. To encourage broader adoption of translation strategies, additional incentives from purchasing or regulatory agencies may be needed.
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The gap between research findings and practice has been, and continues to be, a concern for the international community. A number of descriptive studies have elucidated barriers and facilitators of evidence-based practice in nursing. It is argued that it is now time to use findings from these studies to design and test interventions that explicitly target barriers to the use of evidence in practice rather than doing further research to describe generic barriers and facilitators to evidence-based practice. This article discusses research methods to advance our knowledge regarding the efficacy of translating research into practice (TRIP) interventions that promote and hasten adoption of evidence in practice. ⋯ The article discusses factors such as sample attainment, unit of analysis, intervention characteristics, outcome measurement, and sustainability. Although there are a myriad of initiatives aimed at increasing use of evidence in practice, there is little systematic evidence of the effectiveness of these initiatives. In order to advance knowledge, translation research needs more experimental studies that test TRIP interventions through, for example, partnership models.
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Worldviews Evid Based Nurs · Jan 2004
A process for systematically reviewing the literature: providing the research evidence for public health nursing interventions.
Several groups have outlined methodologies for systematic literature reviews of the effectiveness of interventions. The Effective Public Health Practice Project (EPHPP) began in 1998. Its mandate is to provide research evidence to guide and support the Ontario Ministry of Health in outlining minimum requirements for public health services in the province. Also, the project is expected to disseminate the results provincially, nationally, and internationally. Most of the reviews are relevant to public health nursing practice. ⋯ The EPHPP has demonstrated the ability to adapt the most current methods of systematic literature reviews of effectiveness to questions related to public health nursing. Other positive outcomes from the process include the development of a critical mass of public health researchers and practitioners who can actively participate in the process, and the work on dissemination has been successful in attracting external funds. A program of research in this area is being developed.
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Worldviews Evid Based Nurs · Jan 2004
A qualitative study to identify barriers and facilitators to implementation of pilot interventions in the Veterans Health Administration (VHA) Northwest Network.
To identify barriers and facilitators to implementation of pilot interventions designed to improve measurement and management of low-density lipoprotein cholesterol (LDL-c) levels in coronary heart disease patients using the evidence/context/facilitation model of implementation of evidence-based practice. ⋯ Organized team process, documented plans for intervention activities, and ongoing evaluation are essential for sustaining intervention activities. A top priority for facilitating interventions should be the development of educational materials, such as "how to" guides, that teach intervention teams how to anticipate barriers and make plans to address them, as well as identifying and fostering local experts in planning and implementing interventions.