Chapter 16

1. Chapter 16 Translating Research into Practice

2. Research Translation Translating research into practice is the final and most important step in the research process

3. Why Incorporate Research into Practice? • Consumer demands • Pursuit of Magnet designation • Cost implications • Effectiveness of interventions • Regulatory requirements • Healthy policy • Quality and Patient Safety

4. Evidence from Research can be Applied to…. • Assessment processes • Nursing diagnosis of patient problems • Planning effective nursing care • Implementing effective nursing interventions • Evaluating nursing care

5. Ways to Aggregate Evidence • Systematic review • Integrative review • Meta-analysis • Meta-synthesis • Practice Guideline

6. Steps of a Review • Determine the background for the review • State the main review question • Develop inclusion and exclusion criteria for populations, conditions, settings • Devise a search strategy • Develop study selection criteria • Determine study quality criteria • Carry out the review

7. Characteristics of Reviews • Use of objective criteria reduces bias • Multiple studies enhance the credibility of recommendations • Structured approach to the selection and evaluation of studies • Produces a practice recommendation as an outcome

8. Integrative Review A methodology that synthesizes quantitative, qualitative, and comparative effectiveness research to provide a comprehensive understanding of the human condition.

9. Potential of Integrative Reviews • Contribute to nursing knowledge • Inform research • Guide practice • Form policy initiatives

10. Meta-Analysis A statistical method of aggregating the results of quantitative studies so an overall effect size can be evaluated.

11. Qualitative Meta-Synthesis The development of overarching themes about the meaning of human events based on a synthesis of multiple qualitative studies.

12. Criteria for Evaluating Clinical Practice Guidelines • Assure that the scope, purpose, and overall clinical question are explicit • Stakeholders, i.e.: patients, are involved in the development of the guideline in some way • Development of the guideline is rigorous and peer reviewed • Recommendations are clear and easily identified; both summary and patient education information in final guidelines • Implementation considerations – including cost and patient acceptability are considered in final guidelines • The group funding the practice guidelines has no financial interest in the outcome

13. Models of Research Utilization • The Iowa Model of EBP • Identify a nursing problem and search the literature • Determine the organizational priority of the problem • Form a team to develop, implement and evaluate the project • Assemble the relevant literature • Critique the literature and formulate recommendations

14. The Johns Hopkins Model • Practice question phase • Evidence phase • Translation phase

15. Integrating EBP in Magnet • Establish a foundation for EBP • Identify areas of concern • Create internal expertise • Implement evidence-based practice • Contribute to a research study

16. Outcomes Focused Knowledge Translation at the Bedside • Aimed at influencing nursing – sensitive outcomes • Four elements: - Sources of evidence - Patient preferences - Context of care - Facilitation

17. Collaborative Model for Knowledge Translation • Interactive model of knowledge transfer • Includes two dimensions: - Process: dynamic part of the model - Content: translates knowledge from a program of research into practice

18. The Community Based Research Translation Model • Phase One: Focus on expert analysis of the critical health issues facing a population. Results in identification of a specific health issue to be addressed. • Phase Two: Nurses analyze the cause of morbidity and mortality, appraise and select evidence-based interventions, adapt the interventions to the community, and develop measures that will reflect outcomes.