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.