Background: The gap between knowledge and practice is a global issue, which increases wasteful spending in healthcare. There are several models and frameworks to address this gap and try to solve the challenge. Promoting Action on Research Implementation in Health Services (PARIHS) framework highlights the interaction of three main elements: evidence, context and facilitation, to implement research into practice, successfully. This framework can use as a tool to evaluate the situation and guide the changing. This study conducted to explain the status of knowledge implementation in Iran's healthcare management system. Methods: This qualitative study was done by using a directive content analysis approach through conducting indepth, structured interviews with 15 health managers based on the PARIHS framework. Guiding questions were based on the three main elements of the framework: evidence, context and facilitation. The content of the interviews entered into the Qualitative Data Analysis software (MAXQDA version 10) and, then, analyzed. Results: The most common source of evidence used by managers for decision-making was local information and previous experience. Evaluation more emphasized compared to other sub-elements of context, i.e. culture and leadership. In terms of facilitation, performing tasks by others was the dominant opinion. Conclusion: Our results showed that managers in the healthcare system of Iran use their own and other manager's experience and the local information for decision-making and have no ideas about facilitation.
Background and aimSpiritual care is an important part of nursing practice that seems to provide comprehensive care to patients. Nursing manager’s attention to the spiritual dimension is one of the most important aspects affecting human health. Therefore, the aim of this study was to determine nursing managers’ attitude to spirituality and spiritual care in hospitals in Khorasan Razavi Province in 2016.MethodsIn this cross-sectional study, 110 management nurses (8 matrons, 37 supervisors and 65 head nurses) of hospitals in Khorasan Razavi Province (2016) were recruited for the study. Data were collected using a Spirituality & Spiritual Care Rating Scale (SSCRS) questionnaire in two parts, demographic information and questions related to the research objectives. Data were collected and analyzed using SPSS 16 software and doing descriptive (frequency, mean, standard deviation) and inferential statistics (independent-samples t-test, ANOVA) and considering levels of significance (p<0.05).ResultsThe results showed mean and standard deviation in management nursing attitude to spirituality (4.01±0.35) and spiritual care (4.03±0.78). The result showed significant differences between the attitude to spirituality and spiritual care and gender, age and work experience in nursing management (p<0.05).ConclusionsManagement nursing has high level attitude to spirituality and spiritual care. Therefore, providing the perfect platform to provide this care, and for nurses to implement it in hospitals is recommended.
Background:The gap between knowledge and practice is a global issue that reduces service quality by creating barriers to knowledge implementation, and thus strategies should be developed to resolve it. The present study aimed to explain barriers and strategies for implementing knowledge implementation into Iranian health system management. Methods: This qualitative study was conducted on 53 managers and health management graduates in 2018. Participants were recruited through purposive sampling in Medical Sciences Universities in Iran. Data were collected by semi-structured interviews based on the "Promoting Action on Research Implementation (PARiHS)" framework, focus group discussions and Delphi technique. The PARiHS framework has three main elements including; evidence, context and facilitation. The Lincoln and Guba criterion was used to assess the rigor of the study. Data were analyzed in MAXQDA software version 10 using directional content analysis. Results: After data analysis 9 subcategories and 3 main categories including; evidence, context, and facilitation were emerged. In addition to three subcategories including, culture, leadership and evaluation, the socio-political subcategory was a context for knowledge implementation main barrier in the organizational context. The systematic structural planning for the combined use of four sources of knowledge is the most important strategy.
Conclusion:The lack of context readiness in using knowledge and lack of efficient system impeded knowledge implementation in the health system management. Therefore, managers and policy makers need to design a comprehensive system based on current knowledge and successful experiences.
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