Implementing Evidence-Based Practices: Considerations for the Hospice Setting

Sanders, Sara; Mackin, Melissa Lehan; Reyes, Jimmy; Herr, Keela; Titler, Marita G.; Fine, Perry G.; Forcucci, Chris

doi:10.1177/1049909109358695

Cited by 13 publications

(18 citation statements)

References 14 publications

(44 reference statements)

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“…Additionally, engagement of physicians in the implementation process was difficult as noted by the ratings of nurses and other non‐physician hospice staff on the process evaluation questionnaire. Items related to physician involvement were all rated as least helpful in implementing the intervention and were also mentioned in the post‐intervention focus groups as barriers to implementation [15]. The issue of engaging physicians was also noted in the prior TRIP study conducted in the acute care setting [13].…”

Section: Discussionmentioning

confidence: 90%

The Effect of a Translating Research into Practice (TRIP)-Cancer Intervention on Cancer Pain Management in Older Adults in Hospice

et al. 2012

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Pain is a major concern for individuals with cancer, particularly older adults who make up the largest segment of individuals with cancer and have some of the most unique pain challenges. One of the priorities of hospice is to provide a pain free death, and while outcomes are better in hospice, patients still die with poorly controlled pain. Objective This paper reports on the results of a Translating Research Into Practice intervention designed to promote the adoption of evidence-based pain practices for older adults with cancer in community-based hospice. Setting This IRB approved study was a cluster randomized trial implemented in sixteen Midwestern hospices. Methods Retrospective medical records from newly admitted patients were used to determine the intervention effect. Additionally, survey and focus group data gathered from hospice staff at the completion of the intervention phase were analyzed. Results Improvement on the Cancer Pain Practice Index, an overall composite outcome measure of evidence-based practices for the experimental sites was not significantly greater than control sites. Decrease in patient pain severity from baseline to post intervention in the experimental group was greater, however, the result was not statistically significant (p=0.1032). Conclusions Findings indicate a number of factors may impact implementation of multi-component interventions, including unique characteristics and culture of the setting, the level of involvement with the change processes, competing priorities and confounding factors, and complexity of the innovation (practice change). Our results suggest future study is needed on specific factors to target when implementing a community-based hospice intervention, including determining and measuring intervention fidelity prospectively.

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Section: Discussionmentioning

confidence: 90%

The Effect of a Translating Research into Practice (TRIP)-Cancer Intervention on Cancer Pain Management in Older Adults in Hospice

et al. 2012

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“…The importance of guidelines and implementation strategies of these were highlighted (34). Staff culture is also described as an important factor for successful implementation of evidencebased medicine (EBM) into evidence-based practice (EBP) (35). Resistance to alter practice, conflict with competing priorities, lack of time and resources may be important barriers.…”

Section: Btp In the Out-patient Populationmentioning

confidence: 99%

“…Sanders et al (35) reported that agency culture might be an important barrier for implementing EBM into EBP. A standardized care pathway (SCP) might be an effective method to improve implementation (38,39) (40,41).…”

Section: Btp In the Out-patient Populationmentioning

confidence: 99%

Is it possible to detect an improvement in cancer pain management? A comparison of two Norwegian cross-sectional studies conducted 5 years apart

Thronæs

Raj

Brunelli

et al. 2015

Support Care Cancer

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Is it possible to detect an improvement in cancer pain management? A comparison of two Norwegian cross-sectional studies conducted five years apart.Purpose: Cancer pain (CP) management is challenging. In recent years, efforts were undertaken to achieve better CP management, e.g. clinical research, new treatment modalities, development of guidelines, education, and focus on implementation. The aim of the present study was to compare the prevalence and characteristics of pain and breakthrough pain (BTP) between cross-sectional studies conducted in 2008 and 2014. It was hypothesized that an improvement in pain control would be observed the years in-between. Methods:Two cross-sectional studies were conducted where adult cancer patients answered questions from Brief Pain Inventory and the Alberta Breakthrough Pain Assessment Tool for cancer patients. Physicians reported socio-demographic and medical data. Regression models were applied for analysis.

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“…23,31,32 Titler et al 23 utilized the model when developing strategies aimed at promoting EBP for management of acute hip pain in older patients with hip fracture. During the planning phase, each of the areas within the TRIP model was used to develop implementation strategies.…”

Section: Examples From Other Health-care Professionsmentioning

confidence: 99%

“…29 This model was selected as it has been shown to positively influence adoption of EBP when tested in other clinical environments. 23,[30][31][32] The model serves as a framework for developing strategies that promote implementation of EBP. It assumes that adoption of research is influenced by the characteristics of the EBP topic (type and strength of evidence; clinical relevance) and the manner in which it is communicated to users in a social system.…”

Section: Theoretical Frameworkmentioning

confidence: 99%

Translating research into prosthetic and orthotic practice

Ramstrand

2013

Prosthetics &Amp; Orthotics International

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Background: Evidence-based practice is commonly accepted as a means of improving patient outcomes; however, there is little understanding of the processes required to successfully implement it into prosthetic and orthotic practice. Objectives: To discuss factors affecting adoption of evidence-based practice and present a theoretical framework for its implementation into prosthetic and orthotic practice. Discussion: Numerous factors that affect adoption of evidence-based practice are discussed, ranging from individual factors to those that can be attributed to administrative and environmental issues. Specific factors are likely to be context specific and are influenced by the manner in which evidence-based practice is introduced into the working environment. It is argued that successful implementation of evidence-based practice requires consideration of numerous interrelated factors. A formal translating research into practice model is presented as a means of developing a strategic plan that considers all relevant factors and maximizes acceptance of evidence-based practice into prosthetics and orthotics clinical practice. Conclusions: The use of a theoretical model for implementation of evidence-based practice is likely to improve its adoption by prosthetic and orthotic clinicians. Clinical relevanceThe demand for prosthetists/orthotists to utilize evidence-based practice is increasing. Lack of strategic planning throughout the implementation phase is likely to compromise adoption of evidence-based practices by clinicians.

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Implementing Evidence-Based Practices: Considerations for the Hospice Setting

Cited by 13 publications

References 14 publications

The Effect of a Translating Research into Practice (TRIP)-Cancer Intervention on Cancer Pain Management in Older Adults in Hospice

The Effect of a Translating Research into Practice (TRIP)-Cancer Intervention on Cancer Pain Management in Older Adults in Hospice

Is it possible to detect an improvement in cancer pain management? A comparison of two Norwegian cross-sectional studies conducted 5 years apart

Translating research into prosthetic and orthotic practice

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