Knowledge to action: a scoping review of approaches to educate primary care providers in the identification and management of routine sleep disorders

King, Svetlana; Damarell, Raechel; Schuwirth, Lambert; Vakulin, Andrew; Chai-Coetzer, Ching Li; McEvoy, R. Doug

doi:10.5664/jcsm.9374

Cited by 7 publications

(4 citation statements)

References 51 publications

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“…Such activities are often both convenient and cost‐effective and can be maintained without draining staffing levels and disrupting delivery of patient care [19]. King et al [20] emphasise the importance of the clinical relevance of workplace‐based learning to motivate staff to participate. In Flekkefjord, the competence development programme made each employee responsible for completing modules responding to their lack of competence.…”

Section: Discussionmentioning

confidence: 99%

Lifelong learning in community healthcare: Testing competence after learning activities in a blended learning space

Bing‐Jonsson,

Førsund,

Hansen Stålesen

et al. 2023

Scandinavian Caring Sciences

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Aims and ObjectivesThis study reports from a municipality in Norway that implemented a competence enhancement programme for all its institutional nursing staff during the COVID‐19 pandemic to fill identified competence gaps.BackgroundMany Norwegian municipalities are experiencing a demand for expanded community healthcare services due to an increase in elderly patients and patients with extensive and complex needs. At the same time, most municipalities are striving to recruit and keep competent health personnel. New ways of organising and increasing the competence of the workforce may help ensure that the healthcare delivered corresponds to patients' changing needs.Design and MethodsNursing staff were encouraged to complete targeted competence enhancing activities with the aim of enhancing their competence in identified areas. The learning activities were blended and consisted of e‐learning courses, lectures, supervision, vocational training and meetings with a superior. Competence was measured before and after the competence enhancing activities (n = 96). The STROBE checklist was applied.ResultsThe results provide insight into the competence development of registered nurses and assistant nurses in institutional community health services. They show that the implementation of a workplace‐based blended learning programme improved competence significantly, especially for assistant nurses.ConclusionsOffering workplace‐based competence enhancing activities seems to be a sustainable way of facilitating lifelong learning among nursing staff. Facilitation of learning activities in a blended learning space may enhance accessibility and increase the potential for participation. A combination of reorganisation of roles and simultaneous competence enhancing activities can ensure that both managers and nursing staff prioritise filling competence gaps.

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Section: Discussionmentioning

confidence: 99%

Lifelong learning in community healthcare: Testing competence after learning activities in a blended learning space

Bing‐Jonsson,

Førsund,

Hansen Stålesen

et al. 2023

Scandinavian Caring Sciences

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“…Studies using the KTA model have demonstrated the dynamic, nonlinear aspect of knowledge translation and implementation [ 25 ]. However, recent scope reviews that used KTA in behavioral change in rehabilitation and educational interventions for the management of sleep disorders supported the complexity of knowledge implementation and recognized the need to (1) complement the KTA model with determinant models to better assess barriers to implementation and influence implementation outcomes and (2) guide the selection of implementation strategies [ 38 , 39 ]. Along the same line, our hybrid model supports the need for a determinant model (ie, the CFIR) to complement a process model (ie, KTA or GTO) and the need for a refined list of context- and evidence-based implementation and QI strategies to improve implementation fidelity, that is, the list of implementation strategies from Powell et al [ 23 ].…”

Section: Methodsmentioning

confidence: 99%

Model for Doctor of Nursing Practice Projects Based on Cross-Fertilization Between Improvement and Implementation Sciences: Protocol for Quality Improvement and Program Evaluation Studies

Sowan,

Chinman

2024

JMIR Res Protoc

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Background Hundreds of nursing professionals graduate each year from Doctor of Nursing Practice (DNP) programs, entrusted with roles as practice scholars and leaders. Graduates are tasked to lead multidisciplinary knowledge implementation projects to improve safety, quality, and key performance metrics. Nevertheless, there is a continued lack of agreement and faculty dissatisfaction with the format, focus, and results of the DNP graduation projects. The use of a wide range of models and methodologies from different sciences for knowledge implementation introduces challenges to DNP students; affects the scientific rigor of the projects; and results in the overuse, superficial use, or misuse of the models. Quality improvement (QI) and program evaluation studies are substantial investments that may lead to waste and even harm if not well conducted. Traditional QI methodologies, commonly used in DNP projects, were found to be uncertain in improving health care outcomes. The complexity of health care systems calls for cross-fertilization between improvement and implementation sciences to improve health care outcomes. Objective This study describes the development, implementation, and evaluation of a hybrid model for QI and program evaluation studies to guide scholarship in the DNP program. Methods The hybrid model was based on cross-fertilization between improvement and implementation sciences. The model adapted the Getting to Outcome (GTO) and Knowledge to Action (KTA) models as the overarching process models for knowledge implementation. Within each phase of the GTO and KTA models, expected barriers and facilitators for the implementation and adoption of innovation were identified based on the CFIR (Consolidated Framework for Implementation Research). Accordingly, strategies to facilitate the implementation and adoption of innovations were identified based on a refined list of implementation strategies and QI tools. The choice of these models was based on the top 5 criteria for selecting implementation science theories and frameworks. Seven DNP students used the hybrid model to conduct QI projects. Students evaluated their experiences by responding to a Qualtrics survey. Results The hybrid model encouraged a comprehensive systematic way of thinking, provided tools essential to implementation success, emphasized the need for adaptability in implementation, maintained rigor in QI, and guided the sustainability of change initiatives. Some of the challenges faced by students included finding reliable and valid measures, attaining and maintaining staff buy-in, and competing organizational priorities. Conclusions Cross-fertilization between improvement and implementation sciences provided a roadmap and systematic thinking for successful QI projects in the DNP program. The integration of the CFIR with the GTO or KTA process models, enforced by the use of evidence-based implementation strategies and QI tools, reflected the complexity of health care systems and emphasized the need for adaptability in implementation. International Registered Report Identifier (IRRID) RR1-10.2196/54213

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“…Even among specialty NPs who practice in sleep centers, a 2012 survey study of NPs ( n = 45) and physician assistants ( n = 20) found that 84 percent of NPs reported that sleep-specific education was primarily received through “on-the-job” training, 9 percent through continuing education, 2 percent through formal education, and 9 percent from other sources (one NP selected three types of education; Colvin et al, 2014). A recent scoping review evaluating 22 studies found the most common educational approaches to educating primary care providers, including NPs, in the identification and management of sleep disorders included didactic (32 percent), active (18 percent), and blended (41 percent) approaches using technology-mediated (45 percent), face-to-face (27 percent), and multimodal (5 percent) delivery (King et al, 2021). By providing sleep curricular content, the practice of NPs in both specialty and primary care practices will be further enhanced to meet the health needs of the population.…”

Section: Introductionmentioning

confidence: 99%

“…There is a growing awareness of sleep disorders among primary care providers (Simon, 2016), but this has not translated to widespread integration of sleep education into nursing curricula (Gellerstedt et al, 2019; Meaklim et al, 2020) despite numerous recommendations put forth over the years (Colten & Altevogt, 2006; King et al, 2021; Lee et al, 2004; Meaklim et al, 2020; Ramar et al, 2021; Redeker & McEnany, 2011; Ye & Smith, 2015). Some studies have addressed sleep education in nursing curricula (Colvin et al, 2014; Gellerstedt et al, 2019; King et al, 2021; McIntosh & MacMillan, 2009; Meaklim et al, 2020; Redeker & McEnany, 2011; Ye & Smith, 2015), but consistent with the prior decade of research, advanced practice nurses continue to report little (two hours) to no education about sleep and sleep disorders (Sawyer et al, 2022). Furthermore, a recent narrative review to evaluate sleep education provided across health care provider training programs included 16 published studies, only one of which focused on sleep in nursing curricula (Meaklim et al, 2020).…”

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confidence: 99%

Exploring Nurse Practitioner Students’ Perceptions of a Sleep e-Learning Program

et al. 2023

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AIM The aim of this study was to explore nurse practitioner (NP) students’ perceptions of a sleep e-learning program. BACKGROUND Sleep assessment is uncommon as nursing curricula lack sleep education. By preparing NPs to conduct sleep assessment and screening and understand basic sleep diagnostics, sleep health is more likely to be part of the differential diagnosis. METHOD The study is a qualitative descriptive study utilizing two focus groups. A directed content analysis, guided by the Kirkpatrick model, was used for analysis. RESULTS Twenty-four students participated in focus groups. Two overarching themes emerged: perceptions of course design and content. Asynchronous, case-based scenarios and quizzes were favorable. Students spoke of content relevance to themselves and patients and intentions to adopt sleep assessment practices. CONCLUSION NP students embraced sleep education and declared intention to apply learned skills in practice. This study highlights the feasibility of increasing curricular exposure to sleep education and ensuring NPs have skills to recognize implications of poor and disordered sleep in patients.

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Knowledge to action: a scoping review of approaches to educate primary care providers in the identification and management of routine sleep disorders

Cited by 7 publications

References 51 publications

Lifelong learning in community healthcare: Testing competence after learning activities in a blended learning space

Lifelong learning in community healthcare: Testing competence after learning activities in a blended learning space

Model for Doctor of Nursing Practice Projects Based on Cross-Fertilization Between Improvement and Implementation Sciences: Protocol for Quality Improvement and Program Evaluation Studies

Exploring Nurse Practitioner Students’ Perceptions of a Sleep e-Learning Program

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