Translating Research into Clinical Practice: Making Change Happen

Abstract

Translating research into clinical practice is challenging for staff across disciplines. Developing strategies to address common challenges identified in this study may facilitate the adoption of innovative programs within healthcare organizations.

Sustained Transfer of Knowledge to Practice in Long-Term Care: Facilitators and Barriers of a Mental Health Learning Initiative

“…Training alone is insufficient to ensuring knowledge transfer, competence, and performance improvement (Stolee et al, 2005;Stone et al, 2002). Evidence suggests that effective continuing education is facilitated by guidelinebased interventions (Colon-Emeric et al, 2004), efforts to change practice that include multiple learning strategies, such as reminders, feedback, and practice opportunities (Bero et al, 1998); access to expert resources, ongoing support and information sharing (Stolee et al, 2005); and the inclusion of strategies for maintaining momentum (Bradley et al, 2004). In the P.I.E.C.E.S.…”

“…Simply disseminating information as a form of continuing education in LTC is unlikely to result in changes to clinical practice (Colon-Emeric et al, 2004). Effective continuing education is facilitated by organization and management support (Stolee et al, 2005;Stone et al, 2002); physician and staff support and commitment from individual champions (Resnick, Quinn, & Baker, 2004); guideline-based interventions (ColonEmeric et al, 2004); efforts to change practice that include multiple learning strategies, such as reminders, feedback, and practice opportunities (Bero et al, 1998); access to expert resources, ongoing support, and information sharing (Stolee et al, 2005); and the inclusion of strategies for maintaining momentum (Bradley, Schlesinger, Webster, Baker, & Inouye, 2004). Enabling factors (conditions and resources within the environment that allow or enable the implementation of new skills) and reinforcing factors (those that provide cues or reminders to implement new skills or that reinforce the use of new skills) should be incorporated into training initiatives (Green & Kreuter, 1991).…”

Health workers at the core of the health system: Framework and research issues

“…If health workers decide to adopt a treatment technology, they may modify it to suit their patients, work patterns and institutional context [33,34]. Yet, there are examples where health workers modify treatments inappropriately (such as in the Nigerian study where physicians added spasmolytics or antibiotics to ORT [32]).…”

Delirium: actualización en manejo no farmacológico

“…En una primera instancia, HELP fue evaluado en un ensayo clínico controlado, realizándose posteriormente más de 10 estudios de seguimiento con diversas poblaciones, obteniendo siempre resultados satisfactorios [40][41][42] al lograr reducir el riesgo de desarrollar delirium, el número total de días con delirium y el número total de episodios con delirium. Este programa en la actualidad se implementa en más de 200 hospitales en todo el mundo, siendo necesario en algunas oportunidades realizar adaptaciones por falta de recursos o poca disponibilidad de profesionales interdisciplinarios calificados 43,44 . Otras intervenciones multicomponentes son las sugeridas por el Instituto Nacional de Salud y Excelencia Clínica del Reino Unido (National Institute for Health and Clinical Excellence, NICE), quienes desarrollaron una guía que incluye 10 recomendaciones para prevenir el delirium, sumando a los ya recientemente comentados 6 factores prevenibles de HELP, la prevención o corrección de hipoxemia, infección, dolor y constipación 21,45 .…”