Turning Knowledge Into Action at the Point‐of‐Care: The Collective Experience of Nurses Facilitating the Implementation of Evidence‐Based Practice

Dogherty, Elizabeth J.; Harrison, Margaret B.; Graham, Ian D.; Vandyk, Amanda; Keeping‐Burke, Lisa

doi:10.1111/wvn.12009

Cited by 91 publications

(113 citation statements)

References 29 publications

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“…An integrative review, case audit and structured interviews, and an international two-day facilitator’s forum were used to delineate key practical and conceptual elements of facilitation as a ‘process beyond an assigned role’ in implementation [11,12,20]. Facilitation is described as a multifaceted process comprising more than 50 specified actions grouped across four stages: planning for change, leading and managing change, monitoring progress and on-going implementation, and evaluating change.…”

Section: Resultsmentioning

confidence: 99%

Guideline adaptation and implementation planning: a prospective observational study

et al. 2013

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BackgroundAdaptation of high-quality practice guidelines for local use has been advanced as an efficient means to improve acceptability and applicability of evidence-informed care. In a pan-Canadian study, we examined how cancer care groups adapted pre-existing guidelines to their unique context and began implementation planning.MethodsUsing a mixed-methods, case-study design, five cases were purposefully sampled from self-identified groups and followed as they used a structured method and resources for guideline adaptation. Cases received the ADAPTE Collaboration toolkit, facilitation, methodological and logistical support, resources and assistance as required. Documentary and primary data collection methods captured individual case experience, including monthly summaries of meeting and field notes, email/telephone correspondence, and project records. Site visits, process audits, interviews, and a final evaluation forum with all cases contributed to a comprehensive account of participant experience.ResultsStudy cases took 12 to >24 months to complete guideline adaptation. Although participants appreciated the structure, most found the ADAPTE method complex and lacking practical aspects. They needed assistance establishing individual guideline mandate and infrastructure, articulating health questions, executing search strategies, appraising evidence, and achieving consensus. Facilitation was described as a multi-faceted process, a team effort, and an essential ingredient for guideline adaptation. While front-line care providers implicitly identified implementation issues during adaptation, they identified a need to add an explicit implementation planning component.ConclusionsGuideline adaptation is a positive initial step toward evidence-informed care, but adaptation (vs. ‘de novo’ development) did not meet expectations for reducing time or resource commitments. Undertaking adaptation is as much about the process (engagement and capacity building) as it is about the product (adapted guideline). To adequately address local concerns, cases found it necessary to also search and appraise primary studies, resulting in hybrid (adaptation plus de novo) guideline development strategies that required advanced methodological skills.Adaptation was found to be an action element in the knowledge translation continuum that required integration of an implementation perspective. Accordingly, the adaptation methodology and resources were reformulated and substantially augmented to provide practical assistance to groups not supported by a dedicated guideline panel and to provide more implementation planning support. The resulting framework is called CAN-IMPLEMENT.

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Section: Resultsmentioning

confidence: 99%

Guideline adaptation and implementation planning: a prospective observational study

et al. 2013

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“…Specifically with regard to implementation, Aarons, Ehrhart, Farahnak, and Sklar (2014) have described how leaders can utilize Schein’s (2010) embedding mechanisms to bolster the implementation climate in their organizations, and Aarons, Ehrhart, Farahnak, and Hurlburt (2015) describe leadership training specifically targeting improvement in EBP implementation. Research has also shown that development of strategic partnerships, the use of multiple strategies, and facilitator characteristics are associated with successful EBP implementation (Dogherty, Harrison, Graham, Vandyk, & Keeping-Burke, 2013). Future research could analyze the effectiveness of different types of leadership, strategies, and individual characteristic variables that either help to develop, foster, or impede EBP implementation climate.…”

Section: Discussionmentioning

confidence: 99%

Validating the Implementation Climate Scale (ICS) in child welfare organizations

Ehrhart

Torres

Wright

et al. 2016

Child Abuse & Neglect

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There is increasing emphasis on the use of evidence-based practices (EBPs) in child welfare settings and growing recognition of the importance of the organizational environment, and the organization’s climate in particular, for how employees perceive and support EBP implementation. Recently, Ehrhart, Aarons, and Farahnak (2014) reported on the development and validation of a measure of EBP implementation climate, the Implementation Climate Scale (ICS), in a sample of mental health clinicians. The ICS consists of 18 items and measures six critical dimensions of implementation climate: focus on EBP, educational support for EBP, recognition for EBP, rewards for EBP, selection or EBP, and selection for openness. The goal of the current study is to extend this work by providing evidence for the factor structure, reliability, and validity of the ICS in a sample of child welfare service providers. Survey data were collected from 215 child welfare providers across three states, 12 organizations, and 43 teams. Confirmatory factor analysis demonstrated good fit to the six-factor model and the alpha reliabilities for the overall measure and its subscales was acceptable. In addition, there was general support for the invariance of the factor structure across the child welfare and mental health sectors. In conclusion, this study provides evidence for the factor structure, reliability, and validity of the ICS measure for use in child welfare service organizations.

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“…Still, there is a need for more focus on implementation and probably that need its own intervention. Successful implementation needs more strategies than an educational intervention [24].…”

Section: Lessons Learnedmentioning

confidence: 99%

Education to Increase Skills in Research Methods among Clinicians in Health Care

Dannapfel¹,

Törnvall²,

Wressle³

2017

J Health Med Inform

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Introduction: The aim of this study was to evaluate participants' and managers' experience of the design and content of an education programme. The Knowledge to Action (KTA) framework was applied to identify the steps of knowledge creation and action in the education programme.Methods: Data were collected from 18 participants representing two groups: participants in the intervention and supervisors and managers. Two focus groups took place: two with participants in the intervention (4 and 3 in each) and one with eleven managers.Results: All steps in the KTA framework were identified and discussed from several aspects. The importance of selecting projects that were relevant and added value in their clinics was mentioned by all participants. The participants also mentioned that after the education, they had further understanding and increased skills in how to be active and perform continuous improvement projects. The step in the KTA process regarding how to adapt knowledge to local context was not discussed explicitly by the participants or managers.Discussion: Education in research methods and performing improvement projects to develop the clinic creates a more positive attitude to working with continuous improvement. The participant's self-esteem and knowledge increased regarding how to work with improvements. It is important to have the manager's support to perform a project. Emphasis was on knowledge inquiry and synthesis and presenting the results with or without possible solutions. The participants and managers talked about barriers and knowledge use more generally and at an organizational level. This means that the participants did not gain the last bit of knowledge needed to put the action into practice. This implies that the problem regarding lack of implementation skills in health care might remain.

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Turning Knowledge Into Action at the Point‐of‐Care: The Collective Experience of Nurses Facilitating the Implementation of Evidence‐Based Practice

Cited by 91 publications

References 29 publications

Guideline adaptation and implementation planning: a prospective observational study

Guideline adaptation and implementation planning: a prospective observational study

Validating the Implementation Climate Scale (ICS) in child welfare organizations

Education to Increase Skills in Research Methods among Clinicians in Health Care

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