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Posts tagged ‘translational research’

Improving Outcomes of Care – Evidence-Based Implementation

Our current featured article addresses one of the great concerns in health care today — evidence-based Intervention (EBI), or  the adoption and implementation of practices that are supported by research evidence.  The title of the article is “Synthesizing Marketing, Community Engagement, and Systems Science Approaches for Advancing Translational Research.” by Shawn M. Kneipp, PhD, RN, ANP-BC, APHN-BC, FAANP; Jennifer Leeman, DrPH, MDIV; Pamela McCall, BSN, RN, MPH; Kristen Hassmiller-Lich, PhD; Georgiy Bobashev, PhD; Todd A. Schwartz, DrPH; Robert Gilmore, BS; Scott Riggan, BA; and Benjamin Gil. This is a thought-provoking article that adds significantly to the ongoing discussion of the meaning of “evidence,” and the issues surrounding the links between and among research, theory and practice.  Here is the abstract of the article:

The adoption and implementation of evidence-based interventions (EBIs) are the goals of translational research; however, potential end-users’ perceptions of an EBI value have contributed to low rates of adoption. In this article, we describe our application of emerging dissemination and implementation science theoretical perspectives, community engagement, and systems science principles to develop a novel EBI dissemination approach. Using consumer-driven, graphics-rich simulation, the approach demonstrates predicted implementation effects on health and employment outcomes for socioeconomically disadvantaged women at the local level and is designed to increase adoption interest of county program managers accountable for improving these outcomes in their communities.

I invite you to read this article and consider ways the ideas might advance our collective interest in strengthening the connections between evidence and practice.  Visit the ANS web site today to download itt, and return here to add your comments and responses!

Integrated Knowledge Translation: Addressing the Knowing/Doing Gap

Gweneth Hartrick Doane and Sheryl Reimer-Kirkham have been working with a team of nursing scholars for several years, exploring the philosophic underpinnings and the practice implications of translational research.  The current issue of ANS features two articles based on their work.  The current featured article is “(Re)theorizing Integrated Knowledge Translation: A Heuristic for Knowledge-As-Action” authored by Gweneth Hartrick Doane, PhD; Sheryl Reimer-Kirkham, PhD; Elisabeth Antifeau, MSN and Kelli Team600Stajduhar, PhD.  The second article which will appear as a featured article starting on September 19th, is titled “Translational Scholarship and a Palliative Approach: Enlisting the Knowledge-As-Action Framework” authored by Sheryl Reimer-Kirkham, PhD; Gweneth Hartrick Doane, PhD; Elisabeth Antifeau, MSN; Barbara Pesut, PhD; Pat Porterfield, MSN; Della Roberts, MSN; Kelli Stajduhar, PhD; and Nicole Wikjord, MSN. Dr. Doane and Dr. Reimer-Kirkham provided this message about their work for ANS readers:

We have been engaged in translational scholarship—under the umbrella of “knowledge translation” for some time, interested in its philosophic underpinnings on the one hand and its practice orientation on the other. The two papers in the ANS 38:3 issue were developed in the context of a research-practice collaborative in British Columbia (iPANEL) that shares a common goal of advancing the further integration of a palliative approach into the healthcare system. We are indebted to the many nurses engaged in this initiative as investigators, clinicians, and affiliates and to Michael Smith Foundation for Health Research (MSFHR) for their generous funding.

Within the knowledge translation (KT) literature how to actually do interactive and integrative KT has been identified as the primary question researchers are currently facing. It has become increasingly clear that something beyond instrumental, prescriptive approaches that arise out of externally-driven knowledge concerns, and impose directives for evidenced-based ‘best’ practice are needed to affect meaningful change at the practice level.

As we have conducted our various KT research projects and pondered possibilities, three key insights that offer a different KT approach (at the conceptual and practical level) have emerged. First, we have come to see the fundamental importance of KT being an inquiry process. Taking an inquiry approach involves working between the existing (what is known) and the emergent (what is not fully known and/or what might be needed). Structuring KT as a process of inquiry and working ‘in-between’ what is known/not known focuses attention on the specific features of a situation and highlights that the question “How best to proceed?” can only be answered within those particularities.

Typically KT is focused toward ‘filling a knowledge gap.’ It is assumed that ‘the problem’ is one of knowledge—people simply lack the latest research knowledge. However, that assumption has not held up in our research. As we describe in our papers, even when the latest research evidence is known there may still be a gap between the care that should be provided and the care that is offered. Subsequently a second insight we propose is that KT is not about filling a gap as much as working in the gap—the gap between the real and the ideal, between realities and possibilities— and seeing that practice gap as a fruitful site for the development of knowledge and practice capacity. It is this gap between real and ideal practice that is of utmost concern to patients, nurses and other health practitioners and that serves as the greatest impetus for practice change. Orienting KT toward a shared practice concern (i.e., the gap between real and ideal care) serves to align practitioners’ deeply felt concerns with their capacity to address those concerns. Moreover, it enables practice concerns to be heard and shared and knowledge to be enlisted to effect change. It also democratizes the knowledge process and knowledge milieu, fostering inclusivity and responsiveness to multiple forms of knowledge.

Finally our third insight is the importance of having a KT process in which nurses and other health practitioners play a central role. And this is where the KITE heuristic, the Knowledge-AS-Action Framework (see Figure below), that we describe in our papers comes in. If the goal of KT is to have the most up-to-date knowledge inform and reshape practice, is it not the practitioners who need to be supported to take the active and central role of determining the relevance and usability of any research knowledgeand, moreover, of determining the direction of the KT process itself? The KITE heuristic opens the space for practitioners to put their own expertise to work. At the same time the heuristic structure serves to identify the multiple forms of knowledge that exist, the further knowledge that might be needed as well as directions for action. The heuristic by its very nature provides an integrated way of thinking about practice development and change that is grounded in explicit and shared values and goals.

While our papers discuss the use of the KITE heuristic in integrating a palliative approach into nursing practice, we believe the heuristic may have utility across a range of practice contexts and concerns. As part of the blog discussion we invite you to consider that possibility and respond to what we have proposed—even consider trying out the heuristic in your area of nursing practice and/or with a current concern. We look forward to hearing your thoughts and experiences.

Indeed, these two articles provide compelling insights and possibilities for practice in many clinical situations. I hope you will visit the ANS web site, download these articles while they are featured, and then return here to add your responses and ideas!

Design by University Communications, Trinity Western University

Design by University Communications, Trinity Western University

New ANS Issue Just Released Featuring “Translational Scholarship”

Today we released ANS 38:3, which features articles on the topic “Translational Scholarship” as well as two “General Topic” articles!  I am particularly excited about this issue because it contains ground-breaking 38-3 coverinformation that has real implications for both nursing practice and nursing knowledge development.  Please take a few minutes to browse the Table of Contents.  I am confident that you will see something in this issue that you will want to read, and/or share with someone you know!

Thanks to all of the dedicated scholars who contributed to this issue.  As with most issues of ANS, the authors include some well-known scholars whose work is already widely recognized for its importance to the discipline.  But there are also authors who are early in the development of their careers and whose work promises to become increasingly valuable as they move forward.

As always, we would love to hear from you about this issue.  Each article will be featured here on the blog, with a message from the authors, over the next 12 weeks. Remember, while each article is featured it will be available for download without charge!   If you want to be notified when this happens, just subscribe to this blog, and an email will be delivered with content from the featured blog post!

Issue topic announced – Translational Scholarship

Translational Scholarship will be the topic for the issue to be published in September, 2015.  The date manuscripts for this issue will be due is January 15, 2015 – so you have time to plan your manuscript to be considered for this issue!  Here is the issue description:

Vol 38:3 – Translational Scholarship

For this issue of ANS we are seeking manuscripts that provide methodologic innovations that bring nursing theory, research and practice together, including translational research, emancipatory and participative approaches. Nursing research reports of studies using these methodologies are welcome, as are manuscripts that provide philosophic, theoretical or methodologic explanations of these approaches to scholarship. Manuscripts should include a strong emphasis on the development of nursing as a discipline. Date manuscripts are due: January 15, 2015

This information is posted on the ANS web site – along with a link to the “Information for Authors” for detailed information about manuscript preparation and submission.

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