The document discusses the importance of translating evidence into practice in nursing. It notes that while scientific advances have improved health outcomes, gaps remain between evidence and action. Nurses perceive time and knowledge as barriers to evidence-based practices. Translating evidence requires understanding different types and levels of evidence, as well as overcoming barriers like organizational constraints. Strategies to close the gap include disseminating information, training, standardizing guidelines, and developing partnerships. The role of nurses is vital to implementing evidence-based innovations that improve patient-centered care.
Can Bureaucratic Organizations Really Innovate?Ahmad Chamy
Sponsored by Fraser Health Authority, in collaboration with Tracy Irwin (VP, Innovation) & Yabome Gilpin-Jackson (VP, OD) I conducted a qualitative evaluation of one FHA's most innovative and sustained initiatives and summarized the lessons learnt.
I believe this research will help show how public healthcare organizations can innovate!
Dissemination and Implementation Research - Getting FundedHopkinsCFAR
Alice Ammerman, DrPh
Director, Center for Health Promotion and Disease Prevention
Professor, Department of Nutrition
Gillings School of Global Public Health
University of North Carolina
Can Bureaucratic Organizations Really Innovate?Ahmad Chamy
Sponsored by Fraser Health Authority, in collaboration with Tracy Irwin (VP, Innovation) & Yabome Gilpin-Jackson (VP, OD) I conducted a qualitative evaluation of one FHA's most innovative and sustained initiatives and summarized the lessons learnt.
I believe this research will help show how public healthcare organizations can innovate!
Dissemination and Implementation Research - Getting FundedHopkinsCFAR
Alice Ammerman, DrPh
Director, Center for Health Promotion and Disease Prevention
Professor, Department of Nutrition
Gillings School of Global Public Health
University of North Carolina
Commissioning Care Pathways for Chronic DiseasesJames Gupta
Commissioning Care Pathways for Chronic Diseases / Long Term Conditions
This was a presentation I made recently for a conference on Long Term Conditions which was unfortunately cancelled, but I had already written and researched the slides so wanted to put them up for people to see!
Explains how to commission effective services to deal with patients suffering from long-term (chronic) conditions
Challenges in Everyday Leadership Capabilities Conversations with Senior Clin...ijtsrd
Abstract Senior Charge Nurses SCNs are faced with an increasingly wide range of responsibilities as part of their workload and consequently devote less time to patient care. It is noted that Leadership and organizational management are also important, although adequate training, education, resources, and support to realize these ambitions lag needs. Design A mixed method focus group informed by a well established leadership framework was used to explore senior clinical nurses perceptions of their Leadership. Methods Purposive sampling of SCNs working in Scotland was employed. Data sources included a small focus group and one to one face to face interview. 142 SCNs participated in this interview from 2000 to 2013. Results Twelve main themes were identified Patient focused leadership and Organization focused leadership These two themes were further described through domains of Leadership and capabilities that articulate confidence, quality improvement, and team performance. Grace M Lindsay | Sahar Mohammed Aly | Pushpamala Ramaiah "Challenges in Everyday Leadership Capabilities - Conversations with Senior Clinical Nurses" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-4 | Issue-6 , October 2020, URL: https://www.ijtsrd.com/papers/ijtsrd33442.pdf Paper Url: https://www.ijtsrd.com/medicine/nursing/33442/challenges-in-everyday-leadership-capabilities--conversations-with-senior-clinical-nurses/grace-m-lindsay
Strengthen Dissemination, Implementation and Improvement ScienceUCLA CTSI
DII Science at UCLA: Launching a New Initiative (October 25, 2013)
Presented by: Brian Mittman, Moira Inkelas, Stefanie Vassar, Ibrahima Sankare, Arturo Martinez, Arleen Brown
The UCLA CTSI Dissemination, Implementation and Improvement (DII) Science Initiative has three main goals.
1) Expand UCLA’s competitiveness for DII funding and publication opportunities
2) Position UCLA CTSI for future renewal
3) Enhance societal impact and benefits of UCLA research and improve health care quality, health behaviors and health outcomes in Los Angeles County and beyond
The DII vision is to ensure that:
- Results of clinical studies are put into practice in Southern California to benefit diverse populations
- Local providers take part in studies of how to implement, spread and scale findings and innovations
- Research, implementation and dissemination occur seamlessly by design
- Delivery systems can work with researchers to develop system solutions
- Researchers can find delivery systems and/or provider networks with which to partner on implementation-oriented funding proposals and studies
Measuring “Culture of Safety” Tawam’s Experience
Discovery:
Tawam Hospital’s Executive leadership realized the need to establish a “Culture of Safety” within the organization and implemented the Johns Hopkins Medicine “Comprehensive Unit based Safety Program” (CUSP). CUSP was introduced as a pilot project in the Intensive Care Unit (ICU), Neonatal Intensive Care Unit (NNU) and Paediatric Oncology Unit (Peds Onc).
Prior to implementation the leadership decided to measure staff perception of safety using evidence based tool.
Solution:
Tawam partnered with Pascal Metrics to implement the Safety Attitude Questionnaire survey. The SAQ was administered to all Tawam Hospital staff in three phases (2008, 2010 and 2011). In 2010 the pilot CUSP units were also resurveyed to determine the status of safety culture since its introduction in 2008.
An email from the CEO was sent to the participants encouraging them to participate in the SAQ survey.
Physicians, nurses, ward-clerks; respiratory therapist, physiotherapist, dieticians etc were included in the survey.
Those who spent at least 50% of their time in the identified units were only included to participate in the survey.
Survey was administered during departmental meetings to increase response rate.
Conducted separate sessions of physicians.
Staff dropped the completed surveys in an envelope.
82% of staff in the patient care areas of the whole hospital participated in the overall 3 phases of SAQ Survey.
The three CUSP pilot units were re-surveyed in 2010.
Anonymity, privacy and confidentiality were maintained from the beginning till the end.
Outcome:
The survey results were graded against percentage positive responses. Responses that were less than 60% mark were graded in the danger zone and anything above the 80% mark were graded in the goal zone. Teamwork climate and Safety climate scale scores are considered to be primary dependent variables, because they are important in preventing patient harm.
The overall hospital score on all the domain scores were in the danger zone, less than 60%. 20 clinical locations in 2010 and 7 clinical locations in 2011 had less than 60% scores in the primary dependent variables.
The SAQ results were disseminated department wise in the presence of a hospital Senior Executive. Every department did an action plan using the SAQ de-briefer tool. The hospital administrators to bring about the change played a facilitators role and helped the departments to come up with their actionable plans.
The hospital leadership in their pursuit to continuing the culture of safety journey, identified six more units for CUSP implementation based on the Phase 2 SAQ scores of 2010. Accordingly the Medical 1, Medical 2, Surgical 1, Surgical 2, Day Case and OBGYN Units were identified for the CUSP roll out. Senior Executive leaders were assigned to each of these new CUSP units to ensure leadership commi
Knowledge Transfer is a discipline of the Policy Planning field that investigates about the creation, research and dissemination of knowledge in the social and political context
Commissioning Care Pathways for Chronic DiseasesJames Gupta
Commissioning Care Pathways for Chronic Diseases / Long Term Conditions
This was a presentation I made recently for a conference on Long Term Conditions which was unfortunately cancelled, but I had already written and researched the slides so wanted to put them up for people to see!
Explains how to commission effective services to deal with patients suffering from long-term (chronic) conditions
Challenges in Everyday Leadership Capabilities Conversations with Senior Clin...ijtsrd
Abstract Senior Charge Nurses SCNs are faced with an increasingly wide range of responsibilities as part of their workload and consequently devote less time to patient care. It is noted that Leadership and organizational management are also important, although adequate training, education, resources, and support to realize these ambitions lag needs. Design A mixed method focus group informed by a well established leadership framework was used to explore senior clinical nurses perceptions of their Leadership. Methods Purposive sampling of SCNs working in Scotland was employed. Data sources included a small focus group and one to one face to face interview. 142 SCNs participated in this interview from 2000 to 2013. Results Twelve main themes were identified Patient focused leadership and Organization focused leadership These two themes were further described through domains of Leadership and capabilities that articulate confidence, quality improvement, and team performance. Grace M Lindsay | Sahar Mohammed Aly | Pushpamala Ramaiah "Challenges in Everyday Leadership Capabilities - Conversations with Senior Clinical Nurses" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-4 | Issue-6 , October 2020, URL: https://www.ijtsrd.com/papers/ijtsrd33442.pdf Paper Url: https://www.ijtsrd.com/medicine/nursing/33442/challenges-in-everyday-leadership-capabilities--conversations-with-senior-clinical-nurses/grace-m-lindsay
Strengthen Dissemination, Implementation and Improvement ScienceUCLA CTSI
DII Science at UCLA: Launching a New Initiative (October 25, 2013)
Presented by: Brian Mittman, Moira Inkelas, Stefanie Vassar, Ibrahima Sankare, Arturo Martinez, Arleen Brown
The UCLA CTSI Dissemination, Implementation and Improvement (DII) Science Initiative has three main goals.
1) Expand UCLA’s competitiveness for DII funding and publication opportunities
2) Position UCLA CTSI for future renewal
3) Enhance societal impact and benefits of UCLA research and improve health care quality, health behaviors and health outcomes in Los Angeles County and beyond
The DII vision is to ensure that:
- Results of clinical studies are put into practice in Southern California to benefit diverse populations
- Local providers take part in studies of how to implement, spread and scale findings and innovations
- Research, implementation and dissemination occur seamlessly by design
- Delivery systems can work with researchers to develop system solutions
- Researchers can find delivery systems and/or provider networks with which to partner on implementation-oriented funding proposals and studies
Measuring “Culture of Safety” Tawam’s Experience
Discovery:
Tawam Hospital’s Executive leadership realized the need to establish a “Culture of Safety” within the organization and implemented the Johns Hopkins Medicine “Comprehensive Unit based Safety Program” (CUSP). CUSP was introduced as a pilot project in the Intensive Care Unit (ICU), Neonatal Intensive Care Unit (NNU) and Paediatric Oncology Unit (Peds Onc).
Prior to implementation the leadership decided to measure staff perception of safety using evidence based tool.
Solution:
Tawam partnered with Pascal Metrics to implement the Safety Attitude Questionnaire survey. The SAQ was administered to all Tawam Hospital staff in three phases (2008, 2010 and 2011). In 2010 the pilot CUSP units were also resurveyed to determine the status of safety culture since its introduction in 2008.
An email from the CEO was sent to the participants encouraging them to participate in the SAQ survey.
Physicians, nurses, ward-clerks; respiratory therapist, physiotherapist, dieticians etc were included in the survey.
Those who spent at least 50% of their time in the identified units were only included to participate in the survey.
Survey was administered during departmental meetings to increase response rate.
Conducted separate sessions of physicians.
Staff dropped the completed surveys in an envelope.
82% of staff in the patient care areas of the whole hospital participated in the overall 3 phases of SAQ Survey.
The three CUSP pilot units were re-surveyed in 2010.
Anonymity, privacy and confidentiality were maintained from the beginning till the end.
Outcome:
The survey results were graded against percentage positive responses. Responses that were less than 60% mark were graded in the danger zone and anything above the 80% mark were graded in the goal zone. Teamwork climate and Safety climate scale scores are considered to be primary dependent variables, because they are important in preventing patient harm.
The overall hospital score on all the domain scores were in the danger zone, less than 60%. 20 clinical locations in 2010 and 7 clinical locations in 2011 had less than 60% scores in the primary dependent variables.
The SAQ results were disseminated department wise in the presence of a hospital Senior Executive. Every department did an action plan using the SAQ de-briefer tool. The hospital administrators to bring about the change played a facilitators role and helped the departments to come up with their actionable plans.
The hospital leadership in their pursuit to continuing the culture of safety journey, identified six more units for CUSP implementation based on the Phase 2 SAQ scores of 2010. Accordingly the Medical 1, Medical 2, Surgical 1, Surgical 2, Day Case and OBGYN Units were identified for the CUSP roll out. Senior Executive leaders were assigned to each of these new CUSP units to ensure leadership commi
Knowledge Transfer is a discipline of the Policy Planning field that investigates about the creation, research and dissemination of knowledge in the social and political context
Study: The Future of VR, AR and Self-Driving CarsLinkedIn
We asked LinkedIn members worldwide about their levels of interest in the latest wave of technology: whether they’re using wearables, and whether they intend to buy self-driving cars and VR headsets as they become available. We asked them too about their attitudes to technology and to the growing role of Artificial Intelligence (AI) in the devices that they use. The answers were fascinating – and in many cases, surprising.
This SlideShare explores the full results of this study, including detailed market-by-market breakdowns of intention levels for each technology – and how attitudes change with age, location and seniority level. If you’re marketing a tech brand – or planning to use VR and wearables to reach a professional audience – then these are insights you won’t want to miss.
Artificial intelligence (AI) is everywhere, promising self-driving cars, medical breakthroughs, and new ways of working. But how do you separate hype from reality? How can your company apply AI to solve real business problems?
Here’s what AI learnings your business should keep in mind for 2017.
Supporting and developing patient safety collaboratives - Phil Duncan and Fiona Thow, Patient safety collaborative delivery leads, NHS Improving Quality
Presentation from the Patient Safety Collaborative launch event held in London on 14 October 2014
More information at http://www.nhsiq.nhs.uk/improvement-programmes/patient-safety/patient-safety-collaboratives.aspx
EBP is a systemic interconnecting of scientifically generated evidence with the tacit knowledge of the expert practitioner to achieve a change in a particular practice for the benefit of a well-defined client/ patient group.
Evidence to Care: Mobilizing Childhood Disability Research into Practice
Dr. Shauna Kingsnorth
Evidence to Care Lead
Clinical Study Investigator
Assistant Professor (status), Department of Occupational Science
and Occupational Therapy, University of Toronto
Holland Bloorview Kids Rehabilitation Hospital
skingsnorth@hollandbloorview.ca
Presented at: Canadian Knowledge Mobilization Forum
Saskatoon, Saskatchewan June 9, 2014
2. Outline
• Evidence based practices
• Sources of evidence and its level
• Translate the evidence into practice
• Perceive knowledge and attitude on evidence based practices
• The process involved in evidence based practices
• Barriers or gaps between evidence
• Nurses role in translation of evidence into action
• Make a case for change
Prepared By: Gaurav Kohli
3. Introduction
The availability of information and the growth of science-
significant improvement in health outcomes of the
world.
However differences in outcomes, health in equalities and
poorly performing health cause real challenge to nurses.
Acknowledges the not enough understanding on how to
make effective interventions widely available to the
people.
Stronger emphasis is needed not just on the discovery of
new drugs and diagnostics but also on how we put
knowledge into use; on how we close the gap between
evidence and action Prepared By: Gaurav Kohli
4. Perception on EBP
• A study on American Registered Nurses’ perceptions,
attitude and knowledge /skills associated with evidence
based practices (koehn & Lehman 2008). The findings
shows that participants had moderate scores on practice
and attitude toward evidence based practices.
• The two most cited barriers to implementing evidence-
based practice were time and knowledge.
• The findings suggest the value of providing adequate
knowledge for better nursing care.
Prepared By: Gaurav Kohli
5. Evidence Based Practices
• EBP aims to base health care on the finding from
systematic evaluation of the efficacy of given
interventions, rather than tradition or custom and
practice (Taylor 2003)
6.
7. What is ‘Evidence’
• Define as :
the availability facts or circumstance,
supporting or otherwise a belief,
proposition or indicating whether or not a
thing is true or valid
(Oxford English Dictionary 2009)
Prepared By: Gaurav Kohli
8. Types of Evidence
• Not all evidence is equally useful-research findings are
weighed more heavily in decision making process
because it uses systematic methods to collect the data.
• Different types of evidence are more relevant to different
questions and nurses need to be actively engaged in
making sure that relevant research, where available, is
identified, appraised and used appropriately.
Prepared By: Gaurav Kohli
9. How do we decide on the evidence?
Prepared By: Gaurav Kohli
12. The Need to Translate Evidence Into Action
• Pravikoff, Tanner and Pierce (2005) found that nurses
typically using their knowledge from school, their own
experience from the past, or usual practice and
knowledge from co-workers to guide their practice
• Its also found that medical science and technology have
advanced at extreme rapid pace, but delivery of health
care has lagged behind.
• This report made it clear that “usual practice” is not good
enough anymore. The switch must be made based on
evidence.
Prepared By: Gaurav Kohli
13. From Evidence to Action:
• Changes are rarely easy as it involves changing the way
people and the system behave.
• Change can frequently be messy, waste time and can
have unpredicted consequences.
• However change can be exciting and motivating.
• Understanding and planning how to take evidence into
practice, to action knowledge, is important.
• This area, because it is so critical, has been the subject
of an increasing amount of research itself.
Prepared By: Gaurav Kohli
14. Gap Between Translating Evidence into Action
• Practice environment (organizational context)
–Financial disincentives-lack of reimbursement
–Organizational constraints-lack of time, work demand
–Perception of liability-risk of formal complaint
–Patient expectations
–Insufficient guidelines
–Standard practice-Satisfied with usual knowledge and
practice
–Key person does not agree with the evidence
–Lack of knowledge in research method, condition,
management
Prepared By: Gaurav Kohli
15. Gap (con’t)
• Knowledge and attitude
–Sense of competence- self confidence
–Information overload- unable to identify the correct
evidence
• No access to published papers
• Literature is ambiguous or conflicting
Prepared By: Gaurav Kohli
16. Bridging The Gap-evidence into Action
• Building partnerships
– bringing individuals, groups and teams together to
develop a shared vision and sense of purpose
• Using champions/change agents /opinion leaders
–identifying and recruiting key people to support the
change; they need credibility and to be respected by the
individuals you are seeking to influence.
• Feedback on performance
Prepared By: Gaurav Kohli
17. Bridging Gap (Con’t)
• Sharing and disseminating information
– through a variety of media, and designed with specific
audiences in mind; it can involve writing leaflets, the use
of plays, and the other media
• Education and training interventions – such as
continuing education modules, decision support
systems, one to one coaching, online learning, use of
simulations.
• Standardizing practice – using care pathways, clinical
audit, variance reporting, checklists and guidelines.
Prepared By: Gaurav Kohli
18. Make A Case For Change
• Case for change is a process and strategy to discover
new, updated, filtered and approved nursing practices for
the better patient care.
19. Pre-requisites to Make A Case for Change
PRE REQUISITES
Clearly defined boundaries
Appropriate and transparent decision making
Understood power and authority
Appropriate resources
Information and feedback system
Receptive to change
Prepared By: Gaurav Kohli
20. IMPLEMENTATION
TEAM Pt. centered
DEVELOPMENT & evidence EVALUATION
DISCUSSION based
practices
REFIENMENT
SECURING THE
&
SOURCES REQUIRED
MODIFICATION
-RESEARCH
-PROFESSIONAL
EXPERTISE &
CLINICAL EXPERTISE
-LOCAL DATA &
INFORMATION
PROCESS FOR MAKING A CASE
-PATIENT
FOR CHANGE
PREFERENCE &
EXPERIENCE
21. Effective Case For Change Includes :
Valid
Reproductive & Flexible
Cost Effective
Development of team
Prepared By: Gaurav Kohli
22. Illustration:
• A systematic review demonstrated that wearing jewelry
affected efficacy of hand hygiene.
• A randomized control trial demonstrated sufficient
evidence and there is association between jewelry and
hand hygiene
• A team organized to discuss, implement and monitor the
nursing staff to avoid wearing jewelry during pt. care.
• Arranged the sources required to implement the
evidence ( lockers, secure places, manpower, finance)
• Strict guidelines developed based on evidence to avoid
wearing jewelry during patient care
• Team regularly evaluate and refine the guidelines to
increase the effectiveness and utilization of patient
centered and safe care
23. Nurses’ role
• Understand about EBP and involve in putting the
knowledge into action- vital to local service innovation
and the development of new ways of working.
• Disseminate the available evidence
• Committed to developing an environment conducive to
evidence
–-informed decision making and practice- work closely
with the teams that use their findings, including the wider
community.
–Building partnerships among health professionals and
policy makers, nursing education to facilitate
disseminating and application of evidence
Prepared By: Gaurav Kohli
24. Conclusion
• Health care systems need to
implement interventions that
not only increase nurses' EBP
knowledge and skills, but also
strengthen their beliefs about
the benefit of evidence-based
care.
Prepared By: Gaurav Kohli