Lecture 10 - Planned Action Theories (: Flashcards
What are the three pillars of evidence-based practice?
Best research evidence, professional expertise, client values.
Systemic reviews provide what kind of evidence and carry what kind of bias?
Higher quality evidence, lower risk of bias
List the kinds of studies from highest quality or research and lowest chance of bias downward.
Best to worst:
–> Systemic reviews and meta analyses
–> Cohort studies
–> Case-control studies
–> Cross-sectional studies, surveys
–> Case reports, case studies
–> Mechanistic studies
–> Editorials, expert opinions
What is the purpose of EBP in nursing?
Transforming nursing knowledge into clinically usable forms
Implementing across interprofessional teams within a systems context
Measuring meaningful impact on outcomes
EBP guides nurses to…
Provide high quality patient care based on the best available evidence and knowledge
What are some barriers to EBP?
It is time consuming, required access to peer-reviewed literature, knowledge of statistics.
Negative attitudes –> resistance to change
Publication bias
What is meant by publication bias?
Refers that studies with positive or significant findings are more likely to be published, while studies with negative or null results remain unpublished, practitioners and policymakers may base decisions on incomplete or misleading data.
What is the knowledge-to-action gap?
Refers to the disconnect between research knowledge (evidence) and its practical application in real-world settings. Despite the availability of high-quality evidence, many healthcare, social service, and policy environments struggle to implement it effectively.
What is knowledge translation?
Knowledge to practice
“A dynamic and iterative process that includes the synthesis, dissemination, exchange and ethically sound application of knowledge to improve health, provide more effective health services and products and strengthen the health care system” - Canadian Institute for Health Research
What are the two kinds of theories of change?
Classical & Planned Action
What are classical theories of change?
Passive theories that explains and describes how change occurs
What are planned action theories?
Prescriptive - provide a plan
–> Have a higher likelihood of success than theories that seem like a good idea at the time
How long does it take research to translate into healthcare practice?
An average of 17 years
What is the main idea of the knowledge to action framework described by Straus, Tetroe, & Graham (2013)?
Knowledge inquiry leads to synthesis leads to tools to acquire it.
–> With this we can identify a problem, gap, and review and select knowledge
This knowledge is then adapted to context, assessed for barriers to its use, interventions are created. Its use is then monitored, outcomes are evaluated, and its use is sustained
What is integrated knowledge translation?
Researchers work with knowledge users to translate knowledge to practice productively
The first step of knowledge creation is knowledge inquiry. What is meant by this?
Refers to primary, single studies that are not ready to be translated but are essential to inform future research
The second step of knowledge creation is knowledge synthesis. What is meant by this?
Takes place in systematic reviews, meta-analyses, and meta-syntheses
What is a systematic review?
Use of systematic & explicit methods to identify, select, and critically appraise studies
What are meta-analyses?
Synthesis of analysis of quantitative studies using statistical techniques
What is a meta-synthesis?
Analysis/synthesis of multiple quantitative studies
What is the purpose of synthesizing knowledge?
It makes vast literature more reliable, readable.
Minimizes risk of bias
Maps our state of knowledge on a topic, reveals where there is not strong evidence and guides future researchers
The third step of the knowledge production is producing knowledge tools and products. What is meant by this?
Critical practice guidelines and patient decision aids
What are the two main drivers to adapting knowledge to the local context?
To ensure knowledge fits in local circumstances and to give users a sense of ownership to promote implementation
How can we monitor knowledge use?
Observation - such as through administrative databased
Active measurement - such as questionnaires
Summary results from clinical trials must be available when?
Summary must be publicly available within 12 months of visit with last participant
What is the purpose of evidence based medicine, according to Sacket et al. (1996)?
Integrating individual clinical enterprise, patient preferences, and the best external evidence
What tools can be used to assess barriers to knowledge use?
Conceptual models, instruments, existing taxonomies
