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NUR3300 > Research Implementation and Dissemination > Flashcards

Research Implementation and Dissemination Flashcards

1
Q

Ways to implement evidence

instrumental

A

Use of evidence to alter specific actions.

Nurse/agency adopts a “let’s make a change” attitude

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2
Q

ways to implement evidence

conceptual

A

Use of evidence to stimulate discussion, questioning, and further research.
Nurse/agency adopts a “wait and see” attitude.

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3
Q

Knowledge creep

A

 The process of transferring the evidence in the research to the practice setting

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4
Q

decision accretion

A

 The layering of evidence which is required for the final “push” for a change.
 Tipping point

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5
Q

Research-Practice Gap

A

 Many studies reveal that nurses do not keep up with the current research.
 Lack of critical review of research articles results in little or no knowledge creep.
 Education level of many practicing staff nurses may not emphasize the need for critical review of research.

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6
Q

Educational responsibilities

AD

A

Be aware, identify problems, assist

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7
Q

Educational responsibilities

BSN

A

Read, interpret, and evaluate research
Identify problems
Implement findings
Gather data and share findings

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8
Q

Educational responsibilities

MSN

A

Develop hypotheses
Provide clinical expertise
Facilitate investigations
Assist in application

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9
Q

Educational responsibilities

PhD

A 
Develop theories, designs, and methods
Conduct research
Share findings
Facilitate others investigations
Educate
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10
Q

Benefits reflected in:

A 
Assessment
Diagnosis
Planning
Implementation
Evaluation
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11
Q

Roger’s Theory of Knowledge Diffusion and Integration

innovation

A

a new idea

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12
Q

Roger’s Theory of Knowledge Diffusion and Integration

communication channels

A

multiple

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13
Q

Roger’s Theory of Knowledge Diffusion and Integration

other elements:

A

Time requirement
Social system
The organization
The opinion leaders

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14
Q

Roger’s Theory of Knowledge Diffusion and Integration

Process:

A

Knowledge—persuasion—decision—implementation—confirmation

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15
Q

Barriers to Implementation of Evidence

A

 Organizational culture
 Nurse’s belief systems
 Research related barriers

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16
Q

Organizational Culture

adequate resources

A

 Library utilization

 Journals

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17
Q

Organizational Culture

support and encoragement

A

 Collaboration

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18
Q

Organizational Culture

job expectation

A

 Be given time
 Ask why and expect an answer—demand an evidence base
 Cost : benefit, value, quality, satisfaction

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19
Q

Organizational Culture

formal committe structure

A

 In-services/conferences

 Encourage dissemination of findings

20
Q

role of nursing research committees

A 
	Provide leadership
	Provide consultation
	Conduct seminars
	Establish guidelines
	Seek solutions
	Share findings
	Interact with nurses
	Seek out resources
21
Q

nurses’ beliefs

A

 Resistance to change
 Lack of educational focus on research
 Personalities

22
Q

Research Related

A

 Difficulty in reading and interpreting
 Jargon
 Statistics
 Poor studies

23
Q

Ways to Foster Change

A

Know the environment
Assess
Focus on immediate change needs
Engage stakeholders
Acknowledge worth of current system but focus on positive aspects of change
 Cue into and attend to emotional responses

24
Q

Kotter’s phases of change

A 
	Establish urgency
	Create coalition
	Develop vision
	Communicate vision
	Empower action
	Generate short term gains
	Consolidate gains and produce more gains
	Anchor approaches
25
Q

Historical Attempts to Increase Utilization of Evidence

WICHE

A

 Western Interstate Commission for Higher Education
 6 year (mid 70s) study involving regional collaboration
 Looked at target and non-targeted research and utilization.
 Resulted in push for research to be included in all BSN programs

26
Q

Historical Attempts to Increase Utilization of Evidence

CURN

A

 Conduct and Utilization of Research in Nursing
 Michigan Nurse’s Association
 5 year project
 Looked at dissemination of findings, facilitating organizational changes, and encouraging collaborative research.
 Found that research needs to be disseminated widely and must be relevant to nurse’s job
 Resulted in a 9 volume series of research

27
Q

Historical Attempts to Increase Utilization of Evidence

RARIN

A

 Retrieval and Application of Research in Nursing (California)
 To facilitate transfer from research to practice.
 Stimulated organizational changes to increase value in research.

28
Q

Implementation Models

Provide some guidance for integrating research into practice on several levels:

A

 Clinical Scholars Model (see lecture on theory)
 Johns Hopkins Model (see lecture on theory)
 Stetler
 Iowa

29
Q

Stetler Model

A

 Based on Stetler & Marram
 Evaluates both products and processes of EBP
 Individual nurses must read research and use evidence based practice (tricky because the evidence keeps changing).

30
Q

Stetler Model

Preparation

A

select an appropriate articles

31
Q

Stetler Model

Validation

A

is evidence sound, sufficient, and credible?

32
Q

Stetler Model

Comparative/Decision Making

A

assess if reliable and valid, organize, condense, label, and determine meaning,

33
Q

Stetler model

Translation and application

A

is it suitable for this organization, cost/benefit, how will info be used and evaluated?

34
Q

Stetler model

evaluation

A

impact, was it successful?

35
Q

Iowa model

A

Focus on organization as a whole
Answers questions
Is there sufficient evidence?
Is the change appropriate for adoption?
Process:
Selection of a clinical problem or theoretical issue
Literature review for scientific merit and sufficiency as a basis for change.
Assessment and planning
Examine transferability, feasibility, and cost:benefit ratio
Implementation and evaluation
Pilot or clinical trial
Examine process, barriers, outcomes

36
Q

Considerations for Clinical Trials

A 
Replication needed?
Sound research base?
Applied to real situations?
Significance?
Nursing control?
Contribution to care?
Contribution to knowledge?
37
Q

Evidence based practice centers

A

Designated by the AHRQ
Topic specific
Role is to develop evidence based guidelines for practice.
Also develop tools for measurement.

38
Q

other national and international organizations

A

Development of evidence based practice guidelines for individual specialties.
Development of evidence based nursing protocols for incorporation into education and practice.
Examples:
STTI
AWHONN

39
Q

Dissemination

The 3 Ps of Dissemination

A

Posters
Presentations
Papers

40
Q

Posters

A

Attend a conference
Present a poster on completed or work in progress
Allows for interactions with others interested in the topic
Allows for brainstorming

41
Q

Process for posters

A

Watch for call for abstracts
Submit abstract as requested
Plan graphic poster in format determined by the conference
Design poster with power point or other graphic program
Produce a few handouts of poster information
Usually stand beside poster for discussions during the session

42
Q

poster design

A

Lettering that can be read from 4-6 feet away
Only necessary charts
Pictures for attracting interest
Sufficient white space so it doesn’t overwhelm the visual senses
Contents
Arrangement

43
Q

Oral presentations

A

At a conference or staff in-service
Power point presentation
Have handouts
About 15 minutes + question time

44
Q

Papers in journals

A 
Pilot your information first as a poster or oral presentation
Consider authorship order
Review submission guidelines
Send editor a query letter
Follow guidelines exactly
Have a colleague read for feedback
Revised based on feedback of colleague
Submit for review
Revise, resubmit, revise, resubmit, revise .
45
Q

Ethics of dissemination

A

Original work
Acknowledge appropriately
No “salami slicing” (writing the same article over and over again, but changing it slightly before submitting it.)
No “data dredging”(trying to find SOMETHING that’s correlated, SOMETHING significant from your results)

NUR3300 (20 decks)

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