Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz

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Gewählte Publikation:

Breimaier, H.
Implementation of research-based knowledge. Lessons learned from the nursing perspective.
Doktoratsstudium der Sozial- und Wirtschaftswissenschaften; Gesundheits- und Pflegewissenschaft; [ Dissertation ] ; 2015. pp.247. [OPEN ACCESS]


Autor/innen der Med Uni Graz:
Breimaier Helga Elisabeth
Lohrmann Christa

In order to achieve the best patient care, the use of research-based knowledge such as evidence based clinical practice guidelines (CPGs) is currently a requirement in clinical practice. Nurses are expected to take into account such knowledge during their daily practice. However, only a small proportion of that knowledge is actually used in the daily nursing practice, which can negatively affect nursing care recipients. Evidence-based CPGs are intended to promote the translation of research-based knowledge into clinical practice. Nevertheless, incorporating these CPGs effectively and sustainably into nursing practice is challenging. The aim of this doctoral thesis was to obtain in-depth information about the process of implementing research-based knowledge into nursing care. Three studies were conducted. The first chapter includes information on the four components of the doctoral thesis: guideline implementation, influential factors, implementation strategies and the Consolidated Framework for Implementation Research (CFIR) and its combination with participatory action research. Chapter two provides a brief overview of the methods used, specifically the design, setting, sample, data collection and study analyses. Chapters three to six present the results of the three studies conducted as part of the thesis. These have been published or submitted for publication. Chapter three describes factors that influence an implementation endeavour. The findings revealed nurses’ insufficient knowledge about nursing research and research implementation and their need for adequate information, certain structural requirements (e.g., sufficient time, means/materials) and professional support to overcome barriers. In chapter four, the strategies used in three countries to implement evidence based CPGs into nursing practice are described. Providing written materials was the implementation strategy most frequently used, followed by changes in patient record system. Financial incentives or regulatory strategies were rarely used. Chapter five emphasises the effectiveness of multifaceted and tailored implementation strategies to implement an evidence-based CPG to prevent patient falls into acute care nursing practice. Participants significantly gained knowledge on fall prevention and improved their attitudes. Required fall prevention equipment could be purchased and environmental adaptations were made. Chapter six presents the evaluation of the CFIR. Generally, the CFIR is a comprehensive framework that can be used to implement a guideline into a hospital-based nursing practice, however, some crucial factors such as stakeholder aims should be added to the planning phase, and two CFIR constructs (reflecting & evaluating and engaging) need a more specific definition. The framework with its supplements was easily applicable (e.g., to facilitate qualitative data analysis or to explain the main findings). A brief overview of the results, general discussion of the main findings and a discussion of methodological aspects appear in chapter seven. Based on the results and limitations of this thesis, further research in the field of implementing research-based knowledge into nursing practice is recommended. Instruments should be investigated (and developed) to assess influential factors and outcomes of implementation processes, and the effectiveness of implementation strategies as well as cost- and resource-related aspects should be examined. To improve nursing practice through the implementation of research-based knowledge, a revision of Austrian nursing curricula is suggested. Nursing research methods must be included in basic and extended curricula. Furthermore, a participatory action research approach in combination with the CFIR as a theoretical framework is recommended when implementing current knowledge.

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