Question

What methods can be used to develop, implement, or evaluate evidence-based practice in clinical setting?

Answer 1

Ans) Translation science is young, and although there is a growing body of knowledge in this area, we have, to date, many unanswered questions.

- These include the type of audit and feedback (e.g., frequency, content, format) strategies that are most effective, the characteristics of opinion leaders that are critical for success, the role of specific context variables, and the combination of strategies that are most effective.

- We also know very little about use of tailored implementation interventions, or the key context attributes to assess and use in developing and testing tailored interventions.

- The types of clinical reminders that are most effective for making EBP knowledge available at the point of care require further empirical explanation.

- We also know very little about the intensity and intervention dose of single and multifaceted strategies that are effective for promoting and sustaining use of EBPs or how the effectiveness differs by type of topic (e.g., simple versus complex).

- Only recently has the context of care delivery been acknowledged as affecting use of evidence, and further empirical work is needed in this area to understand how complex adaptive systems of practice incorporate knowledge acquisition and use.

- Lastly, we do not know what strategies or combination of strategies work for whom, in what context, why they work in some settings or cases and not others, and what is the mechanism by which these strategies or combination of strategies work.

- This is an exciting area of investigation that has a direct impact on implementing patient safety practices. In planning investigations, researchers must use a conceptual model to guide the research and add to the empirical and theoretical understanding of this field of inquiry.

- Additionally, funding is needed for implementation studies that focus on evidence-based patient safety practices as the topic of concern.

- To generalize empirical findings from patient safety implementation studies, we must have a better understanding of what implementation strategies work, with whom, and in what types of settings, and we must investigate the underlying mechanisms of these strategies.

- This is likely to require mixed methods, a better understanding of complexity science, and greater appreciation for nontraditional methods and realistic inquiry.