Evaluation of Outcomes

As you translate evidence into practice, it is essential to consider how you will evaluate the outcomes. As introduced in Week 8, you are likely to encounter barriers as you integrate research findings into practice. Using a framework for evaluation can assist in minimizing those barriers.

As a nurse engaged in advanced practice, it is now time to take your practicum project to the next level—evaluating the outcomes you identified for the Week 9 Discussion and then developing new practice guidelines.

To prepare:

  • The course text, Translation of Evidence into      Nursing and Health Care Practice, provides a list of questions that should      be considered when planning for evaluation. See page 239 for this list of      questions.
  • Review the Learning Resources focusing on the      various evaluation frameworks presented. Select a framework and determine      how you would evaluate the outcomes you identified in the Week 9      Discussion (see week 9 discussion in the file area).
  • Based on the possible results of your      evaluation, envision new practice guidelines you would develop.
  • What new standards of care might this lead to?

By tomorrow Wednesday 10/30/18 at 12 pm, write a minimum of 550 words essays in APA format with at least 3 references from the list of REQUIRED READINGS (see attached files) below. Include the headers as numbered below:

Post a cohesive scholarly response that addresses the following:

1) In the first line of your posting, state the outcomes you are addressing (those you initially identified in the Week 9 Discussion [see week 9 discussion in the file area]).

2) How would you evaluate the outcomes? Support your response with evidence from the literature.

3) What new practice guidelines would you create based on your evaluation of those outcomes?

4) Discuss any new standards of care that would be appropriate based on the new practice guidelines.

Required Readings

White, K. M., Dudley-Brown, S., & Terharr, M. F. (2016). Translation of evidence into nursing and health care practice (2nd ed.). New York, NY: Springer.

  • Chapter      17, “Data Management and Evaluation of Translation” (see attached file)

Erickson, K., Monsen, K.A., Artleson, I.S., Radosevich, D.M., Oftedahl, G., Neely, C., & Thorsen, D.R. Translation of obesity practice guidelines: Measurement and evaluation. Public Health Nursing, 12(3), 222–23. doi: 10.1111/phn.12169. (see attached file)

Wang, Y., Xiao, L.D., Ullah, S., Guo-Ping, H., & De Bellis, A. Evaluation of a nurse-led dementia education and knowledge translation programme in primary care: A cluster randomized controlled trial (2017). Nurse Education Today, 49, 1-7. https://doi.org/10.1016/j.nedt.2016.10.016. (see attached file)

Abdullah, G., Rossy, D., Ploeg, J., Davies, B., Higuchi, K., Sikora, L., & Stacey, D. (2014). Measuring the effectiveness of mentoring asa knowledge translation intervention for implementing empirical evidence: A systematic review. Worldviews on Evidence-Based Nursing, 11 (5) 284–300. https://doi-org.ezp.waldenulibrary.org/10.1111/wvn.12060 (see attached file)

Einarson, A., Egberts, T.c., & Heerdink, E.R. (2015). Antidepressant use in pregnancy: knowledge transfer and translation of research findings. Journal of Evaluation in Clinical Practice, 21, 579-583 doi:10.1111/jep.12338 (see attached file)

PIICOT Question

In patients in extended intensive care within an urban acute care facility in Eastern United States, how does early mobilization as recommended by National Institute of Health and Care Excellence clinical guidelines on rehabilitation of patients after critical illness impact early transfers from intensive care as measured 6 months post-implementation when compared to the current standard of care including minimal mobilization of patients?

P: Adult patients 

I: in extended intensive care within an urban acute care facility

I: increased mobilization of the patients 

C: minimal mobilization of the patients

O: early transfers of the patients from intensive care

T: 6 months

Antidepressant use in pregnancy: knowledge transfer and
translation of research findings
Adrienne Einarson RN, PhD candidate,1 Toine C. Egberts PhD2 and E. Rob Heerdink PhD2

1PhD candidate, Department of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht
University, Utrecht, The Netherlands
2Professor, Clinical Pharmacy / Clinical Pharmacoepidemiology, Department of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute
for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands

Keyword

antidepressants, knowledge, pregnancy,
transfer

Correspondence

Ms Adrienne Einarson
Department of Pharmacoepidemiology &
Clinical Pharmacology, Utrecht Institute for
Pharmaceutical Sciences
Utrecht University
37 Ellen Street #602
Barrie, Ontario L4N 6G2
Canada
E-mail: [email protected]

Accepted for publication: 18 January 2015

doi:10.1111/jep.12338

Abstract
Rationale Knowledge transfer and translation (KT) has become an important component
in health care systems worldwide. Antidepressant use in pregnancy has become a contro-
versial subject for a number of reasons, including differing interpretations of study results.
Methods Selected key articles were indentified and retrieved from the literature. Relevant
information was extracted and synthesized into themes, addressing each of the stated
objectives.
Objectives (1) To determine how knowledge regarding the safety/risk of antidepressant
use in pregnancy is created; (2) to describe different research models and statistical
analyses that have been used, so as to critically evaluate the results; and (3) to identify how
this information is currently disseminated.
Results All of the methods used for examining the safety of antidepressants in pregnancy
have some deficiencies in study design and analysis, thus reinforcing the need for accurate
interpretations when discussing results. In addition, dissemination in both the scientific and
lay press has been selective and therefore potentially biased.
Conclusion It is critical, starting with the creators of knowledge, through to the recipients
that discrepancies are resolved, as lack of clarity may impede the transfer of unambiguous
evidence-based information from health care providers to patients, thus impacting decision
making. For example, by implementing improved (KT) strategies, a pregnant, depressed
woman, will be empowered to make a rational evidence-based decision regarding whether
or not she should take an antidepressant during pregnancy.

Introduction
Traditional dissemination strategies have followed a mostly
passive exercise of sharing knowledge, most often carried out
through peer-reviewed journals and at scientific conferences.
Howe

Original Article

Measuring the Effectiveness of Mentoring as
a Knowledge Translation Intervention for
Implementing Empirical Evidence:
A Systematic Review
Ghadah Abdullah, RN, MSc • Dianne Rossy, RN, MScN, GNC(C) • Jenny Ploeg, RN,
PhD • Barbara Davies, RN, PhD • Kathryn Higuchi, RN, PhD • Lindsey Sikora, BSc,
MISt • Dawn Stacey, RN, PhD

Keywords

evidence-based
practice,

mentorship,
outcome evaluation,

professional
issues/professional
ethics/professional

standards,
advanced

practice/advanced
nursing practice,

meta-analysis

ABSTRACT
Background: Mentoring as a knowledge translation (KT) intervention uses social influence among
healthcare professionals to increase use of evidence in clinical practice.

Aim: To determine the effectiveness of mentoring as a KT intervention designed to increase
healthcare professionals’ use of evidence in clinical practice.

Methods: A systematic review was conducted using electronic databases (i.e., MEDLINE,
CINAHL), grey literature, and hand searching. Eligible studies evaluated mentoring of health-
care professionals responsible for patient care to enhance the uptake of evidence into practice.
Mentoring is defined as (a) a mentor more experienced than mentee; (b) individualized support
based on mentee’s needs; and (c) involved in an interpersonal relationship as indicated by mu-
tual benefit, engagement, and commitment. Two reviewers independently screened citations for
eligibility, extracted data, and appraised quality of studies. Data were analyzed descriptively.

Results: Of 10,669 citations from 1988 to 2012, 10 studies were eligible. Mentoring as a KT
intervention was evaluated in Canada, USA, and Australia. Exposure to mentoring compared to
no mentoring improved some behavioral outcomes (one study). Compared to controls or other
multifaceted interventions, multifaceted interventions with mentoring improved practitioners’
knowledge (four of five studies), beliefs (four of six studies), and impact on organizational out-
comes (three of four studies). There were mixed findings for changes in professionals’ behaviors
and impact on practitioners’ and patients’ outcomes: some outcomes improved, while others
showed no difference.

Linking Evidence to Action: Only one study evaluated the effectiveness of mentoring alone as a
KT intervention and showed improvement in some behavioral outcomes. The other nine studies
that evaluated the effectiveness of mentoring as part of a multifaceted intervention showed
mixed findings, making it difficult to determine the added effect of mentoring. Further research
is needed to identify effective mentoring as a KT intervention.

INTRODUCTION
Knowledge translation (KT) interventions are designed to sup-
port the uptake of best available evidence, including clinical
guidelines into practice (Straus, Tetroe, & Graham, 2013). One
catego

POPULATIONS AT RISK ACROSS THE LIFESPAN: PROGRAM EVALUATIONS

Translation of Obesity Practice
Guidelines: Measurement and
Evaluation
Kristin J. Erickson, MS, RN, PHN,1 Karen A. Monsen, PhD, RN, FAAN,2 Ingrid S. Attleson, BSN, RN,3

David M. Radosevich, PhD, RN,4 Gary Oftedahl, MD,5 Claire Neely, MD,6 and Diane R. Thorson, MS,
RN, PHN7
1Health Initiatives and Evaluation, Otter Tail County Public Health and PartnerSHIP 4 Health, Fergus Falls, Minnesota; 2School of Nursing
Affiliate Faculty, Institute for Health Informatics, University of Minnesota School of Nursing, Minneapolis, Minnesota; 3School of Public
Health, University of Minnesota, Minneapolis, Minnesota; 4Clinical Outcomes Research Center, University of Minnesota, Minneapolis,
Minnesota; 5Institute for Clinical Systems Improvement, Bloomington, Minnesota; 6Institute for Clinical Systems Improvement,
Bloomington, Minnesota; and 7Public Health Department, Otter Tail County, Fergus Falls, Minnesota

Correspondence to:

Kristin Erickson, Otter Tail County Public Health, PartnerSHIP 4 Health Project Evaluator, 560 Fir Ave West, Fergus Falls, MN 56537.

E-mail: [email protected]

ABSTRACT Objective(s): A public health nurse (PHN) in the Midwestern United States (U.S.)
led a collaborative system-level intervention to translate the Institute of Clinical Systems
Improvement (ICSI) Adult Obesity Guideline into interprofessional practice. This study (1) evalu-
ated the extent of guideline translation across organizations and (2) assessed the Omaha System
as a method for translating system-level interventions and measuring outcomes. Design and Sam-
ple: This retrospective, mixed methods study was conducted with a purposeful sample of one
administrator (n = 10) and two to three clinicians (n = 29) from each organization (n = 10).
Measures: Omaha System Problem Rating Scale for Outcomes Knowledge, Behavior, and Status
(KBS). KBS ratings gathered from semi-structured interviews and Omaha System documentation
were analyzed using standard descriptive and inferential statistics and triangulated findings with
participant quotes. Results: KBS ratings and participant quotes revealed intervention effectiveness in
creating sustained system-level changes. Self-reported and observed KBS ratings demonstrated
improvement across organizations. There was moderate to substantial agreement regarding bench-
mark attainment within organizations. On average, self-reported improvement exceeded observer
improvement. Conclusions: System-level PHN practice facilitator interventions successfully translated
clinical obesity guidelines into interprofessional use in health care organizations. The Omaha System
Problem Rating Scale for Outcomes reliably measured system-level outcomes.

Key words: adult, health

Nurse Education Today 49 (2017) 1–7

Contents lists available at ScienceDirect

Nurse Education Today

journal homepage: www.elsevier.com/nedt

Evaluation of a nurse-led dementia education and knowledge translation
programme in primary care: A cluster randomized controlled trial

Yao Wang a,b, Lily Dongxia Xiao b,⁎, Shahid Ullah c, Guo-Ping He a,⁎⁎, Anita De Bellis b
a Xiang Ya Nursing School, Central South University, Changsha, Hunan Province, China
b School of Nursing and Midwifery, Flinders University, Adelaide, South Australia, Australia
c ANZDATA and ANZOD Registry, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia, Australia

⁎ Correspondence to: L.D. Xiao, School of Nursing and
GPO Box 2100, Adelaide SA 5001, Australia.
⁎⁎ Correspondence to: G.-P. He, Xiang Ya Nursing Sch
Changsha 410013, Hunan Province, China.

E-mail addresses: [email protected] (Y. Wang), lily
(L.D. Xiao), [email protected] (S. Ullah), hgpcsu512@
[email protected] (A. De Bellis).

http://dx.doi.org/10.1016/j.nedt.2016.10.016
0260-6917/© 2016 Elsevier Ltd. All rights reserved.

a b s t r a c t

a r t i c l e i n f o

Article history:
Received 30 November 2015
Received in revised form 16 October 2016
Accepted 31 October 2016

Background: The lack of dementia education programmes for health professionals in primary care is one of the
major factors contributing to the unmet demand for dementia care services.
Aims: To determine the effectiveness of a nurse-led dementia education and knowledge translation programme
for health professionals in primary care; participants’ satisfaction with the programme; and to understand par-
ticipants’ perceptions of and experiences in the programme.
Design: A cluster randomized controlled trial was used as the main methodology to evaluate health professionals’
knowledge, attitudes and care approach. Focus groups were used at the end of the project to understand health
professionals’ perceptions of and experiences in the programme.
Participants and Settings: Fourteen community health service centres in a province in China participated in the
study. Seven centres were randomly assigned to the intervention or control group respectively and 85 health pro-
fessionals in each group completed the programme.
Methods: A train-the-trainer model was used to implement a dementia education and knowledge translation
programme. Outcome variables were measured at baseline, on the completion of the programme and at 3-
month foll

Quality Improvement and Patient Safety Initiatives

NAME

SCHOOL

DATE

1

The Practice Issue

The quality and safety of care for intensive care patients

Patients are admitted for extended periods of time

Evidence shows that this increases chances of negative outcomes.

Early mobilization can be used to increase chances for positive outcomes

Some barriers and challenges influence the implementation of the new practice approach.

This presentation develops strategies to deal with the barriers to improve patient safety.

The practice problem that requires intervention is the care for patients in the ICU. The patients in intensive care are admitted for extended periods of time. According to research, the length of stay in the ICU increases the chances of negative outcomes. Patients tend to have a higher chance of readmission, mortality, and negative experiences (Schneider et al., 2016). The intervention that is recommended to deal with this problem is early mobilization of patients. Early mobilization reduces issues such as muscle atrophy and speeds up the recovery process. Therefore, patients have a higher chance of positive outcomes when this recommendation is implemented. However, there are some challenges and barriers that prevent the successful implementation of this practice approach. The purpose of this presentation is to demonstrate how quality can be improved to enhance patient safety. The presentation will evaluate some of macro and micro systems that effect the implementation of the intervention and the strategies that can be used to increase chances of success.

 

2

Macro Systems

Unavailability of resources

There may be a limitation of resources to implement the new approach successfully.

Inadequate staff members

Mobilization of patients may require new nurses.

Lack of knowledge and skills on mobilization

Nurses lack adequate training on effectively mobilizing patients.

The macro factors that influence the successful implementation of the new practice approach include the unavailability of adequate resources, inadequate staffing, and the lack of knowledge and skills to effectively mobilize the patients as recommended. First, the unavailability of resources could limit the effective implementation of new standards of practice that will help to improve patient safety. Secondly, the standard of mobilizing patients will require more working time for nurses. There is already a limitation of healthcare professionals. Adding more work will increase the problem of burnouts, which reduce the quality of care. Therefore, there may be need to add more personnel. Lastly, effective mobilization of patients may require training to be done effectively. Patients