Theory-informed approaches to translating pain evidence into practice

2021 ◽  
pp. 607-616
Author(s):  
Janet Yamada ◽  
Alison M. Hutchinson ◽  
Shelly-Anne Li
Keyword(s):  
Chronic Pain ◽  
Clinical Practice ◽  
Pain Assessment ◽  
Organizational Context ◽  
Management Practices ◽  
Management Strategies ◽  
Practice Change ◽  
Evidence Based ◽  
Practice Gap ◽  
Implementing Strategies

Despite great strides in evidence-based pain assessment and management strategies, infants and children still experience acute pain (including multiple painful procedures) and chronic pain during hospitalization. Translating best evidence on pain assessment and management into clinical practice remains a challenge. The knowledge- or evidence-to-practice gap in pain in children can be addressed by implementing strategies, underpinned by knowledge translation theories, frameworks, and models, to promote and sustain practice change. A range of factors related to the organizational context and individual behavior play a role in the adoption of new pain assessment and management practices.

Theory-informed approaches to translating pain evidence into practice

2013 ◽  
pp. 633-641
Author(s):  
Janet Yamada ◽  
Alison M. Hutchinson
Keyword(s):  
Chronic Pain ◽  
Pain Assessment ◽  
Organizational Context ◽  
Management Practices ◽  
Management Strategies ◽  
Practice Change ◽  
Evidence Based ◽  
Individual Behaviour ◽  
Practice Gap ◽  
Implementing Strategies

Despite great strides in evidence-based pain assessment and management strategies, infants and children still experience acute pain (including multiple painful procedures) and chronic pain during hospitalization. Translating best evidence on pain assessment and management into clinical practice remains a challenge. The knowledge- or evidence-to-practice gap in pain in children can be addressed by implementing strategies, underpinned by knowledge translation theories, frameworks, and models, to promote and sustain practice change. A range of factors related to the organizational context and individual behaviour play a role in the adoption of new pain assessment and management practices.

scholarly journals Exploring the impact of a decision support algorithm to improve clinicians’ chemotherapy-induced peripheral neuropathy assessment and management practices: a two-phase, longitudinal study

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Robert Knoerl ◽  
Emanuele Mazzola ◽  
Fangxin Hong ◽  
Elahe Salehi ◽  
Nadine McCleary ◽  
...  
Keyword(s):  
Decision Support ◽  
Peripheral Neuropathy ◽  
Management Practices ◽  
Management Strategies ◽  
Clinic Visit ◽  
Evidence Based ◽  
Two Phase ◽  
Assessment Index ◽  
Patient Reported ◽  
The Impact

Abstract Background Chemotherapy-induced peripheral neuropathy (CIPN) negatively affects physical function and chemotherapy dosing, yet, clinicians infrequently document CIPN assessment and/or adhere to evidence-based CIPN management in practice. The primary aims of this two-phase, pre-posttest study were to explore the impact of a CIPN clinician decision support algorithm on clinicians’ frequency of CIPN assessment documentation and adherence to evidence-based management. Methods One hundred sixty-two patients receiving neurotoxic chemotherapy (e.g., taxanes, platinums, or bortezomib) answered patient-reported outcome measures on CIPN severity and interference prior to three clinic visits at breast, gastrointestinal, or multiple myeloma outpatient clinics (n = 81 usual care phase [UCP], n = 81 algorithm phase [AP]). During the AP, study staff delivered a copy of the CIPN assessment and management algorithm to clinicians (N = 53) prior to each clinic visit. Changes in clinicians’ CIPN assessment documentation (i.e., index of numbness, tingling, and/or CIPN pain documentation) and adherence to evidence-based management at the third clinic visit were compared between the AP and UCP using Pearson’s chi-squared test. Results Clinicians’ frequency of adherence to evidence-based CIPN management was higher in the AP (29/52 [56%]) than the UCP (20/46 [43%]), but the change was not statistically significant (p = 0.31). There were no improvements in clinicians’ CIPN assessment frequency during the AP (assessment index = 0.5440) in comparison to during the UCP (assessment index = 0.6468). Conclusions Implementation of a clinician-decision support algorithm did not significantly improve clinicians’ CIPN assessment documentation or adherence to evidence-based management. Further research is needed to develop theory-based implementation interventions to bolster the frequency of CIPN assessment and use of evidence-based management strategies in practice. Trial registration ClinicalTrials.Gov, NCT03514680. Registered 21 April 2018.

scholarly journals A Self-Led Approach to Improving Classroom Management Practices Using Video Analysis

2020 ◽  
Vol 53 (1) ◽  
pp. 24-32
Author(s):  
Sarah A. Nagro ◽  
Shanna E. Hirsch ◽  
Michael J. Kennedy
Keyword(s):  
Classroom Management ◽  
Students With Disabilities ◽  
Video Analysis ◽  
Teacher Educators ◽  
Management Practices ◽  
Management Strategies ◽  
Evidence Based ◽  
Self Reflection ◽  
Classroom Management Strategies ◽  
Analysis Process

Strong classroom management may be the key to finding success as a new teacher. Yet many teachers seek additional professional development in managing classrooms that include students with disabilities. The purpose of this article is to provide new teachers and teacher educators with a prescriptive yet self-led approach to systematically improving classroom management practices using a sequential video analysis process. This article outlines an easy-to-follow four-step process that teachers can use to record, review, reflect on, and revise their instruction. A checklist of evidence-based classroom management strategies with video exemplar links, a free online observation tool called the Classroom Teaching Scan, and a guide for self-reflection called the Reflection Matrix are all explained. Through this highly structured yet self-led approach, teachers can independently engage in noticing elements of teaching, identify their own areas of strength and weakness, reflect in a meaningful way, and implement evidence-based classroom management practices.

Safe chemotherapy: Clinicians driving technology and not the other way around.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 183-183
Author(s):  
Vishal Kukreti ◽  
Roxanne Cosby ◽  
Annie Cheung ◽  
Marie Hamasoor ◽  
Sherrie Hertz ◽  
...  
Keyword(s):  
Clinical Practice ◽  
System Integration ◽  
Quality Care ◽  
Management Strategies ◽  
User Involvement ◽  
Clinical Work ◽  
Future Research ◽  
Evidence Based ◽  
Unanticipated Consequences ◽  
Evidence Based Guideline

183 Background: Although information technology (IT) has the potential to improve the quality and safety of patient care, introduction into the clinical work flow may create unanticipated consequences. IT solutions such as computerized physician order entry (CPOE) are often designed and executed without end-user involvement. An evidence based guideline for systemic treatment (ST) CPOE was developed. The guideline looks at the features, functionalities and components of a ST CPOE system required to ensure safe and high-quality care. Methods: The guideline was developed by an interdisciplinary panel of physicians, nurses, pharmacists, methodologists, IT specialists, and human factors experts. A systematic review was conducted of the available clinical and technology literature and key informant interviews were conducted. Role-specific CPOE functionalities were process mapped for physicians, nurses and pharmacists. Two expert panels (i.e., clinical and supporting tools) were convened to review the information and provide feedback on guideline content. The guideline was also reviewed externally by content experts from provincial, national and international organizations. Results: The resulting evidence-based guideline focused on two distinct yet interconnected parts: clinical practice (e.g., error prevention, unanticipated consequences, impact on practice, clinical decision support), and technology requirements (e.g., usability features, system integration, effective alerts, audit logs, regimen building). The recommendations also highlight the importance of change management strategies and clinician engagement. Conclusions: This innovative guideline provides an approach to technology evaluation focusing on clinical practice needs driving IT solutions. Future research to help standardize design and usability of such systems is necessary. The non-vendor specific recommendations can be used as the foundation for evaluation of ST CPOE systems to reduce errors, improve safety, and support clinical practice. The application of the recommendations as an assessment of ST CPOE system guideline concordance will also be valuable.

The Editor's Roundtable: Closing the Clinical Practice Gap—Using Evidence-Based Treatments for Managing Lipids

2011 ◽  
Vol 107 (2) ◽  
pp. 230-242
Author(s):  
William C. Roberts ◽  
Antonio M. Gotto ◽  
John Guyton ◽  
John LaRosa ◽  
Ronald Viggiani
Keyword(s):  
Clinical Practice ◽  
Evidence Based ◽  
Evidence Based Treatments ◽  
Practice Gap

Pain in children with intellectual or developmental disabilities

2021 ◽  
pp. 157-167
Author(s):  
Andrina MacDonald ◽  
Kristi Bennett ◽  
Jean C.K. Stansbury ◽  
Chantel C. Barney ◽  
John Belew ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Clinical Practice ◽  
Pain Management ◽  
Developmental Disabilities ◽  
Pain Assessment ◽  
Early Recognition ◽  
Assessment Instruments ◽  
Accurate Assessment ◽  
Typically Developing ◽  
Pain Syndromes

Children with intellectual and developmental disabilities (I/DD) are estimated to have more than twice the incidence of chronic pain than their typically developing peers. Pain assessment is particularly challenging given the array of individual cognitive and communication abilities found in children with I/DD. Early recognition and accurate assessment of pain is essential for effective management and ultimately preventing the development of pain syndromes resulting from untreated nociceptive pain. Pain assessment instruments are available to support better pain management; however, more widespread use of these assessments within clinical practice and research studies is a necessary next step.

scholarly journals Progress in Clinical Neurosciences: Status Epilepticus: A Critical Review of Management Options

2002 ◽  
Vol 29 (3) ◽  
pp. 206-215 ◽  
Author(s):  
Eelco F.M. Wijdicks ◽  
Nicholas D. Lawn
Keyword(s):  
Clinical Practice ◽  
Status Epilepticus ◽  
Critical Review ◽  
Critical Appraisal ◽  
Management Strategies ◽  
Individual Preference ◽  
Evidence Based ◽  
Management Options ◽  
Local Hospital ◽  
Expert Recommendations

Although generalized tonic-clonic status epilepticus (SE) is frequently seen, an evidence-based approach to management is limited by a lack of randomized clinical studies. Clinical practice, therefore, relies on a combination of expert recommendations, local hospital guidelines and dogma based on individual preference and past successes. This review explores selected and controversial aspects of SE in adults and provides a critical appraisal of currently recommended management strategies.

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