The effectiveness of knowledge translation interventions for promoting evidence-informed decision-making among nurses in tertiary care: a systematic review and meta-analysis

Nurses are increasingly expected to engage in evidence-informed decision-making (EIDM) to improve client and system outcomes. Despite an improved awareness about EIDM, there is a lack of use of research evidence and understanding about the effectiveness of interventions to promote EIDM. This project aimed to discover if knowledge translation (KT) interventions directed to nurses in tertiary care are effective for improving EIDM knowledge, skills, behaviours, and, as a result, client outcomes. It also sought to understand contextual factors that affect the impact of such interventions. Methods A systematic review funded by the Canadian Institutes of Health Research (PROSPERO registration: CRD42013003319) was conducted. Included studies examined the implementation of any KT intervention involving nurses in tertiary care to promote EIDM knowledge, skills, behaviours, and client outcomes or studies that examined contextual factors. Study designs included systematic reviews, quantitative, qualitative, and mixed method studies. The search included electronic databases and manual searching of published and unpublished literature to November 2012; key databases included MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Excerpta Medica (EMBASE). Two reviewers independently performed study selection, risk of bias assessment, and data extraction. Studies with quantitative data determined to be clinically homogeneous were synthesized using meta-analytic methods. Studies with quantitative data not appropriate for meta-analysis were synthesized narratively by outcome. Studies with qualitative data were synthesized by theme. Results Of the 44,648 citations screened, 30 citations met the inclusion criteria (18 quantitative, 10 qualitative, and 2 mixed methods studies). The quality of studies with quantitative data ranged from very low to high, and quality criteria was generally met for studies with qualitative data. No studies evaluated the impact on knowledge and skills; they primarily investigated the effectiveness of multifaceted KT strategies for promoting EIDM behaviours and improving client outcomes. Almost all studies included an educational component. A meta-analysis of two studies determined that a multifaceted intervention (educational meetings and use of a mentor) did not increase engagement in a range of EIDM behaviours [mean difference 2.7, 95 % CI (−1.7 to 7.1), I 2 = 0 %]. Among the remaining studies, no definitive conclusions could be made about the relative effectiveness of the KT interventions due to variation of interventions and outcomes, as well as study limitations. Findings from studies with qualitative data identified the organizational, individual, and interpersonal factors, as well as characteristics of the innovation, that influence the success of implementation. Conclusions KT interventions are being implemented and evaluated on nurses’ behaviour and client outcomes. This systematic review may inform the selection of KT interventions and outcomes among nurses in tertiary care and decisions about further research.

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The effectiveness of knowledge translation interventions for promoting evidence-informed decision-making among nurses in tertiary care: a systematic review and meta-analysis

10.32920/14636286.v1 ◽

2021 ◽

Author(s):

Jennifer Yost ◽

Rebecca Ganann ◽

David Thompson ◽

Fazila Aloweni ◽

Kristine Newman ◽

...

Keyword(s):

Systematic Review ◽

Decision Making ◽

Knowledge Translation ◽

Quantitative Data ◽

Qualitative Data ◽

Meta Analysis ◽

Tertiary Care ◽

Informed Decision Making ◽

Client Outcomes ◽

The Impact

Nurses are increasingly expected to engage in evidence-informed decision-making (EIDM) to improve client and system outcomes. Despite an improved awareness about EIDM, there is a lack of use of research evidence and understanding about the effectiveness of interventions to promote EIDM. This project aimed to discover if knowledge translation (KT) interventions directed to nurses in tertiary care are effective for improving EIDM knowledge, skills, behaviours, and, as a result, client outcomes. It also sought to understand contextual factors that affect the impact of such interventions. Methods A systematic review funded by the Canadian Institutes of Health Research (PROSPERO registration: CRD42013003319) was conducted. Included studies examined the implementation of any KT intervention involving nurses in tertiary care to promote EIDM knowledge, skills, behaviours, and client outcomes or studies that examined contextual factors. Study designs included systematic reviews, quantitative, qualitative, and mixed method studies. The search included electronic databases and manual searching of published and unpublished literature to November 2012; key databases included MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Excerpta Medica (EMBASE). Two reviewers independently performed study selection, risk of bias assessment, and data extraction. Studies with quantitative data determined to be clinically homogeneous were synthesized using meta-analytic methods. Studies with quantitative data not appropriate for meta-analysis were synthesized narratively by outcome. Studies with qualitative data were synthesized by theme. Results Of the 44,648 citations screened, 30 citations met the inclusion criteria (18 quantitative, 10 qualitative, and 2 mixed methods studies). The quality of studies with quantitative data ranged from very low to high, and quality criteria was generally met for studies with qualitative data. No studies evaluated the impact on knowledge and skills; they primarily investigated the effectiveness of multifaceted KT strategies for promoting EIDM behaviours and improving client outcomes. Almost all studies included an educational component. A meta-analysis of two studies determined that a multifaceted intervention (educational meetings and use of a mentor) did not increase engagement in a range of EIDM behaviours [mean difference 2.7, 95 % CI (−1.7 to 7.1), I 2 = 0 %]. Among the remaining studies, no definitive conclusions could be made about the relative effectiveness of the KT interventions due to variation of interventions and outcomes, as well as study limitations. Findings from studies with qualitative data identified the organizational, individual, and interpersonal factors, as well as characteristics of the innovation, that influence the success of implementation. Conclusions KT interventions are being implemented and evaluated on nurses’ behaviour and client outcomes. This systematic review may inform the selection of KT interventions and outcomes among nurses in tertiary care and decisions about further research.

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Systematic Review and Meta-Analysis: Considerations for Evidence-Informed Decision Making

Physical & Occupational Therapy In Pediatrics ◽

10.3109/01942638.2015.1055994 ◽

2015 ◽

Vol 35 (3) ◽

pp. 213-217

Author(s):

Robert J. Palisano

Keyword(s):

Systematic Review ◽

Decision Making ◽

Meta Analysis ◽

Informed Decision ◽

Informed Decision Making

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Intelligent Structured Intermittent Auscultation (ISIA): A Mixed Methods Evaluation of an Informed Decision-Making Framework for Fetal Heart Rate Monitoring

10.26686/wgtn.17000677 ◽

2021 ◽

Author(s):

◽

Robyn Mary Maude

Keyword(s):

Decision Making ◽

Mixed Methods ◽

Knowledge Translation ◽

Focus Groups ◽

Medical Records ◽

Fetal Heart ◽

Informed Decision ◽

Low Risk ◽

Informed Decision Making ◽

Low Risk Women

Intermittent Auscultation (IA) of the fetal heart (FH) is a screening tool for the assessment of fetal well-being during labour; the detection of changes in the FH rate and rhythm may signal fetal compromise. While the evidence reveals that IA is as effective as continuous cardiotocography (CTG) for FH monitoring for low-risk women, current practitioners favour the use of continuous CTG despite the risk of significantly increased maternal and fetal morbidity. Translating the knowledge of the effectiveness of IA into practice became the primary aim of this study. While auscultation and palpation are essential midwifery skills, the teaching of IA does not go beyond simply outlining the protocol for frequency, duration, and timing and less is understood about the underlying physiology associated with what is heard and the reassurance of fetal wellbeing that this provides. A knowledge translation intervention, in the form of an evidence-based informed decision-making framework for Intelligent Structured Intermittent Auscultation (ISIA) and a comprehensive educational intervention were developed to enhance midwives‘ knowledge and awareness of IA and to influence decision-making and practice for FH monitoring for low-risk women. A mixed methods non-experimental pre- and post - intervention study design was used to evaluate the knowledge intervention. Pre measures included a retrospective review of 511 medical records to assess existing FH monitoring practices, and focus groups with 14 midwives explored barriers and facilitators to the use of IA. The intervention was then delivered to a mix of 33 midwives and doctors three months later, followed by a second review of 422 medical records and focus groups with seven midwives to determine any changes in practice and to evaluate outcomes. The findings revealed a statistically significant increase in the use of ISIA with improved documentation, and a relative decrease of 14% in the use an admission CTG for low risk women. The ISIA framework has wide applicability in all maternity settings. This research has illuminated the effects of culture, organisation and the socio-political context on the ability for midwives to utilise their fundamental midwifery skills to promote, facilitate and protect normal physiological birth in the institutional maternity care setting. Engagement with a Knowledge Translation project and the introduction of the ISIA framework for FHR monitoring for low risk women has given midwives voice to generate change.

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PLD.55 Introduction of Breech Clinic in a tertiary care setting to aid informed decision-making in mothers with breech presentation at term

Archives of Disease in Childhood - Fetal and Neonatal Edition ◽

10.1136/archdischild-2014-306576.354 ◽

2014 ◽

Vol 99 (Suppl 1) ◽

pp. A123.1-A123 ◽

Cited By ~ 1

Author(s):

J Costa

Keyword(s):

Decision Making ◽

Care Setting ◽

Tertiary Care ◽

Breech Presentation ◽

Informed Decision ◽

Informed Decision Making ◽

Tertiary Care Setting

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Health literacy and informed decision making regarding colorectal cancer screening: a systematic review

European Journal of Public Health ◽

10.1093/eurpub/ckv005 ◽

2015 ◽

Vol 25 (4) ◽

pp. 575-582 ◽

Cited By ~ 31

Author(s):

Iris van der Heide ◽

Ellen Uiters ◽

A. Jantine Schuit ◽

Jany Rademakers ◽

Mirjam Fransen

Keyword(s):

Colorectal Cancer ◽

Systematic Review ◽

Decision Making ◽

Health Literacy ◽

Cancer Screening ◽

Colorectal Cancer Screening ◽

Informed Decision ◽

Informed Decision Making

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Essential skills for using research evidence in public health policy: a systematic review

Evidence & Policy A Journal of Research Debate and Practice ◽

10.1332/174426421x16250726996691 ◽

2021 ◽

Author(s):

Saliha Ziam ◽

Pierre Gignac ◽

Élodie Courant ◽

Esther Mc Sween-Cadieux

Keyword(s):

Public Health ◽

Systematic Review ◽

Decision Making ◽

Research Evidence ◽

Informed Decision ◽

Decision Makers ◽

Informed Decision Making ◽

Evidence Use ◽

Public Health Decision ◽

Health Decision

Background: Decisions related to the development and implementation of public health programmes or policies can benefit from more effective use of the best available knowledge. However, decision makers do not always feel sufficiently equipped or may lack the capacity to use evidence. This can lead them to overlook or set aside research results that could be relevant to their practice area.Aims and objectives: The objective of this systematic review was to synthesise the essential skills that facilitate the use of research evidence by public health decision makers.Methods: Thirty-nine articles that met our inclusion criteria were included. An inductive approach was used to extract data on evidence-informed decision-making-related skills and data were synthesised as a narrative review.Findings: The analysis revealed three categories of skills that are essential for evidence-informed decision-making process: interpersonal, cognitive, and leadership and influencing skills. Such cross-sectoral skills are essential for identifying, obtaining, synthesising, and integrating sound research results into the decision-making process.Discussion and conclusions: The results of this systematic review will help direct capacity-building efforts towards enhancing research evidence use by public health decision makers, such as developing different types of training that would be relevant to their needs. Also, when considering the evidence-informed decision-making skills development, there are several useful and complementary approaches to link research most effectively to action. On one hand, it is important not only to support decision makers at the individual level through skills development, but also to provide them with a day-to-day environment that is conducive to evidence use. Key messages <ul><li>Public health programmes or policies can benefit from more effective use of the best available knowledge;</li> <li>This review identified 39 studies on skills related to evidence-informed decision making;</li> <li>Three categories of skills are proposed: cognitive, interpersonal and leadership and influencing skills;</li> <li>It will help direct capacity-building efforts towards enhancing evidence use by decision makers.</li></ul>

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