Evidence-Based Review in Policy and Practice
Preface Evidence-based Nursing: S y n t h e s i z i n g t h e B e s t Ava i l a b l e E v i d e n c e t o Tr a n s l a t e i n t o Action in Policy and Practice
Alan Pearson, AM, RN, ONC, DipNEd, DANS, MSc, PhD, FCNA, FAAG, FAAN, FRCN Editor
INTRODUCTION
Evidence-based nursing, although a new term, is a much older concept in both the Eastern and the Western world. Nurses have been talking about, and encouraged to engage in, “research-based practice” for many years. Evidence-based nursing is the same thing as research-based practice in nursing. As more knowledge is generated through research, and as the ability to transmit information via such media as the Internet or direct broadcast increases, all professionals in all fields will come under increasing pressure to show that they are abreast of current knowledge, and that they exhibit this through delivering services that are in line with the most recent and rigorous evidence. TRANSLATING KNOWLEDGE INTO ACTION IN HEALTH CARE
The rapid development of medical, nursing, and health science over the past fifty years has led to an enormous growth in knowledge. As a result, the expansion in the range of interventions and knowledge available to assist health professionals in their clinical decision-making and to inform service users in making care choices is unprecedented. This burgeoning of knowledge has not, however, necessarily led to an increase in the availability of knowledge to policymakers and clinical practitioners. Many health professionals rely on what they learned in their initial professional training and may be uninformed about current scientific findings. As a result, researchers, policymakers,
Nurs Clin N Am 49 (2014) xiii–xv http://dx.doi.org/10.1016/j.cnur.2014.09.001 nursing.theclinics.com 0029-6465/14/$ – see front matter Ó 2014 Elsevier Inc. All rights reserved.
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Preface
and political leaders increasingly suggest that the need to constantly translate current knowledge into action at both the policy and the practice levels is poorly addressed. Knowledge translation is a process derived from the need to ensure that our best knowledge (that is, the best available evidence) is used in practice and involves the ongoing, iterative, and interactive process of translating knowledge from research into clinical practice and policy through ethically sound application and complex interactions between research developers and end users of research.1–5 The main principles of knowledge translation are the dissemination of research by researchers, the synthesis of evidence by translational scientists, the utilization of research by policymakers and clinicians, and the implementation of evidence into policy and practice through the transfer of knowledge.2,6 Knowledge translation strategies therefore require the communication of research findings in ways that influence decision-making, produce effective and collaborative working relationships among all stakeholders (particularly decision-makers and researchers), and ensure that the research is relevant to the intended consumers of that research.2 EVIDENCE SYNTHESIS
Evidence synthesis is the evaluation or analysis of research evidence and opinion on a specific topic to aid in decision-making in health care. Although the science of evidence synthesis has developed most rapidly in relation to the meta-analysis of numerical data linked to theories of cause and effect, the further development of theoretical understandings and propositions of the nature of evidence, its role in health care delivery, and the facilitation of improved global health have increased rapidly since 2000. Pearson and colleagues7 assert the view that evidence of feasibility, appropriateness, meaningfulness, effectiveness, and economics is legitimate focus for the systematic review process, and that diverse forms of evidence (from experience, opinion, and research that involves numerical and/or textual data) can be appraised, extracted, and synthesized. The articles appearing in this issue of Nursing Clinics of North America examine the role of evidence synthesis in nursing and health care and are written by expert translational scientists from across the world. Three introductory articles overview evidence synthesis and its role in evidence-based health care; methods, issues, and trends in the systematic review of health care evidence; and the development of a robust evidence base for nursing. Subsequent articles explore the impact of systematic reviews on policy and practice in a variety of settings, including perioperative care, pediatrics, rehabilitation and long-term/continuing care, mental health, and public health. The final articles discuss the impact of evidence on health policy and practice and the complexities of translating evidence into policy and practice. These articles show the importance of synthesizing evidence and translating policy and practice into action in our quest to improve health care and health outcomes. Alan Pearson, AM, RN, ONC, DipNEd, DANS, MSc, PhD, FCNA, FAAG, FAAN, FRCN The Joanna Briggs Institute School of Translation Health Science Faculty of Health Sciences The University of Adelaide Adelaide, Australia E-mail address: [email protected]
Preface
REFERENCES
1. Pyra K. Knowledge translation: a review of the literature. Halifax (NS): Nova Scotia Health Research Foundation; 2003. 2. Bowen S, Martens P. Need to Know Team. Demystifying knowledge translation: learning from the community. J Health Serv Res Policy 2005;10(4):203–11. 3. Lang ES, Wyer PC, Haynes RB. Knowledge translation: closing the evidence-topractice gap. Ann Emerg Med 2007;49(3):355–63. 4. Mitton C, Adair CE, McKenzie E, et al. Knowledge transfer and exchange: review and synthesis of the literature. Milbank Q 2007;85(4):729–68. 5. Scott NA, Moga C, Barton P, et al, Alberta Ambassador Program Team. Creating clinically relevant knowledge from systematic reviews: the challenges of knowledge translation. J Eval Clin Pract 2007;13(4):681–8. 6. Armstrong R, Waters E, Roberts H, et al. The role and theoretical evolution of knowledge translation and exchange in public health. J Publ Health 2006;28(4): 384–9. 7. Pearson A, Wiechula R, Court A, et al. A re-consideration of what constitutes “evidence” in the healthcare professions. Nurs Sci Q 2007;20(1):85–8.
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Preface Evidence-based Nursing: S y n t h e s i z i n g t h e B e s t Ava i l a b l e E v i d e n c e t o Tr a n s l a t e i n t o Action in Policy and Practice
Alan Pearson, AM, RN, ONC, DipNEd, DANS, MSc, PhD, FCNA, FAAG, FAAN, FRCN Editor
INTRODUCTION
Evidence-based nursing, although a new term, is a much older concept in both the Eastern and the Western world. Nurses have been talking about, and encouraged to engage in, “research-based practice” for many years. Evidence-based nursing is the same thing as research-based practice in nursing. As more knowledge is generated through research, and as the ability to transmit information via such media as the Internet or direct broadcast increases, all professionals in all fields will come under increasing pressure to show that they are abreast of current knowledge, and that they exhibit this through delivering services that are in line with the most recent and rigorous evidence. TRANSLATING KNOWLEDGE INTO ACTION IN HEALTH CARE
The rapid development of medical, nursing, and health science over the past fifty years has led to an enormous growth in knowledge. As a result, the expansion in the range of interventions and knowledge available to assist health professionals in their clinical decision-making and to inform service users in making care choices is unprecedented. This burgeoning of knowledge has not, however, necessarily led to an increase in the availability of knowledge to policymakers and clinical practitioners. Many health professionals rely on what they learned in their initial professional training and may be uninformed about current scientific findings. As a result, researchers, policymakers,
Nurs Clin N Am 49 (2014) xiii–xv http://dx.doi.org/10.1016/j.cnur.2014.09.001 nursing.theclinics.com 0029-6465/14/$ – see front matter Ó 2014 Elsevier Inc. All rights reserved.
xiv
Preface
and political leaders increasingly suggest that the need to constantly translate current knowledge into action at both the policy and the practice levels is poorly addressed. Knowledge translation is a process derived from the need to ensure that our best knowledge (that is, the best available evidence) is used in practice and involves the ongoing, iterative, and interactive process of translating knowledge from research into clinical practice and policy through ethically sound application and complex interactions between research developers and end users of research.1–5 The main principles of knowledge translation are the dissemination of research by researchers, the synthesis of evidence by translational scientists, the utilization of research by policymakers and clinicians, and the implementation of evidence into policy and practice through the transfer of knowledge.2,6 Knowledge translation strategies therefore require the communication of research findings in ways that influence decision-making, produce effective and collaborative working relationships among all stakeholders (particularly decision-makers and researchers), and ensure that the research is relevant to the intended consumers of that research.2 EVIDENCE SYNTHESIS
Evidence synthesis is the evaluation or analysis of research evidence and opinion on a specific topic to aid in decision-making in health care. Although the science of evidence synthesis has developed most rapidly in relation to the meta-analysis of numerical data linked to theories of cause and effect, the further development of theoretical understandings and propositions of the nature of evidence, its role in health care delivery, and the facilitation of improved global health have increased rapidly since 2000. Pearson and colleagues7 assert the view that evidence of feasibility, appropriateness, meaningfulness, effectiveness, and economics is legitimate focus for the systematic review process, and that diverse forms of evidence (from experience, opinion, and research that involves numerical and/or textual data) can be appraised, extracted, and synthesized. The articles appearing in this issue of Nursing Clinics of North America examine the role of evidence synthesis in nursing and health care and are written by expert translational scientists from across the world. Three introductory articles overview evidence synthesis and its role in evidence-based health care; methods, issues, and trends in the systematic review of health care evidence; and the development of a robust evidence base for nursing. Subsequent articles explore the impact of systematic reviews on policy and practice in a variety of settings, including perioperative care, pediatrics, rehabilitation and long-term/continuing care, mental health, and public health. The final articles discuss the impact of evidence on health policy and practice and the complexities of translating evidence into policy and practice. These articles show the importance of synthesizing evidence and translating policy and practice into action in our quest to improve health care and health outcomes. Alan Pearson, AM, RN, ONC, DipNEd, DANS, MSc, PhD, FCNA, FAAG, FAAN, FRCN The Joanna Briggs Institute School of Translation Health Science Faculty of Health Sciences The University of Adelaide Adelaide, Australia E-mail address: [email protected]
Preface
REFERENCES
1. Pyra K. Knowledge translation: a review of the literature. Halifax (NS): Nova Scotia Health Research Foundation; 2003. 2. Bowen S, Martens P. Need to Know Team. Demystifying knowledge translation: learning from the community. J Health Serv Res Policy 2005;10(4):203–11. 3. Lang ES, Wyer PC, Haynes RB. Knowledge translation: closing the evidence-topractice gap. Ann Emerg Med 2007;49(3):355–63. 4. Mitton C, Adair CE, McKenzie E, et al. Knowledge transfer and exchange: review and synthesis of the literature. Milbank Q 2007;85(4):729–68. 5. Scott NA, Moga C, Barton P, et al, Alberta Ambassador Program Team. Creating clinically relevant knowledge from systematic reviews: the challenges of knowledge translation. J Eval Clin Pract 2007;13(4):681–8. 6. Armstrong R, Waters E, Roberts H, et al. The role and theoretical evolution of knowledge translation and exchange in public health. J Publ Health 2006;28(4): 384–9. 7. Pearson A, Wiechula R, Court A, et al. A re-consideration of what constitutes “evidence” in the healthcare professions. Nurs Sci Q 2007;20(1):85–8.
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