Shannon Scott-Findlay

Sources of Practice Knowledge Among Nurses

Several studies have been published listing sources of practice knowledge used by nurses. However, the authors located no studies that asked clinicians to describe comprehensively and categorize the kinds of knowledge needed to practice or in which the researchers attempted to understand how clinicians privilege various knowledge sources. In this article, the authors report findings from two large ethnographic case studies in which sources of practice knowledge was a subsidiary theme. They draw on data from individual and card sort interviews, as well as participant observations, to identify nurses’ sources of practice knowledge. Their findings demonstrate that nurses categorize their sources of practice knowledge into four broad groupings: social interactions, experiential knowledge, documents, and a priori knowledge. The insights gained add new understanding about sources of knowledge used by nurses and challenge the disproportionate weight that proponents of the evidence-based movement ascribe to research knowledge.

Interventions aimed at increasing research use in nursing: a systematic review

BackgroundThere has been considerable interest recently in developing and evaluating interventions to increase research use by clinicians. However, most work has focused on medical practices; and nursing is not well represented in existing systematic reviews. The purpose of this article is to report findings from a systematic review of interventions aimed at increasing research use in nursing.ObjectiveTo assess the evidence on interventions aimed at increasing research use in nursing.MethodsA systematic review of research use in nursing was conducted using databases (Medline, CINAHL, Healthstar, ERIC, Cochrane Central Register of Controlled Trials, and Psychinfo), grey literature, ancestry searching (Cochrane Database of Systematic Reviews), key informants, and manual searching of journals. Randomized controlled trials and controlled before- and after-studies were included if they included nurses, if the intervention was explicitly aimed at increasing research use or evidence-based practice, and if there was an explicit outcome to research use. Methodological quality was assessed using pre-existing tools. Data on interventions and outcomes were extracted and categorized using a pre-established taxonomy.ResultsOver 8,000 titles were screened. Three randomized controlled trials and one controlled before- and after-study met the inclusion criteria. The methodological quality of included studies was generally low. Three investigators evaluated single interventions. The most common intervention was education. Investigators measured research use using a combination of surveys (three studies) and compliance with guidelines (one study). Researcher-led educational meetings were ineffective in two studies. Educational meetings led by a local opinion leader (one study) and the formation of multidisciplinary committees (one study) were both effective at increasing research use.ConclusionLittle is known about how to increase research use in nursing, and the evidence to support or refute specific interventions is inconclusive. To advance the field, we recommend that investigators: (1) use theoretically informed interventions to increase research use, (2) measure research use longitudinally using theoretically informed and psychometrically sound measures of research use, as well as, measuring patient outcomes relevant to the intervention, and (3) use more robust and methodologically sound study designs to evaluate interventions. If investigators aim to establish a link between using research and improved patient outcomes they must first identify those interventions that are effective at increasing research use.

Critical Issues in Interviewing People with Traumatic Brain Injury

People with cognitive impairments often cannot effectively recall and articulate experiences, feelings, and perceptions. Therefore, interviewing them can be fraught with pragmatic and methodological difficulties. Given this situation, the authors’ experience in a study on the allocation of rehabilitative services to survivors of traumatic brain injury is discussed. Participants had physiological impairments affecting their ability to focus on interview questions. The authors discuss the unique challenges, including participants’ recall of events, intolerance to stimuli, and image management and offer strategies for mitigating these concerns. The traditional view that reality is captured only in the subjective accounts of articulate people who can remember events in a precise and reflective manner is challenged.

Methodological Issues in Interviews Involving People With Communication Impairments After Acquired Brain Damage

Qualitative research has made a significant contribution to the body of knowledge related to how people experience living with various chronic diseases and disabilities; however, the voices of certain vulnerable populations, particularly those with impairments that affect their ability to communicate, are commonly absent. In recent years, a few researchers have attempted to explore the most effective ways to ensure that the voices of people with communication impairments from acquired brain damages can be captured in qualitative research interviews; yet several methodological issues related to including this population in qualitative research remained unexamined. In this article, the authors draw on insights derived from their research on the experiences of adult survivors of stroke and traumatic brain injury to describe methodological issues related to sampling, informed consent, and fatigue in participant and researcher while also making some recommendations for conducting qualitative interviews with these populations.

Taking stock of current societal, political and academic stakeholders in the Canadian healthcare knowledge translation agenda

BackgroundIn the past 15 years, knowledge translation in healthcare has emerged as a multifaceted and complex agenda. Theoretical and polemical discussions, the development of a science to study and measure the effects of translating research evidence into healthcare, and the role of key stakeholders including academe, healthcare decision-makers, the public, and government funding bodies have brought scholarly, organizational, social, and political dimensions to the agenda.ObjectiveThis paper discusses the current knowledge translation agenda in Canadian healthcare and how elements in this agenda shape the discovery and translation of health knowledge.DiscussionThe current knowledge translation agenda in Canadian healthcare involves the influence of values, priorities, and people; stakes which greatly shape the discovery of research knowledge and how it is or is not instituted in healthcare delivery. As this agenda continues to take shape and direction, ensuring that it is accountable for its influences is essential and should be at the forefront of concern to the Canadian public and healthcare community. This transparency will allow for scrutiny, debate, and improvements in health knowledge discovery and health services delivery.

Knowledge Translation and Pain Management

Over the last few decades, there has been substantial growth in pediatric pain research, yet children continue to endure pain despite this well-established body of evidence. Assessing, treating, and managing pain in children is complex because of the developmental issues involved in assessing and understanding the child’s pain, the nature and the structure of health care professionals’ work, the immense and varied influences on health care professionals’ decisions, the heuristics or mental shortcuts that health care professionals use to cope in high-velocity environments overloaded with information, the added challenges with children with developmental delays, and a host of personal attitudes and beliefs about pain. These factors and others contribute to poor pain management in children. We believe, however, that the core challenge to improving pediatric pain management is knowledge translation. Rather than an issue of knowledge deficit or lack of research (although these are nontrivial), we argue that the core issue is a failure to put what we already know to use. In this chapter, we discuss knowledge translation challenges in relation to pediatric pain management and to offer possible solutions to closing the gap between science and practice.

Nursing Human Resource Planning in Alberta: What Went Wrong?:

Health care organizations in most of the Western world are struggling with a shortage of nurses. An aging population with greater health care needs, a graying profession, declining nursing school enrollments, and more career choices for women all contribute to the shortage. The extent of the Canadian registered nursing shortage is predicted to reach between 60,000 and 112,000 by 2011. Through this policy analysis, it is shown how a number of factors conspired to create the current nursing shortage in Alberta. Through the analysis of qualitative interviews with key stakeholders, five themes are identified as factors causing this shortage. These themes are national and provincial political contexts during the 1990s, increased need for nurses, lack of timely information, nurses’ political inexperience, and a loss of institutional nursing leadership. Recommendations to address the crisis are also presented.