Doran Diane M, Sidani Souraya
Faculty of Nursing, University of Toronto, Toronto, ON, Canada.
Worldviews Evid Based Nurs. 2007;4(1):3-13. doi: 10.1111/j.1741-6787.2007.00073.x.
Regularly accessing information that is current and reliable continues to be a challenge for front-line staff nurses. Reconceptualizing how nurses access information and designing appropriate decision support systems to facilitate timely access to information may be important for increasing research utilization.
An outcomes-focused knowledge translation framework was developed to guide the continuous improvement of patient care through the uptake of research evidence and feedback data about patient outcomes. The framework operationalizes the three elements of the PARIHS framework at the point of care. Outcomes-focused knowledge translation involves four components: (a) patient outcomes measurement and real-time feedback about outcomes achievement; (b) best-practice guidelines, embedded in decision support tools that deliver key messages in response to patient assessment data; (c) clarification of patients' preferences for care; and (d) facilitation by advanced practice nurses and practice leaders. In this paper the framework is described and evidence is provided to support theorized relationships among the concepts in the framework.
The framework guided the design of a knowledge translation intervention aimed at continuous improvement of patient care and evidence-based practice, which are fostered through real-time feedback data about patient outcomes, electronic access to evidence-based resources at the point of care, and facilitation by advanced practice nurses. The propositions in the framework need to be empirically tested through future research.
对于一线护士来说，定期获取及时且可靠的信息仍然是一项挑战。重新构思护士获取信息的方式，并设计合适的决策支持系统以促进及时获取信息，对于提高研究成果的利用率可能至关重要。
开发了一个以结果为导向的知识转化框架，以通过采用研究证据和有关患者结果的反馈数据来指导患者护理的持续改进。该框架在护理点实施了PARIHS框架的三个要素。以结果为导向的知识转化包括四个组成部分：（a）患者结果测量以及关于结果达成情况的实时反馈；（b）最佳实践指南，嵌入到决策支持工具中，根据患者评估数据传递关键信息；（c）明确患者的护理偏好；（d）由高级实践护士和实践领导者提供便利。本文描述了该框架，并提供了证据来支持框架中各概念之间的理论关系。
该框架指导了一项知识转化干预措施的设计，旨在持续改进患者护理和循证实践，这通过有关患者结果的实时反馈数据、在护理点电子获取循证资源以及高级实践护士提供的便利来实现。框架中的命题需要通过未来的研究进行实证检验。
