Yamada Janet, Shorkey Allyson, Barwick Melanie, Widger Kimberley, Stevens Bonnie J
The Hospital for Sick Children, Toronto, Ontario, Canada.
The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
BMJ Open. 2015 Apr 13;5(4):e006808. doi: 10.1136/bmjopen-2014-006808.
The aim of this systematic review was to evaluate the effectiveness of toolkits as a knowledge translation (KT) strategy for facilitating the implementation of evidence into clinical care. Toolkits include multiple resources for educating and/or facilitating behaviour change.
Systematic review of the literature on toolkits.
A search was conducted on MEDLINE, EMBASE, PsycINFO and CINAHL. Studies were included if they evaluated the effectiveness of a toolkit to support the integration of evidence into clinical care, and if the KT goal(s) of the study were to inform, share knowledge, build awareness, change practice, change behaviour, and/or clinical outcomes in healthcare settings, inform policy, or to commercialise an innovation. Screening of studies, assessment of methodological quality and data extraction for the included studies were conducted by at least two reviewers.
39 relevant studies were included for full review; 8 were rated as moderate to strong methodologically with clinical outcomes that could be somewhat attributed to the toolkit. Three of the eight studies evaluated the toolkit as a single KT intervention, while five embedded the toolkit into a multistrategy intervention. Six of the eight toolkits were partially or mostly effective in changing clinical outcomes and six studies reported on implementation outcomes. The types of resources embedded within toolkits varied but included predominantly educational materials.
Future toolkits should be informed by high-quality evidence and theory, and should be evaluated using rigorous study designs to explain the factors underlying their effectiveness and successful implementation.
本系统评价旨在评估工具包作为一种知识转化（KT）策略，促进将证据应用于临床护理的有效性。工具包包括用于教育和/或促进行为改变的多种资源。
对关于工具包的文献进行系统评价。
在MEDLINE、EMBASE、PsycINFO和CINAHL数据库进行检索。纳入的研究需评估工具包支持将证据整合到临床护理中的有效性，且研究的KT目标是在医疗环境中提供信息、分享知识、提高认识、改变实践、改变行为和/或临床结局、为政策提供信息或使创新商业化。至少两名评审员对纳入研究进行文献筛选、方法学质量评估和数据提取。
39项相关研究纳入全面评审；8项在方法学上被评为中等至强，其临床结局可部分归因于工具包。八项研究中有三项将工具包作为单一的KT干预措施进行评估，而五项将工具包纳入多策略干预措施中。八项工具包中有六项在改变临床结局方面部分或大部分有效，六项研究报告了实施结果。工具包中包含的资源类型各不相同，但主要包括教育材料。
未来的工具包应以高质量的证据和理论为依据，并应使用严格的研究设计进行评估，以解释其有效性和成功实施的潜在因素。
