Graham Nicole D, Graham Ian D, Vanderspank-Wright Brandi, Nadalin-Penno Letitia, Fergusson Dean A, Squires Janet E
School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.
School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
JBI Evid Implement. 2025 Jan 1;23(1):90-102. doi: 10.1097/XEB.0000000000000458.
The aim of this paper is to provide insights into conducting an implementation needs assessment using a case example in a less-research-intensive setting.
In the case example, an implementation needs assessment was conducted, including (1) an environmental scan of the organization's website and preliminary discussions with key informants to learn about the implementation context, and (2) a formal analysis of the evidence-practice gap (use of sedation interruptions) deploying a chart audit methodology using legal electronic reports.
Our needs assessment was conducted over 5 months and demonstrated how environmental scans reveal valuable information that can inform the evidence-practice gap analysis. A well-designed gap analysis, using suitable indicators of best practice, can reveal compliance rates with local protocol recommendations, even with a small sample size. In our case, compliance with the prescribed practices for sedation interruptions ranged from 65% (n=53) to as high as 84% (n=69).
Implementation needs assessments provide valuable information that can inform implementation planning. Such assessments should include an environmental scan to understand the local context and identify both current recommended best practices and local best practices for the intervention of interest. When addressing an evidence-practice gap, analyses should quantify the difference between local practice and desired best practice.
The insights gained from the case example presented in this paper are likely transferrable to implementation research or studies conducted in similar, less-research-intensive settings.
本文旨在通过一个在研究资源相对较少的环境中的案例，深入探讨如何进行实施需求评估。
在该案例中，进行了一次实施需求评估，包括（1）对组织网站进行环境扫描，并与关键信息提供者进行初步讨论，以了解实施背景；（2）使用合法的电子报告，采用图表审核方法对证据与实践的差距（镇静中断的使用情况）进行正式分析。
我们的需求评估历时5个月，展示了环境扫描如何揭示有价值的信息，为证据与实践的差距分析提供依据。精心设计的差距分析，使用合适的最佳实践指标，即使样本量较小，也能揭示当地协议建议的合规率。在我们的案例中，镇静中断规定做法的合规率从65%（n = 53）到高达84%（n = 69）不等。
实施需求评估提供了有价值的信息，可为实施计划提供依据。此类评估应包括环境扫描，以了解当地情况，并确定当前推荐的最佳实践以及针对感兴趣干预措施的当地最佳实践。在解决证据与实践的差距时，分析应量化当地实践与期望的最佳实践之间的差异。
本文所呈现案例的见解可能适用于在类似的、研究资源较少的环境中进行的实施研究。
