scholarly journals Building a Knowledge to Action Program in Stroke Rehabilitation

2016 ◽  
Vol 43 (5) ◽  
pp. 619-625 ◽  
Author(s):  
Shannon Janzen ◽  
Amanda McIntyre ◽  
Marina Richardson ◽  
Eileen Britt ◽  
Robert Teasell
Keyword(s):  
Clinical Practice ◽  
Knowledge Creation ◽  
Stroke Rehabilitation ◽  
Best Practice ◽  
Evidence Based ◽  
Clinical Implementation ◽  
Evidence Based Practices ◽  
Knowledge To Action ◽  
Best Practice Guidelines ◽  
Action Project

AbstractThe knowledge to action (KTA) process proposed by Graham et al (2006) is a framework to facilitate the development and application of research evidence into clinical practice. The KTA process consists of the knowledge creation cycle and the action cycle. The Evidence Based Review of Stroke Rehabilitation is a foundational part of the knowledge creation cycle and has helped guide the development of best practice recommendations in stroke. The Rehabilitation Knowledge to Action Project is an audit-feedback process for the clinical implementation of best practice guidelines, which follows the action cycle. The objective of this review was to: (1) contextualize the Evidence Based Review of Stroke Rehabilitation and Rehabilitation Knowledge to Action Project within the KTA model and (2) show how this process led to improved evidence-based practice in stroke rehabilitation. Through this process, a single centre was able to change clinical practice and promote a culture that supports the use of evidence-based practices in stroke rehabilitation.

Meeting the Best Practice for Hearing Aid Verification in Children: Challenges and Future Directions

2019 ◽  
Vol 28 (4) ◽  
pp. 877-894
Author(s):  
Nur Azyani Amri ◽  
Tian Kar Quar ◽  
Foong Yen Chong
Keyword(s):  
Clinical Practice ◽  
Hearing Aids ◽  
Best Practice ◽  
Hearing Aid ◽  
Evidence Based ◽  
Future Directions ◽  
Major Barrier ◽  
Klang Valley ◽  
Age Range ◽  
Fitting Hearing Aids

Purpose This study examined the current pediatric amplification practice with an emphasis on hearing aid verification using probe microphone measurement (PMM), among audiologists in Klang Valley, Malaysia. Frequency of practice, access to PMM system, practiced protocols, barriers, and perception toward the benefits of PMM were identified through a survey. Method A questionnaire was distributed to and filled in by the audiologists who provided pediatric amplification service in Klang Valley, Malaysia. One hundred eight ( N = 108) audiologists, composed of 90.3% women and 9.7% men (age range: 23–48 years), participated in the survey. Results PMM was not a clinical routine practiced by a majority of the audiologists, despite its recognition as the best clinical practice that should be incorporated into protocols for fitting hearing aids in children. Variations in practice existed warranting further steps to improve the current practice for children with hearing impairment. The lack of access to PMM equipment was 1 major barrier for the audiologists to practice real-ear verification. Practitioners' characteristics such as time constraints, low confidence, and knowledge levels were also identified as barriers that impede the uptake of the evidence-based practice. Conclusions The implementation of PMM in clinical practice remains a challenge to the audiology profession. A knowledge-transfer approach that takes into consideration the barriers and involves effective collaboration or engagement between the knowledge providers and potential stakeholders is required to promote the clinical application of evidence-based best practice.

When a Baby Is Sent Away: Evidence to Support Best Practice After Neonatal Transport

2018 ◽  
Vol 37 (3) ◽  
pp. 178-181
Author(s):  
Sabrina Schwartz ◽  
Deborah A. Raines
Keyword(s):  
Best Practice ◽  
Care Center ◽  
Bonding Process ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
Neonatal Transport ◽  
Child Relationship ◽  
The Hours ◽  
Mother Child Relationship

Every day neonates are transported from the birth hospital to a tertiary neonatal care center. Separation of mother and neonate in the hours immediately following birth interrupts the bonding process and can have long-term implications for the mother–child relationship. This article synthesizes the literature focused on mothers’ experiences with a neonate being transported to a tertiary NICU and identifies evidence-based practices specific to these situations.

scholarly journals Implementation—The Missing Link in the Research Translation Pipeline: Is It Any Wonder No One Ever Implements Evidence-Based Practice?

2018 ◽  
Vol 32 (9) ◽  
pp. 751-761 ◽  
Author(s):  
Elizabeth A. Lynch ◽  
Brigit M. Chesworth ◽  
Louise A. Connell
Keyword(s):  
Clinical Practice ◽  
Stroke Rehabilitation ◽  
Evaluation Research ◽  
Well Being ◽  
Professional Associations ◽  
Evidence Base ◽  
Care Practice ◽  
Research Translation ◽  
Evidence Based ◽  
Rehabilitation Research

Despite the exponential growth in the evidence base for stroke rehabilitation, there is still a paucity of knowledge about how to consistently and sustainably deliver evidence-based stroke rehabilitation therapies in clinical practice. This means that people with stroke will not consistently benefit from research breakthroughs, simply because clinicians do not always have the skills, authority, knowledge or resources to be able to translate the findings from a research trial and apply these in clinical practice. This “point of view” article by an interdisciplinary, international team illustrates the lack of available evidence to guide the translation of evidence to practice in rehabilitation, by presenting a comprehensive and systematic content analysis of articles that were published in 2016 in leading clinical stroke rehabilitation journals commonly read by clinicians. Our review confirms that only a small fraction (2.5%) of published stroke rehabilitation research in these journals evaluate the implementation of evidence-based interventions into health care practice. We argue that in order for stroke rehabilitation research to contribute to enhanced health and well-being of people with stroke, journals, funders, policy makers, researchers, clinicians, and professional associations alike need to actively support and promote (through funding, conducting, or disseminating) implementation and evaluation research.

Using a health improvement methodology to standardise leg ulcer management

2020 ◽  
Vol 25 (Sup9) ◽  
pp. S20-S25
Author(s):  
Kirsten Mahoney ◽  
Wendy Simmonds
Keyword(s):  
Clinical Practice ◽  
Patient Outcomes ◽  
Best Practice ◽  
Leg Ulcer ◽  
Health Improvement ◽  
Evidence Based ◽  
Leg Ulcers ◽  
Venous Leg Ulcers ◽  
Poor Patient ◽  
Pdsa Cycle

Despite guidelines, best-practice statements and CQUIN targets, venous leg ulcers have been highlighted as an area that continues to demonstrate lack of evidence-based practice and variation in practice, which contribute to poor patient outcomes and escalating costs. Leg ulcer services that use a systematic and standardised approach to leg ulcer management are highly successful in improving healing rates, preventing recurrence and contributing to patients' wellbeing. This article seeks to explore the use of the plan-do-study-act (PDSA) cycle in clinical practice to improve and standardise leg ulcer management.

scholarly journals Implementation interventions to promote the uptake of evidence-based practices in stroke rehabilitation

2020 ◽  
Author(s):  
Liana S Cahill ◽  
Leeanne M Carey ◽  
Natasha A Lannin ◽  
Megan Turville ◽  
Cheryl L Neilson ◽  
...  
Keyword(s):  
Stroke Rehabilitation ◽  
Evidence Based ◽  
Evidence Based Practices

scholarly journals Developing best practice guidelines for designing living environments for people with dementia and sight loss

2017 ◽  
Vol 38 (5) ◽  
pp. 900-925 ◽  
Author(s):  
ALISON BOWES ◽  
ALISON DAWSON ◽  
CORINNE GREASLEY-ADAMS ◽  
LOUISE MCCABE
Keyword(s):  
Iterative Process ◽  
Best Practice ◽  
Development Process ◽  
Evidence Base ◽  
Design Guidelines ◽  
Evidence Based ◽  
Best Practice Guidelines ◽  
People With Dementia ◽  
Sight Loss ◽  
Research Findings

ABSTRACTThe paper considers a process of developing evidence-based design guidelines to be used in environments where people with dementia and sight loss are living. The research involved a systematically conducted literature review and a series of consultations with people affected by dementia and/or sight loss who lived or worked in care homes or in domestic settings. Findings from the literature and the consultations were used in an iterative process to develop the guidelines. The process is outlined, providing examples from the guidelines about lighting and colour and contrast. In discussing the research findings and the development process, the authors consider implications of the work including the weakness of the evidence base, the challenges of improving this and the need for innovative approaches to understanding the complexities of design for people with dementia and sight loss. They highlight the emphasis in the literature on independence for people with sight loss and the focus on control of people with dementia, arguing that this falls short of a genuinely person-centred approach, which recognises the active participation of people with dementia and sight loss.

Pediatric Audiology in North America: Current Clinical Practice and How It Relates to the American Academy of Audiology Pediatric Amplification Guideline

2016 ◽  
Vol 27 (03) ◽  
pp. 166-187 ◽  
Author(s):  
Sheila Moodie ◽  
Eileen Rall ◽  
Leisha Eiten ◽  
George Lindley ◽  
Dave Gordey ◽  
...  
Keyword(s):  
Clinical Practice ◽  
North America ◽  
Data Collection ◽  
Practice Guidelines ◽  
Best Practice ◽  
Intervention Program ◽  
Hearing Aid ◽  
Evidence Based ◽  
Pediatric Audiology ◽  
Family Centered

Background: There is broad consensus that screening and diagnosis of permanent hearing loss in children must be embedded within a comprehensive, evidence-based, family-centered intervention program. Clinical practice guidelines (CPGs) for pediatric hearing assessment and hearing aid verification aim to reduce variability in practice and increase the use of effective evidence-based diagnostic and treatment options so that optimal outcomes may be achieved. To be of value, guidelines must be translated and implemented into practice and ongoing monitoring of their use in practice should occur. Purpose: This paper provides the results of two studies that aim to examine current pediatric audiology and amplification practice in North America. Research Design: A concurrent embedded mixed methods design was used. Study Sample: An electronic survey was distributed to North American audiologists who delivered pediatric audiology services with 350 audiologists participating in study 1 and 63 audiologists participating in study 2. Data Collection and Analysis: A quantitative approach was the predominant method of data collection. Respondents were prompted to provide additional qualitative text and detail regarding their quantitative response choice. This qualitative text was used during the analysis phase and combined with quantitative results to assist understanding of respondents’ knowledge, skills, and barriers/facilitators to implement best practice in pediatric amplification. Results: Approximately 70% of audiologists reported using best-practice protocols for pediatric hearing aid fitting. Despite widespread knowledge and increased use of CPGs over the last 18 yrs, results of these studies show that variation in practice patterns continue to exist. Several examples of implementation challenges are discussed with recommendations provided. Conclusions: In order for audiologists working with children who are deaf or hard of hearing and their families to achieve the principles of family-centered early intervention, practice guidelines must continue to be developed, disseminated, and translated as they have a positive impact on the services provided. Researchers and clinical audiologists who deliver services must continue to collaborate to understand the “how” and “why” of implementing guidelines into practice and to identify the barriers/facilitators encountered in trying to do so.

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