Week 5 Discussion
Translation Science Framework: Roger’s Diffusion of Innovation Model
Your post concerning Translation Models and Frameworks, in particular, Rogers’ Diffusion of Innovations theory (DOI), provides a compelling lens to examine technology adoption in healthcare. This theory indeed captures the essence of technology adoption nuances within nursing practice; however, I’d like to shed light on some additional aspects and contrast it with other theories for balance.
Intriguingly, you mentioned the categorization of adopters within Rogers’ diffusion process. It is indeed true; however, I would propose a perspective on adopters’ categorization from another angle. Al-Razgan et al. (2021) studied the diffusion of a conceptually different idea; women driving in Saudi Arabia and showed that cultural factors can impact the proportions or even behaviour of these categories dramatically.
Furthermore, according to Duff et al. (2020), the environment contributes significantly to the implementation of evidence-based practice. Considering the DOI theory efficiently considers individual readiness and willingness of healthcare professionals to accept changes, supporting frameworks are needed to assess readiness at an organizational level (Mathieson et al., 2019). So, while Rogers’ theory is vital for individual ideation’s progression across a group, analysing the macro-level factors is also crucial for successful implementation.
Moreover, when applying DOI in healthcare context, complexities may arise due to multifaceted relationships between people, technology, and processes that need perfect alignment (Mathieson et al., 2019). For instance, if a new EBP technique is incompatible with existing workflows or existing health record systems, even early adopters may hesitate to embrace it due to potential disruptions it might cause.
Additionally, considering the complex nature of healthcare organizations, it’s crucial to recognize that while DOI lays an excellent foundation, other theories such as the Normalization Process Theory (NPT) could further elucidate some of these complexities (Mathieson et al., 2019). NPT helps us understand how implementing new practices becomes part of routine work – an aspect worth considering when we talk about knowledge translation in healthcare (Duff et al., 2020).
Thus, while DOI shines as an intuitive model for understanding processes around diffusion of innovations among people and individual readiness for change within healthcare entities – it often requires complementary models or theories focusing on organizational-process factors or sociocultural influences to provide more comprehensive implementation strategies (Duff et al., 2020). Henceforward, we should indeed take advantage from utilizing Rogers’ DOI theory while also ensuring we account for environmental influences and the complex dance between socio-cultural factors and structural requirements in every proposed change implementation within healthcare (Al-Razgan et al., 2021). This balanced approach would affably respect both micro-level (individual readiness) and macro-level (structural environment) aspects which form together a holistic prism through which we examine practical implementation challenges facing EBP translation strategies today.
References
Al-Razgan, M., Alrowily, A., Al-Matham, R. N., Alghamdi, K. M., Shaabi, M., & Alssum, L. (2021). Using diffusion of innovation theory and sentiment analysis to analyze attitudes toward driving adoption by Saudi women. Technology in Society, 65, 1–11. Sciencedirect. https://doi.org/10.1016/j.techsoc.2021.101558Links to an external site.
Duff, J., Cullen, L., Hanrahan, K., & Steelman, V. (2020). Determinants of an evidence-based practice environment: An interpretive description. Implementation Science Communications, 1(1), 1–9. https://doi.org/10.1186/s43058-020-00070-0Links to an external site.
Mathieson, A., Grande, G., & Luker, K. (2019). Strategies, facilitators and barriers to implementation of evidence-based practice in community nursing: A systematic mixed-studies review and qualitative synthesis. Primary Health Care Research & Development, 20(20). https://doi.org/10.1017/s1463423618000488Links to an external site.
My Understanding of Translation Science
Quality improvement and evidence-based practice are commonly referred to regarding practice changes in my workplace. Once a gap in practice or need for change is identified, our group usually looks to current best practices to guide and support our plan for improvement. When I think of translation science, I think of the method of applying science to practice. I would further describe it not only as the “how” but the “why”. QI and EBP seem more practice-based while translation science is more research-based as “implementation science also aims to improve the quality of healthcare, but the approach is focused on systematic adoption and integration of evidence-based health intervention within a particular practice setting” (Boehm, 2020).
Nurses strive to provide the best possible care to diverse clients under consistently changing conditions. From the medications administered to the type of dressing used to heal a wound, nurses apply procedures that have been tested through research and deemed appropriate according to evidence-based standards of practice. Through foundational knowledge related to research methods, translation of research data is used to improve nursing practice and, ultimately, patient outcomes. Therefore, nurses must become familiar with the specific language of scientific research and the research process. As health care professionals, nurses seek to provide their patients with the best possible health care. To determine which approaches to care result in the best possible care, the effectiveness of each approach specific to a chosen population must be investigated. The pursuit of knowledge is the basis for research. Researchers seek to find answers to various scientific questions, but there are the boundaries associated with the pursuit of knowledge (Helbig, 2018).
Applying Translation Science to my Practice Problem
There are many different major models of translation science framework and Roger’s Diffusion of Innovations model seems to apply to my practice problem as it focuses on the new idea of integrating ultrasound-guided peripheral IV insertion into practice. This model is a 5 step innovation-decision process that I think will be integral to implementing this change in practice. As this model supports, this is an innovative way of practice and it is not replacing but helping to improve our current practice, especially for difficult IV sticks. The 5 stages of this model are knowledge, persuasion, decision, implementation and confirmation. Every staff member will adapt to this new innovation differently and “the personal characteristics of those individuals involved with the innovation, as described previously, affect how early in the innovation-decision process each individual engages and begins to adopt the new idea” (white, Dudley-Brown & Terhaar, 2019, 36-37). I think this model will help introduce this new idea and help individuals that are more prone to resist change understand the rationale of why this will help improve patient care and view it as an innovative tool.
References
Beeber, A., Palmer, C., Waldrop, J., Lynn, M., Jones, C., (2019). The role of Doctor of Nursing Practice-prepared nurses in practice settings. Nursing Outlook, 67(4), 354-364.
https://doi.org/10.1016/j.outlook.2019.02.006.
Boehm, L. M.,PhD.R.N.A.C.N.S.-B.C., Stolldorf, D. P.,PhD.R.N., & Jeffery, A. D.,PhD.R.N. (2020). Implementation science training and resources for nurses and nurse scientists. Journal of Nursing Scholarship, 52(1), 47-54. doi:http://dx.doi.org.ezp.waldenulibrary.org/10.1111/jnu.12510
Fiset, V. , Davies, B. , Graham, I. , Gifford, W. , Woodend, K. & (2019). Developing guideline-based quality indicators. International Journal of Evidence-Based Healthcare, 17 (2), 92-105. doi: 10.1097/XEB.0000000000000160.
White, K.M., Dudley-Brown, S., & Terhaar, M.F.. (Eds.). (2019). Translation of evidence into nursing and healthcare (3rd ed.). Springer.
I enjoyed reading your post. i would like to add that ,Diffusion of innovation describes how a new idea, behavior, or item (an innovation) is disseminated to a population in a given period of time through specific avenues of communication (Rogers, 2003). I would say that Innovations are not always adopted even when they have apparent and clear-cut advantages.
Patient care should be scientific and research-based to get positive patient outcomes. Nurses do want to bring innovation in their practice which helps them provide effective and quality care. However, despite their knowledge of its importance and value, most nurses do not incorporate research findings into their practice. Because of lack of administrative support and mentorship, nurses lack authority to change practice, inadequate basic research knowledge, incomprehensible statistics, and insufficient time to implement change are the significant barriers for nurses’ utilization of research in practice and diffusion of innovation. As a result, the process of dissemination of innovation in our practice setting is very slow. Therefore, there is a need to develop some strategies to start up the process of innovation-diffusion.
References
Bennett, J., & Bennett, L. (2003). A Review of Factors that Influence the Diffusion of Innovation when Structuring a Faculty Training Program. Internet and Higher Education,6,53-63.
Rogers, E. M (2003). Diffusion of Innovations (5th ed.). New York: Free Press.
Hello Florence, your choice of the transition science framework is appropriate as it seeks to enhance the constancy of chronic disease patients to medication. The Theory of Reasoned Action (TRA) is suitable as it seeks to explain factors affecting patients’ behavior. Adherence to the prescribed medication is one of the requisite factors for improved care. The focus on this patient population is warranted as chronic patients are linked to poor medication adherence (Kasahun et al., 2022). Some reasons support your choice of the TRA as the appropriate transition science framework. For instance, it helps with understanding that patient satisfaction with medication is according to their beliefs concerning potential outcomes relating to the medication (Shikiar & Rentz, 2004). The framework helps nurses to consider all the salient factors that affect medication adherence from the patient’s perspective. The TRA also offers a guide to nurses to match the behavior of focus to the degree of specificity of the inherent beliefs and values (Shikiar & Rentz, 2004). For instance, if the particular behavior in consideration is medication adherence, then the degree of inquiry should focus on the patient’s outcomes linked to taking the prescription and the value underlying those outcomes. Therefore, the TRA guides nurses in promoting medication adherence among patients with chronic illnesses.
The Theory of Planned Behavior is another translation science model that can be considered for enhancing medication adherence among patients with chronic diseases. It is a framework extensively utilized for health-related and unrelated studies. The framework has been determined to more accurately illustrate constructs necessary to understand a patient (Alhamad & Donyai, 2021). It is more appropriate due to studies outside health behaviors, which outline additional consideration factors.
References
Alhamad, H., & Donyai, P. (2021). The validity of the theory of planned behavior for understanding people’s beliefs and intentions toward reusing medicines. Pharmacy, 9(1), 58. https://doi.org/10.3390/pharmacy9010058
De Sousa, M. M., Almeida, T. de, Andrade, S. S., Gouveia, B. D., & Oliveira, S. H. (2018). Teoria da ação racional e suas características em pesquisas na enfermagem. Enfermería Global, 17(3), 575. https://doi.org/10.6018/eglobal.17.3.305911
Shikiar, R., & Rentz, A. M. (2004). Satisfaction with medication: An overview of conceptual, Methodologic, and regulatory issues. Value in Health, 7(2), 204–215. https://doi.org/10.1111/j.1524-4733.2004.72252.x
