NURS 8114 Discussion: Translation Models and Frameworks
DQ Post an explanation of the translation science framework or model that you selected and explain why it is most relevant to your practice problem
Applying research-based information in real-world environments is complex and fraught with difficulties. As a result, it is imperative to understand current research data and contextualize it before it is used. Various translation models, including Roger’s Diffusion of Innovation, Knowledge-to-Action, and Theory of Reasoned Action, are used to integrate scientific research evidence into practice (Myrick, 2010). They increase the uptake and use of evidence to enhance patient outcomes and population health. This paper focuses on the Knowledge-to-Action framework.
Health professionals worldwide face similar challenges in translating the best available evidence into practical health treatments on time to provide adequate care and service. The Knowledge to Action Framework is a conceptual framework designed to assist people involved in knowledge translation to deliver sustainable, evidence-based initiatives (Powell et al., 2015). Information translation has been characterized as a process that includes the synthesis, dissemination, exchange, and ethical application of knowledge to improve health, provide more effective health services and products, and strengthen the healthcare system. The capacity to identify and document issues at every stage of knowledge creation, synthesis, and sharing is crucial for successfully translating evidence into practice (Rew et al., 2020). Problems are documented in findings, discussion forums, clinical records, or research papers so that they may be detected by scholars and other specialists who can develop a solution.
The Knowledge-to-Action (KTA) model facilitates the use of research knowledge by various stakeholders, including practitioners, policymakers, patients, and the public. This model has two significant components that involve knowledge creation and action. Each component has several overlapping, repeated stages that Graham and colleagues describe as dynamic and can impact one another (Curtis et al., 2017). Action phases can be conducted sequentially or concurrently, and knowledge stages may impact them. The Action Cycle is a technique that shows the steps necessary for knowledge to be implemented in reality. Knowledge is customized to the local environment, and the barriers and facilitators to its usage are publicly assessed. It is critical to include stakeholders and tailor information to the needs of the people using it.
Knowledge-to-Action model has been selected to address the practice problem of diabetes management. Knowledge plays a crucial role in the management of diabetes. People with less knowledge about diabetes report lower health status in general and are more likely to experience severe complications associated with the illness. In addition, diabetes has been linked to various factors, such as social and economic elements. Thus, this model is relevant to the practice issue because it can guide the translation of knowledge to promote action on the socioeconomic determinants of health and health equality that impact the management of diabetes.
References
Curtis, K., Fry, M., Shaban, R. Z., & Considine, J. (2017). Translating research findings to clinical nursing practice. Journal of clinical nursing, 26(5-6), pp. 862–872.
Myrick, K. M. (2010). Improving follow-up care for fragility fractures: An evidence-based practice initiative. University of Connecticut.
Powell, B. J., Waltz, T. J., Chinman, M. J., Damschroder, L. J., Smith, J. L., Matthieu, M. M., … & Kirchner, J. E. (2015). A refined compilation of implementation strategies: results from the Expert Recommendations for Implementing Change (ERIC) project. Implementation science, 10(1), 1-14.
Rew, L., Cauvin, S., Cengiz, A., Pretorius, K., & Johnson, K. (2020). Application of project management tools and techniques to support nursing intervention research. Nursing Outlook, 68(4), 396–405.
Translation science involves turning observations or gaps into an intervention to improve health outcomes (Wensing & Grol, 2019). DNP-prepared nurses are equipped to use various conceptual frameworks in promoting health care outcomes in health organizations (Ahmed et al., 2018). Health care providers across different healthcare settings will share challenges in translating the best evidence-based evidence into actual practice in providing the most effective services and care to patients (Wensing & Grol, 2019). Different translation models and frameworks may be used in designing and implementing evidence-based interventions. These include the Knowledge-to-Action (KTA) theory, defined as the process that involves synthesis, exchange, dissemination, and ethical application of evidence-based knowledge in improving health and providing for most effective and relevant health care products and services in the strengthening of the health care systems (Spooner et al., 2018).
KTA consists of two components of creating evidence-based knowledge and action through implementation. Each component involves several phases that may overlap and can also be iterative. The phase of action may be carried out simultaneously or sequentially. The action represents the activities that are needed for evidence-based knowledge or practice to be implemented into practice. First, learning needs to be adapted to the local context where both facilitators and barriers need to be assessed. Secondly, stakeholders, including other health care providers and management teams, need to promote change. The KTA framework provides a reference for organizing thinking and encouraging action or implementation of change within an organization. Advantages of using this framework include making translation science more logical and systematic with an improved likelihood of changed practice and performance of evidence-based practice (Shrubsole, 2019).
KTA will be very effective in the implementation of evidence-based practice in my organization. As a DNP-prepared nurse, I have a
leadership role in developing and implementing various evidence-based practices that promote patient care, such as implementing evidence-based hand-washing of nurses before and after touching patients to control infections in the ICU. KTA will be used first by increasing awareness through the knowledge arm of KTA by educating every person on the need to wash hands and how to wash hands effectively. Secondly, the action arm will be used to implement change. Finally, other actions such as assessment or evaluation of outcomes of using the new evidence-based strategy will also be done on the action arm of KTA (Shrubsole, 2019).
References
Ahmed, S., Andrist, L., Davis, S., & Fuller, V. (2018). DNP Education, Practice, and Policy, 2nd Edition. Faculty and Staff Books. https://digitalcommons.usm.maine.edu/facbooks/523
Shrubsole, K. (2019). Implementation of an integrated multidisciplinary Movement Disorders Clinic: Applying a knowledge translation framework to improve interdisciplinary care. Disability and Rehabilitation, 0(0), 1–13. https://doi.org/10.1080/09638288.2019.1691666
Spooner, A. J., Aitken, L. M., & Chaboyer, W. (2018). Implementation of an Evidence-Based Practice Nursing Handover Tool in Intensive Care Using the Knowledge-to-Action Framework. Worldviews on Evidence-Based Nursing, 15(2), 88–96. https://doi.org/10.1111/wvn.12276
Wensing, M., & Grol, R. (2019). Knowledge translation in health: How implementation science could contribute more. BMC Medicine, 17(1), 88. https://doi.org/10.1186/s12916-019-1322-9
Hello Holly,
I agree with you that translational research is crucial in nurse practice as it promotes the practical application of the EBP outcomes into practice. It is the centerpiece of the applicability of new skills and techniques into nurse practice. One of the major drawbacks that has been in EBP implementation is practice has been lack of sufficient knowledge on translational research. However, as the field gains applicability in almost every field of scientific research, the gap between EBP outcomes and the nurse practice has been reducing over the years. Consequently, it has promoted improved methods of care hence quality service delivery and better customer satisfaction (Weiss et al., n.d.).
In your EBP project work about new ideas of integrating ultrasound-guided peripheral IV insertion into practice, the use of Roger Diffusion Innovation Model is the most appropriate. The model first requires that the developer persuades people of how the new technique is going to improve the quality of healthcare services (Mohammadi et al., 2018). Therefore, it is imperative to convince the practicing nurses, physicians, care givers and patients on the advantages of use of the ultrasound guided IV insertion. Secondly, there is need to elaborate why the technique is most appropriate compared to other already existing methods. The third component of this model looks into rate at which the developed idea is spreading to the relevant people. The rate of diffusion of the new knowledge depends of three crucial components, that is; communication channels, the natures of available social systems and the time frame (Mohammadi et al., 2018).
Alternatively, I do believe the new concept of use of integrated ultra sound guided peripheral IV can also be spread out to the relevant stakeholders and gain applicability through us of the theory of knowledge to action. The model proposes on use of available knowledge to raise inquiry into a prevailing condition, synthesizing of the knowledge and developing the products or tools. However, the KTA model calls on vigilance to constantly evaluate the implementation and use of the knowledge.
References
Mohammadi, M. M., Poursaberi, R., & Salahshoor, M. R. (2018). Evaluating the adoption of evidence-based practice using Rogers’s diffusion of innovation theory: a model testing study. Health Promotion Perspectives, 8(1), 25–32. https://doi.org/10.15171/hpp.2018.03
Weiss, M., Bobay, K., Johantgen, M., & Shirey, M. (n.d.). Aligning Evidence-Based Practice With Translational Research: Aligning Evidence-Based Practice With Translational Research: Opportunities for Clinical Practice Research Opportunities for Clinical Practice Research. https://epublications.marquette.edu/cgi/viewcontent.cgi?article=1606&context=nursing_fac
Knowledge-to-Action
Hello Muktar thank you sor the information you posted for Knowledge-to-Action. I will also address a similar post regarding patients not adhering to their follow-up appointments within the mental health population. Knowledge-to-action is a framework created by I.D. Graham et al. (White et al., 2019). KTA is interdependent of seven phases that require synthesis through the translation process. KTA derives from “knowledge creation and application” (White et al., 2019, p. 42). I.D. Graham et al. identified that KTA is disseminated through seven phases until reaching the final phase of adaptation as follows:
- Identification or review of problem that requires research relevant to the problem addressed.
- Knowledge adaption for local contextual use.
- Assessment of barriers related to knowledge.
- Implement the selected knowledge for the use of interventions and enhancement of information learned.
- Monitor the knowledge attained.
- Evaluate the measures of knowledge used.
- Adhere to applied knowledge learned.
You stated that KTA is derived from two main components of knowledge creation and action (White et al., 2019). KTA encompasses 31 planned-action theories and the creation of knowledge based on holistic approaches applied in clinical settings. KTA is a way to identify and make decisions regarding practice gap concerns (ten Ham-Baloyi, 2022). Translation and dissemination of knowledge are relevant for enhancing health outcomes as the clinician works through the seven phases of KTA. During phase I of KTA, as a DNP-APN, I would implement scientific knowledge and identify problems related to practice gaps, which you did regarding the patients not following up with their appointments. During phase one, the clinician should identify current practices or policies and compare them to evidence-based knowledge that will be more effective (ten Ham-Baloyi, 2022). KTA phase I will allow me to address practice gap issues and make effective decisions relevant to a DNP project that will improve healthcare risks and enhance patient outcomes (ten Ham-Baloyi, 2022).
References
ten Ham-Baloyi, W. (2022). Assisting nurses with evidence-based practice: A case for the Knowledge-to-Action Framework. Health SA Gesondheid, 27(1), 1–3. https://doi.org/10.4102/hsag.v27i0.2118Links to an external site.
White, K. M., Dudley-Brown, S., & Terhaar, M. F. (Eds.). (2019). Translation of evidence into nursing and healthcare (3rd ed.). Springer
The Knowledge-to-Action (KTA) paradigm presented in Chapter 2 of “Translation of Evidence into Nursing and Healthcare” is the reasoning behind the proposed Evidence-Based Practice (EBP) Quality Improvement (QI) intervention. Knowledge development and the action cycle are prerequisites for this paradigm. This comprehensive technique is especially suited to healthcare translation research. Starting with integrating and consolidating information from various sources is the KTA framework (White et al. 2019). This fits in with the original idea of data-based Practice Quality Improvement (EBP QI), whose initial stages are to gather relevant data related to a practice problem (White et al. 2019). It focuses on tailoring information to the individual recipient and adapting evidence to healthcare realities.
The second step focuses on the action cycle, designed to select, adapt, apply, supervise and assess interventions. However, this dynamic strategy suits the nature of quality improvement, which is based on refinement and needs to be adjusted over time (White et al., 2019). The continuing evaluation emphasized in the KTA framework also meshes well with the Plan-Do-Study-Act (PDSA) cycle, which is widely used in QI efforts (White et al. 2019). Besides such procedural aspects, there are also human elements. When Activating the KTA framework (White et al., 2019). This finding is particularly relevant to the practice problems associated with clinical practice changes brought about by those providing healthcare and organizational culture. All these difficult questions are part of the KTA paradigm and give us a comprehensive system for change, which raises the chances of long-term effectiveness. Evidence on how to treat pain effectively is compiled under the framework, considering patient demographics, available resources and staff capabilities (White et al. 2019). Further, it also helps structure and compliance while fitting the surgical unit’s specific features.
The Knowledge-to-Action framework is vital to the Evidence-Based Practice Quality Improvement challenge. This is the method of synthesizing knowledge and the cycle of dynamic action in treating quality improvement, which complements its cyclical character. The focus on adapting knowledge to the situation and respect for human and organizational variables positions it as a sound choice. With the KTA gateway, it’s much more likely that evidence-based procedures will be followed and patient outcomes improved (White et al. 2019). Knowledge translation and implementation science undergird the KTA framework, which guides EBP QI. The dynamic action cycle and knowledge synthesis create a force to transform health care (White et al. 2019). The framework was selected manually and theoretically to deal with the challenges of the QI project.
This selection is because the KTA framework is more flexible and emphasizes follow-up assessment. These will help take the project from the planning to the implementation phase and improve patient results in time. This becomes a practical document that will form the project. As it progresses, the KTA framework should facilitate the improvement of interventions to suit changing requirements for healthcare (White et al. 2019). Continuous evaluation of the framework measures the effects of interventions, supporting evidence-based decision-making through every phase. The KTA framework will guide the project in both theory and practice (White et al., 2019). Such agility and reliance on ongoing self-idents the project’s ability to transition from planning to implementation, giving them a better chance at a successful surgical outcome. Applying the KTA framework demonstrates dedication to data-driven healthcare provision and patient treatment.