Embracing Implementation Science: A Paradigm Shift for Nursing Research.
Embracing Implementation Science: A Paradigm Shift for Nursing Research.
复制标题
拥抱实施科学：护理研究的范式转变。
DOI：
10.1111/jnu.12507
复制
发表时间：
2020
期刊：
影响因子：
--
通讯作者：
DeGeest,Sabina
中科院分区：
文献类型：
--
作者：
Zullig,LeahL;Deschodt,Mieke;DeGeest,Sabina
全球护士构成了最大的医疗保健劳动力，护理干预措施可以积极影响医疗保健服务，临床和经济成果。全世界约有900万名护士。尽管努力促进循证护理，但研究结果与临床实践之间存在差距。事实上，虽然护理研究企业提供了越来越多的证据，有价值的干预措施，可以应用于临床实践，只有一小部分被转化为真实的世界的临床环境，以解决紧迫的临床需要的病人和人口。以下数字证实了这一观察到的“差距”。总的来说，只有三分之一的强有力的证据在学术界的书架上等待，并在临床实践中实施。（Balas和Boren，2000年）虽然关于成功实施的干预措施的可持续性的信息不足，但据估计，一项有效的干预措施从一开始到实现系统可持续性平均需要17年。（Balas & Boren，2000）一个明显但相关的问题是，我们知道有害或无效的做法失去了取消实施的机会。（Kleinman & Mold，2009）因此，我们浪费了研究努力，未能提供尖端的临床护理。弥合这一证据与临床的差距将大大增加护理研究的影响和相关性。实施科学被定义为“对促进将研究成果和其他循证实践系统地纳入日常实践的方法进行科学研究，从而提高卫生服务和护理的质量和有效性”（Eccles & Mittman，2006），是一种为转化渠道提供信息和活力的方式。转化管道中的不同点-从观察性研究开始，从功效到有效性再到实施研究-有不同的方法和目标。
Globally nurses comprise the largest health care workforce and nursing interventions can positively impact health care delivery, clinical, and economic outcomes. There are approximately 9 million nurses worldwide.(World Health Organization) Despite efforts to promote evidencebased nursing, there is a gap between research findings and clinical practice. Indeed, while the nursing research enterprise provides an increasing body of evidence of valuable interventions that could be applied in clinical practice, only a fraction is translated into real world clinical settings to address pressing clinical needs of patients and populations. The following numbers substantiates this observed ‘gap’. Overall only one-third of strong evidence waiting on academics’ bookshelves and is ever implemented in clinical practice.(Balas & Boren, 2000) Although there is insufficient information on sustainability of successfully implemented interventions, it is estimated that it takes an average of 17 years to move an efficacious intervention from inception towards system sustainability.(Balas & Boren, 2000) A distinct yet related problem, are missed opportunities for de-implementation of practices that we know are harmful or ineffective.(Kleinman & Mold, 2009) Consequently, we squander research efforts and fail to provide cutting-edge clinical care. Bridging this evidence-to-clinic gap would dramatically increase the impact and relevance of nursing research. One way to restore the bridge is through implementation science.Implementation science, which has been defined as,“the scientific study of methods to promote the systematic uptake of research findings and other evidence-based practices into routine practice, and, hence, to improve the quality and effectiveness of health services and care”(Eccles & Mittman, 2006), is a way to inform and energize the translational pipeline. The different points in the translational pipeline–starting from observational studies and moving from efficacy to effectiveness to implementation studies—have different approaches and goals.