An exploration of the factors that influence the implementation of evidence into practice
An exploration of the factors that influence the implementation of evidence into practice
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DOI：
10.1111/j.1365-2702.2004.01007.x
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发表时间：
2004-11-01
影响因子：
4.2
通讯作者：
Titchen, A
中科院分区：
文献类型：
--
作者：
Rycroft-Malone, J;Harvey, G;Titchen, A
背景实施循证实践的挑战是复杂而多样的。在此背景下，已经制定了一个框架，以代表可能会影响到实践中的实施证据的多种因素。建议成功实施取决于所使用的证据的性质，背景的质量，以及促进变革过程所需的类型。本研究旨在透过实证调查，详细研究该架构的各项要素。该研究的目的是解决以下问题：从业人员认为哪些因素是将证据付诸实践的最重要因素？从业人员确定哪些因素是将证据付诸实践的中介？证据、背景和便利的概念是否构成将证据付诸实践的框架的关键要素？设计和方法。研究分两个阶段进行。第1阶段：进行探索性焦点小组（n = 2），为制定访谈指南提供信息。这是用于个案研究中心的个别关键线人。第二阶段：研究了两个正在进行或最近实施项目的地点。在网站内进行半结构化访谈（n = 17）。出现了一些与将证据付诸实践相关的关键问题，包括：证据的性质和作用、与组织和实践问题的相关性和适合性、多专业关系和协作、项目负责人的作用和资源。结论。结果进行了讨论，参考更广泛的文献和有关的持续发展的框架。至关重要的是，越来越多的证据表明，专注于实施循证实践的个人方法，如提高从业人员的技能以评估研究证据，本身将是无效的。与临床实践的相关性。提出了在将证据付诸实践时需要注意的关键要素，这些要素可能为今后的实施和评价项目提供有用的清单。
Background. The challenges of implementing evidence-based practice are complex and varied. Against this background a framework has been developed to represent the multiple factors that may influence the implementation of evidence into practice. It is proposed that successful implementation is dependent upon the nature of the evidence being used, the quality of context, and, the type of facilitation required to enable the change process. This study sets out to scrutinize the elements of the framework through empirical enquiry.Aims and objectives. The aim of the study was to address the following questions:What factors do practitioners identify as the most important in enabling implementation of evidence into practice?What are the factors practitioners identify that mediate the implementation of evidence into practice?Do the concepts of evidence, context and facilitation constitute the key elements of a framework for getting evidence into practice?Design and methods. The study was conducted in two phases. Phase 1: Exploratory focus groups (n = 2) were conducted to inform the development of an interview guide. This was used with individual key informants in case study sites. Phase 2: Two sites with on-going or recent implementation projects were studied. Within sites semi-structured interviews were conducted (n = 17).Results. A number of key issues in relation to the implementation of evidence into practice emerged including: the nature and role of evidence, relevance and fit with organizational and practice issues, multi-professional relationships and collaboration, role of the project lead and resources.Conclusions. The results are discussed with reference to the wider literature and in relation to the on-going development of the framework. Crucially the growing body of evidence reveals that a focus on individual approaches to implementing evidence-based practice, such as skilling-up practitioners to appraise research evidence, will be ineffective by themselves.Relevance to clinical practice. Key elements that require attention in implementing evidence into practice are presented and may provide a useful checklist for future implementation and evaluation projects.