Strategic Vision: Development of a Southern California Kaiser Permanente Nursing Research Program Translational Research Model

Transcription

1 Strategic Vision: Development of a Southern California Kaiser Permanente Nursing Research Program Translational Research Model Designed by Regina M Valdez, MA Cecelia Crawford, RN, MSN Joyce Johnson, PhD, RN-BC Anna K. Omery, RN, DNSc, CNAA- BC June Rondinelli, RN, MSN, CNS STTI International Nursing Research Conference July 13-17, 2009

2 Transition to Translational Research In 2008, the Kaiser Permanente (KP) Southern California Nursing Research Program sought to move away from a two model format to an single model format Integrating scientific discoveries into nursing practice The transition consisted of four phases

3 Drivers for Model Development Confusion between evidence-based nursing practice projects and quality. Prioritizing Nursing Research Program personnel activities. Raising the sophistication bar for nurses at Kaiser Permanente (KP). Assisting in the communication about Nursing Research beyond nursing venues.

4 The Team Anna K. Omery, RN, DNSc, NEA-BC Director of Nursing Research Joyce A Johnson, PhD, RN-BC Director of Education and Research Cecelia L Crawford, RN,MSN Project Manager III June L Rondinelli, RN,MSN, CNS Project Manager III Regina M Valdez, MA Project Analyst

5 Phase I- What is Translational Research? Research that translates scientific discoveries and advances from the bench or laboratory into a clinically germane application. National Institutes of Health Scientific investigation of methods interventions and variables that influence adoption of evidence-based practice (EBPs) by individuals and organizations to improve clinical and operational decision making in health care. This includes testing the effect of interventions on promoting and sustaining evidence based practice. Titler, 2004

6 Phase I- What is Translational Research? Chelsa (2008) mentions Translational Research in "type1 and type 2' specifically in nursing research. Mitchell (2008) spoke about the need of Type1 and 2 in nursing research with reference to a possible T3. From the compiled definitions from community and overall healthcare directives, a succinct definition was formalized and adopted by the Southern California Nursing Research Program.

7 Translational Research is: A systematic investigation that has as its purpose the development of generalizable knowledge that explains or improves clinical practice(s) sourced from evidence (including theory testing) or previous research. Southern California Nursing Research Program, 2008

8 Phase II: Model Creation How to translate the definition into a model that illustrates Translational Research The team explored current different models from publications.

9 Phase II: Translational Research Model Areas of Consensus: Built around teams that are comprised of individuals who have: Different areas of expertise and From multiple disciplines. It is an iterative process (from the Laboratory to the Patient and back). Aims to move knowledge from journals or academic setting to practitioners.

10 Phase II: Model Creation Structure + Process = Outcomes Donabedian s model proposes that each component has a direct influence on the next Donabedian, 1972

11 Phase II: From the consensus of the literature Translational Research is divided into three types, that were called T1, T2, and T3. The team defined each T-type as: o T1: Basic science that can potentially affect practice (bench to bedside/laboratory to human) o T2: New knowledge tested in the clinical setting (bedside to community/evidence to practice) o T3: Implementation of evidence beyond the pilot and population(s) with testing systems change

12 Phase II: Model Creation; Table Format Structure/ Type of Research Process Outcome/ Product of Research T 1 Basic Science; Theory development/ Basic Research Basic Science New Knowledge T 2 Test evidence-based interventions in practice Evaluation of findings of Integrative Reviews/ Systematic Reviews in a Population Outcome Improvement in populations T 3 Implement and test systems change; best practice considering consumer factors Guideline Development and Testing Systems Change

13 Structure T 1 T 3 T 2

14 Process T 1 T 3 T 2

15 Structure + Process T 1 T 1 T 3 T 2 T 3 T 2

16 Outcomes T 1 O T 3 O T 2 O

17 T 1 O T 1 T 3 T 2 T 3 O T 2 O

18 Phase III: Adoption Once the graphic and table format of model were created, the team brought the Translation Research Model back to the Southern California Nursing Research Committee to ratify Current Southern California KP projects were then evaluated and assigned a T- type, based on the type of research was being conducted

19 T1 Example: Basic Science; Theory development/ Basic Research Basic Science New Knowledge Nurses attitudes towards people of size ( lb) and people of significant size (500lb- 1200lb)

20 T2 Example: Test evidencebased interventions in practice Evaluation of findings of Integrative Reviews/ Systematic Reviews in a Population Outcome Improvement in populations A Nursing Strategy to Improve Patients Compliance with Self-Monitoring for Symptoms of Heart Failure

21 T1/ T2 Example: Prealbumin Screening to Decrease Hospital Acquired Pressure Ulcer The overall goal is to improve the patient's quality of life, decrease pain, decrease cost and length of stay.

22 T3 Example: Implement and test systems change; best practice considering consumer factors Guideline Development and Testing Systems Change Hourly Rounding: An Action Research Study identify successful structures, tools, and processes in both implementing and sustaining rounding behaviors by staff nurses

23 T2/ T3 Example: CalNOC Partners to Reduce Patient Falls Project (TRIPP) Testing an evidence-based intervention to create a systems change.

24 Implementation of the Model Adaptation and dissemination through the Southern California KP Nursing Research Website, 2009 Grants and Annual Conference Projects are no longer on separate grids and looked at separately but combined and labeled as a T-type The development and implementation of this Model resulted in a strategic infrastructure that gives a voice to nursing research activities within one integrated healthcare system.

25 Questions? For more information please visit our website at

26 References Chesla, C. A. (2008). Translational research: Essential contributions from interpretive nursing science. Research in Nursing Health, 31, Donabedian, A. (1972). Models for organizing the delivery of health services and criteria for evaluating them. Milbank Quarterly, 50, Mitchell, P. H. (2008, April 17). Knowledge That Matters: Integrating Research, Practice and Education. Proceedings of the Communicating Nursing Research Conference and WIN assembly April 17-19th at the Hyatt Regency Orange County, Garden Grove, CA. Annual Publication of the Western Institute of Nursing. Mitchell, P.H. (2004, July-August). Research: Lost in Translation? Journal of Professional Nursing, 20(4),

27 References NIH (National Institutes of Health) Titler, M.G. (2004). Overview of the U.S. Invitational Conference Advancing Quality Care Through Translation Research. Worldviews on Evidence-Based Nursing, 1(Sept), (s1suppl), S1-S5. Whittemore Robin; Grey Margaret (2002). The systematic development of nursing interventions. Journal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing / Sigma Theta Tau 2002;34(2): Woolf, S. H. (2008, January 9/16). The meaning of translational research and why it matters. JAMA, 299(2): (doi: /jama ). retrieved