A review of approaches to integrating research and practice

Networking for research dissemination: Collaboration between education and practice

Current initiatives in the central production of rigorous reviews of the evidence for effectiveness in health care require efficient mechanisms for dissemination to individual practitioners. Nursing needs to ensure that sources of information about 'effectiveness' are routinely accessed, and that the skills to find, evaluate and utilise systematic reviews are available to improve care delivery and develop practice. A collaborative approach between education and practice is proposed, using a network of 'link practitioners' to ensure continuous awareness and dissemination of research. Working together to access the best currently available evidence for practice reduces duplication, shares costs, and ensures that the benefits of combined collaborative participation are greater than the individual contribution of each participating organisation. [ NT Research 1: 2, 113-118]

Developing evidence-based clinicians

Evidence-based care has heralded an advancement for health with extensive rhetoric and incentives encouraging clinicians to become active participants in practice change. This paper explores two mechanisms-research utilization and systematic reviews--as processes to develop empowerment in clinicians, and develop an ethos of basing practice on research. The intent of these approaches is to create an environment that enables clinicians to seek solutions to practice problems, inform practice decisions and develop practice policy using evidence from research. The goal is to develop evidence-based clinicians who remain active and interested in their practice and who are committed to promoting the application of research to practice. The strengths and weaknesses of these methods are explored within two case studies where they are applied to the management of hypothermia and the efficacy of postoperative observations. Key points of application for each of the methods are outlined in the conclusions.

Use of a content methodology process to enhance feeding abilities threatened by ideational apraxia in people with Alzheimer's-type dementia

Self-feeding behavior is often the first of a chain of self-maintenance skills to deteriorate in people with Alzheimer's-type dementia and is a major determinant of institutionalization. Moreover, nurses working in geriatric settings report the feeding of patients as a most difficult management problem. Of the various features of Alzheimer's-type dementia that can affect a person's ability to feed him- or herself, ideational apraxia can explain the loss of ability to conceptualize, plan, and execute the complex sequence of motor actions involving the use of tools or objects necessary for feeding. In this article, a systematic process is used to review the research literature to develop substantive content for nurses caring for people with feeding problems related to ideational apraxia. Ideational apraxia is a condition in which an individual is unable to plan movement related to an object because he or she has lost the perception of the object's purpose. The specific abilities necessary for feeding that are threatened by ideational apraxia are identified. A tool to assess these abilities is described, and nursing interventions aimed at enhancing or preserving existing abilities, preventing excess disability, or compensating for lost abilities are presented.