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Wang M, Dolovich L, Holbrook A, Jack SM. Factors that influence community hospital involvement in clinical trials: A qualitative descriptive study. J Eval Clin Pract 2022; 28:79-85. [PMID: 34008258 DOI: 10.1111/jep.13583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 04/26/2021] [Accepted: 04/27/2021] [Indexed: 11/30/2022]
Abstract
RATIONALE, AIMS AND OBJECTIVES The successful conduct of randomized clinical trials (RCTs) is often impeded by recruitment difficulties. Community hospitals see large volumes of patients but rarely participate in trials. The objective of this study was to explore how research stakeholders identify and understand the contextual, organizational, research, and individual-level factors that influence the engagement of community hospitals in Ontario to participate in RCTs as partner sites. METHODS In this descriptive, qualitative study, semi-structured interviews were conducted with a purposeful sample of 18 individuals who are familiar with the processes associated with engaging community hospitals for research or recruiting participants from these sites into trials. Demographic data were summarized using descriptive statistics. The principles of conventional content analysis were used to code, categorize and synthesize the interview data. RESULTS Informed by participants' descriptions, the results were organized within three unique stages that describe the process of recruitment within community hospitals: (a) community hospital engagement; (b) initiation of the project in the community hospitals; and (c) recruiting patients. The key barriers were the invisibility of the community hospitals to research investigators and the lack of research infrastructure in most of the community hospitals. Increased communication and sharing of resources between academic centers and community hospitals facilitated recruitment across all three stages. CONCLUSION Our results illustrated a willingness of community hospitals to participate in RCTs, but a lack of capacity for research. Additional efforts by trial coordinating sites are required to recruit community hospitals, but their inclusion improves the generalizability of trial results.
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Affiliation(s)
- Mei Wang
- Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, Hamilton, Ontario, Canada.,Father Sean O'Sullivan Research Institute, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Lisa Dolovich
- Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, Hamilton, Ontario, Canada.,Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada.,Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada.,The School of Pharmacy, University of Waterloo, Ontario, Canada
| | - Anne Holbrook
- Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, Hamilton, Ontario, Canada.,Division of Clinical Pharmacology and Toxicology, Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Susan M Jack
- Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, Hamilton, Ontario, Canada.,School of Nursing, McMaster University, Hamilton, Ontario, Canada
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Chiu YW, Weng YH, Lo HL, Hsu CC, Shih YH, Kuo KN. Comparison of evidence-based practice between physicians and nurses: a national survey of regional hospitals in Taiwan. THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2010; 30:132-138. [PMID: 20564703 DOI: 10.1002/chp.20070] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
INTRODUCTION Although evidence-based practice (EBP) has been widely investigated, few studies compare physicians and nurses on performance. METHODS A structured questionnaire survey was used to investigate EBP among physicians and nurses in 61 regional hospitals of Taiwan. Valid postal questionnaires were collected from 605 physicians and 551 nurses during February to May 2007. RESULTS Physicians were more aware of EBP than nurses. Although both groups had high recognition of belief in and favorable attitudes toward EBP, their knowledge of and skill in EBP were relatively low. When compared with nurses, physicians were more willing to support the promotion of EBP implementations in clinical services. Physicians' knowledge and skills regarding the application of EBP principles were greater than nurses. Furthermore, physicians more often accessed the on-line evidence-retrieval databases, including the Cochrane Library. The most commonly ranked barriers to EBP applications for both groups included lack of designated personnel, lack of convenient kits, limited basic knowledge of EBP, and time. In general, nurses generated more barriers than physicians. DISCUSSION There were significant discrepancies between physicians and nurses in their awareness of, attitude toward, knowledge of, skill in, behavior toward, and barriers regarding EBP. In implementing EBP, strategies to overcome barriers and provide on-line evidence-retrieval systems should differ for physicians and nurses.
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Affiliation(s)
- Ya-Wen Chiu
- Division of Health Policy Research and Development, Institute of Population Health Sciences, National Health Research Institutes, 35 Keyan Road, Zhunan, Miaoli, Taiwan
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Promoting research in clinical practice: strategies for implementing research initiatives. AACN Adv Crit Care 2008; 19:155-61; quiz 162-3. [PMID: 18560283 DOI: 10.1097/01.aacn.0000318117.82308.8d] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Promoting the use and conduct of research in clinical practice is an essential component in ensuring best practices and promoting positive outcomes for patients. Yet, it is often difficult for nurses in clinical practice to devote time to research activities because the daily demands of practice often take precedence. This article reviews key strategies for implementing research in clinical practice. Examples of ongoing initiatives being conducted at a variety of clinical settings are highlighted to showcase strategies for implementing clinically focused research projects.
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Abstract
Hospital leaders who are not part of a university system often are not aware of the complexities associated with conducting research or the infrastructure required to successfully support a hospital-based research program. The author discusses a research program, provides recommendations for building a hospital-based infrastructure, and shares one hospital's experience.
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Abstract
As hospitals strive to create strong work environments for nurses, many use the core requirements for Magnet designation to enhance and build new programs in research and evidence-based practice into patient care and operational processes. The problem is the use of quality improvement projects in these efforts as evidence of a healthy "research" program. This confusion can lead to 3 major consequences: (1) poorly designed and interpreted studies; (2) lack of consideration of subject rights; and (3) Institutional Review Board or other regulatory sanctions for noncompliance with federal, state, and local law and institutional policies. The purpose of this article is to differentiate between research and quality improvement, explore the potential risks of confusing quality improvement with research, and suggest criteria by which to determine the difference.
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Affiliation(s)
- Robin P Newhouse
- Nursing Administration, The Johns Hopkins Hospital, Baltimore, MD, USA.
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Abstract
Organizations often do not have processes in place to support nurses through a systematic approach for developing and evaluating nursing interventions, protocols, critical pathways, and policies that are derived from scientific evidence. The development of a framework to guide inquiry will have a positive impact on patients. This process may foster a higher level of professional engagement by nurses that may, in the long-term, help improve nurse retention and recruitment. The authors discuss a nursing evidence-based practice model and guidelines that were developed by a team of hospital and academic nurse leaders and is practical and easy to use. This model has been successfully implemented across the department of nursing as a strategic initiative. Results of the implementation have shown that staff nurses can effectively use this model with the help of knowledgeable mentors.
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Affiliation(s)
- Robin Newhouse
- Johns Hopkins University School of Nursing, 525 N. Wolfe Street, Baltimore, MD 21205, USA
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Abstract
To advance the growth of perianesthesia research and promote research-guided patient care, PACU nurses must use research findings in practice. The purpose of this survey was to explore the perceived barriers to research use in a specific PACU setting so that strategies could be planned to improve research use. The greatest perceived barriers related to attributes of the organization. This is an area that nurse leaders can affect by building the infrastructure needed for nurses to develop skill and knowledge related to research use.
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Affiliation(s)
- Elizabeth Lapierre
- Patient Care Services, Sinai Hospital of Baltimore, 2401 West Belvedere Avenue, Baltimore, MD 21215-5271, USA.
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