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Seedat J. The knowledge-to-action process model for knowledge translation in oral care in South Africa. SOUTH AFRICAN JOURNAL OF COMMUNICATION DISORDERS 2023; 70:e1-e9. [PMID: 37526536 PMCID: PMC10397355 DOI: 10.4102/sajcd.v70i1.951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 12/13/2022] [Accepted: 06/12/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND Literature supports the mismatch between empirical evidence and service delivery. Given this knowledge gap, it is important that research undertaken has a theoretical foundation, considers the context and stakeholders to confirm its need and that it can be feasibly implemented and sustained. OBJECTIVES The study aimed to facilitate knowledge translation in oral care using the knowledge-to-action (K2A) process model among nurses. METHOD The study was completed in an acute hospital in South Africa. A qualitative design with ethnography incorporating video-recordings and semi-structured interviews were used. A total of 139 nurses were recruited using random purposive sampling and received training on oral care, which was monitored. Inductive thematic analysis was completed. RESULTS The model facilitated information transfer and implementation of oral care by nurses. CONCLUSION With clear directions for use and theoretical underpinning, the K2A model was well-suited to the needs of the study and stakeholders, and the complexity of the context. For challenging contexts such as public healthcare institutions in South Africa, this was ideal and critical to the success of the intervention.Contribution: When nursing managers show interest and recognise nurses for their role in implementation of interventions, the buy-in, support and sustained use of that intervention is enhanced. A model such as the K2A promotes involvement of all stakeholders (e.g. nurses and their managers) in the design and planning for implementation of an intervention, and these are critical for the successful and feasible use of the intervention.
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Affiliation(s)
- Jaishika Seedat
- Department of Speech Pathology and Audiology, Faculty of Humanities, University of the Witwatersrand, Johannesburg.
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Greene C, Canning D, Wilson J, Bak A, Tingle A, Tsiami A, Loveday H. I-Hydrate training intervention for staff working in a care home setting: An observational study. NURSE EDUCATION TODAY 2018; 68:61-65. [PMID: 29886286 DOI: 10.1016/j.nedt.2018.05.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 04/10/2018] [Accepted: 05/16/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Dehydration is a complex and well-recognised problem for older people residing in care homes. Within the social care sector support staff provide the majority of direct care for residents, and yet receive minimal training. OBJECTIVES To design, deliver and evaluate a hydration specific training session for care home staff to develop their knowledge and skills in supporting the hydration of care home residents. DESIGN An observational study comprising a pre-test post-test survey of staff knowledge following a training intervention. PARTICIPANTS AND SETTINGS Training of care home staff took place in two care homes in North West London. METHODS An interactive training session was developed and delivered, with content informed by observations of hydration care within the two homes and evaluated using CIRO model. Participant self-evaluation forms were used to collect data after the session regarding satisfaction and usefulness of the session, and pre and post levels of self-reported knowledge across six facets of hydration care. Training facilitators captured qualitative data in the form of field notes. Observations of hydration care explored the impact of training on practice. RESULTS Eighteen training sessions were delivered. A total of 161 participant evaluation forms were returned. There was a significant increase in self-reported knowledge across all six facets of hydration care (p = 0.000). The majority of participants found the training enjoyable and useful, and expressed an expected change in their practice. Participants enjoyed the interactive components of the training. A lack of reflective practice skills meant participants were unable to reflect realistically about the hydration care provided in the home. CONCLUSION Focused training on hydration in the care home environment benefits from being interactive and experiential. Although such training can be effective in increasing staff knowledge, inclusion of skills in reflective practice is required if this knowledge is to be translated into practice.
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Affiliation(s)
- Carolynn Greene
- Richard Wells Research Centre, University of West London, Paragon House, Boston Manor Road, Brentford, Middlesex TW98 9GB, United Kingdom.
| | - Deebs Canning
- College of Nursing, Midwifery and Healthcare, University of West London, United Kingdom.
| | - Jennie Wilson
- Richard Wells Research Centre, University of West London, Paragon House, Boston Manor Road, Brentford, Middlesex TW98 9GB, United Kingdom.
| | - Aggie Bak
- Richard Wells Research Centre, University of West London, Paragon House, Boston Manor Road, Brentford, Middlesex TW98 9GB, United Kingdom.
| | - Alison Tingle
- Richard Wells Research Centre, University of West London, Paragon House, Boston Manor Road, Brentford, Middlesex TW98 9GB, United Kingdom.
| | - Amalia Tsiami
- London Geller College of Hospitality and Tourism, University of West London, St Mary's Rd, London W5 5RF, United Kingdom.
| | - Heather Loveday
- Richard Wells Research Centre, University of West London, Paragon House, Boston Manor Road, Brentford, Middlesex TW98 9GB, United Kingdom.
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Cadorin L, Bagnasco A, Rocco G, Sasso L. An integrative review of the characteristics of meaningful learning in healthcare professionals to enlighten educational practices in health care. Nurs Open 2014; 1:3-14. [PMID: 27708790 PMCID: PMC5047303 DOI: 10.1002/nop2.3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Accepted: 06/24/2014] [Indexed: 11/30/2022] Open
Abstract
AIM Knowledge does not transfer automatically, but requires an active, personal progress through meaningful learning. As posited by the constructivist paradigm, the aim of this study was to identify the characteristics of meaningful learning by analysing definitions and correlated methods found in the literature. DESIGN An integrative review. METHODS Articles were sought on MEDLINE, CINAHL and SCOPUS; no language, time or study-design restrictions were adopted. Only papers referring explicitly to the diverse types of learning were taken into account; 11 articles were included in this review. RESULTS Findings from the literature revealed three different types of meaningful learning: (1) meaningful learning as 'active building-up process'; (2) meaningful learning as 'change'; 3-meaningful learning as 'outcome of experience'. A focus on constructivism and meaningful learning provides a new outlook on healthcare professionals in learning, including nurses, who are gradually taking on greater responsibility in self- and ongoing education.
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Affiliation(s)
- Lucia Cadorin
- Department of Health SciencesUniversity of GenoaI‐16132GenoaItaly
| | | | - Gennaro Rocco
- Centre of Excellence for Nursing Scholarship78 I‐00192RomeItaly
| | - Loredana Sasso
- Department of Health SciencesUniversity of GenoaI‐16132GenoaItaly
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Cadorin L, Bagnasco A, Rocco G, Sasso L. An integrative review of the characteristics of meaningful learning in healthcare professionals to enlighten educational practices in health care. Nurs Open 2014. [PMID: 27708790 DOI: 10.1002/nop2.3.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
AIM Knowledge does not transfer automatically, but requires an active, personal progress through meaningful learning. As posited by the constructivist paradigm, the aim of this study was to identify the characteristics of meaningful learning by analysing definitions and correlated methods found in the literature. DESIGN An integrative review. METHODS Articles were sought on MEDLINE, CINAHL and SCOPUS; no language, time or study-design restrictions were adopted. Only papers referring explicitly to the diverse types of learning were taken into account; 11 articles were included in this review. RESULTS Findings from the literature revealed three different types of meaningful learning: (1) meaningful learning as 'active building-up process'; (2) meaningful learning as 'change'; 3-meaningful learning as 'outcome of experience'. A focus on constructivism and meaningful learning provides a new outlook on healthcare professionals in learning, including nurses, who are gradually taking on greater responsibility in self- and ongoing education.
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Affiliation(s)
- Lucia Cadorin
- Department of Health Sciences University of Genoa I-16132 Genoa Italy
| | | | - Gennaro Rocco
- Centre of Excellence for Nursing Scholarship 78 I-00192 Rome Italy
| | - Loredana Sasso
- Department of Health Sciences University of Genoa I-16132 Genoa Italy
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Clarke N. Transfer of training: the missing link in training and the quality of adult social care. HEALTH & SOCIAL CARE IN THE COMMUNITY 2013; 21:15-25. [PMID: 22804952 DOI: 10.1111/j.1365-2524.2012.01082.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Recent UK social care reforms characterised by a policy of increasing personalisation and choice in adult social care have been accompanied by major reorganisation and investment in workforce training and development. There is an assumed link between training and the quality of care received. This assumption has a long pedigree in social care, but rarely does it receive the scrutiny necessary for us to understand better the nature of this relationship. This paper focuses on the potential for in-service training to contribute to the transformation in social care as expected by policy-makers. Reviewing recent findings from the evaluation of training in social care shows that problems continue to persist in demonstrating that training results in changes in practitioner behaviour back on the job. Findings within the social care literature mirror those found more widely in suggesting learner characteristics, intervention design, and delivery and the workplace environment combine to influence whether training transfers to use on the job. The argument advanced here is that without a focus on the transfer of training, the contribution of training to quality of care outcomes will remain illusory. A shift is required in policy-makers' mindsets away from training, to a focus on training transfer in directing workforce development strategies. It might then be possible to begin to identify how and in what configurations training may be associated with quality of care outcomes.
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Anderson RA, Corazzini K, Porter K, Daily K, McDaniel RR, Colón-Emeric C. CONNECT for quality: protocol of a cluster randomized controlled trial to improve fall prevention in nursing homes. Implement Sci 2012; 7:11. [PMID: 22376375 PMCID: PMC3310735 DOI: 10.1186/1748-5908-7-11] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2011] [Accepted: 02/29/2012] [Indexed: 12/02/2022] Open
Abstract
Background Quality improvement (QI) programs focused on mastery of content by individual staff members are the current standard to improve resident outcomes in nursing homes. However, complexity science suggests that learning is a social process that occurs within the context of relationships and interactions among individuals. Thus, QI programs will not result in optimal changes in staff behavior unless the context for social learning is present. Accordingly, we developed CONNECT, an intervention to foster systematic use of management practices, which we propose will enhance effectiveness of a nursing home Falls QI program by strengthening the staff-to-staff interactions necessary for clinical problem-solving about complex problems such as falls. The study aims are to compare the impact of the CONNECT intervention, plus a falls reduction QI intervention (CONNECT + FALLS), to the falls reduction QI intervention alone (FALLS), on fall-related process measures, fall rates, and staff interaction measures. Methods/design Sixteen nursing homes will be randomized to one of two study arms, CONNECT + FALLS or FALLS alone. Subjects (staff and residents) are clustered within nursing homes because the intervention addresses social processes and thus must be delivered within the social context, rather than to individuals. Nursing homes randomized to CONNECT + FALLS will receive three months of CONNECT first, followed by three months of FALLS. Nursing homes randomized to FALLS alone receive three months of FALLs QI and are offered CONNECT after data collection is completed. Complexity science measures, which reflect staff perceptions of communication, safety climate, and care quality, will be collected from staff at baseline, three months after, and six months after baseline to evaluate immediate and sustained impacts. FALLS measures including quality indicators (process measures) and fall rates will be collected for the six months prior to baseline and the six months after the end of the intervention. Analysis will use a three-level mixed model. Discussion By focusing on improving local interactions, CONNECT is expected to maximize staff's ability to implement content learned in a falls QI program and integrate it into knowledge and action. Our previous pilot work shows that CONNECT is feasible, acceptable and appropriate. Trial Registration ClinicalTrials.gov: NCT00636675
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Moyle W, Borbasi S, Wallis M, Olorenshaw R, Gracia N. Acute care management of older people with dementia: a qualitative perspective. J Clin Nurs 2010; 20:420-8. [PMID: 21029231 DOI: 10.1111/j.1365-2702.2010.03521.x] [Citation(s) in RCA: 105] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM AND OBJECTIVES This Australian study explored management for older people with dementia in an acute hospital setting. BACKGROUND As the population ages, increasing numbers of older people with dementia are placed into an acute care hospital to manage a condition other than dementia. These people require special care that takes into account the unique needs of confused older people. Current nursing and medical literature provides some direction in relation to best practice management; however, few studies have examined this management from the perspective of hospital staff. DESIGN A descriptive qualitative approach was used. METHOD Data were collected using semi-structured audio-taped interviews with a cross section of thirteen staff that worked in acute medical or surgical wards in a large South East Queensland, Australia Hospital. RESULTS Analysis of data revealed five subthemes with the overarching theme being paradoxical care, in that an inconsistent approach to care emphasised safety at the expense of well-being and dignity. A risk management approach was used rather than one that incorporated injury prevention as one facet of an overall strategy. CONCLUSION Using untrained staff to sit and observe people with dementia as a risk management strategy does not encourage an evidence-based approach. Staff education and environmental resources may improve the current situation so that people with dementia receive care that takes into account their individual needs and human dignity. RELEVANCE TO CLINICAL PRACTICE Nurses can assist older people with dementia by encouraging evidence-based care practices to become the part of hospital policy.
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Affiliation(s)
- Wendy Moyle
- Authors: Griffith Health Institute, Griffith University, Nathan Campus, Brisbane, Queensland, Australia.
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Nolan M, Davies S, Brown J, Wilkinson A, Warnes T, McKee K, Flannery J, Stasi K. The role of education and training in achieving change in care homes: a literature review. J Res Nurs 2008. [DOI: 10.1177/1744987108095162] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
AbstractCare homes play a vital role in the provision of support for the frailest members of our society, and given the demographic trends their role will continue for the foreseeable future. However, there remain enduring concerns about the quality of care such homes provide. Training and education for staff are often seen as the key to raising standards and as such are widely promoted. This paper presents a conceptual review and synthesis of the literature on the role of education and training in initiating and supporting change in care homes. A systematic method to the identification of sources was adopted, and a rigorous three-stage approach to analysis applied. The review identifies the barriers and facilitators to change and concludes that education is a necessary but not a sufficient condition for success. Rather it is argued that the role and status of care homes needs to be raised, and that a relationship-centred approach to care adopted, which acknowledges the importance of attending to the needs of all those who live in, work in, or visit care homes.
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Affiliation(s)
- Mike Nolan
- SISA, School of Medicine and Biomedical Sciences, University of Sheffield, Sheffield, UK
| | - Sue Davies
- School of Nursing and Midwifery, University of Sheffield, Sheffield, UK
| | - Jayne Brown
- Research Centre for Applied Gerontological Practice, Glasgow Caledonian University, Glasgow, UK
| | - Anna Wilkinson
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Tony Warnes
- SISA, School of Medicine and Biomedical Sciences, University of Sheffield, Sheffield, UK
| | - Kevin McKee
- SISA, School of Medicine and Biomedical Sciences, University of Sheffield, Sheffield, UK
| | - Jo Flannery
- Division of Clinical Psychology, University of Liverpool, Liverpool, UK
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Bourbonniere M, Strumpf NE. Enhancing Geriatric Nursing Competencies for Rns in Nursing Homes. Res Gerontol Nurs 2008. [DOI: 10.3928/00220124-20091301-02] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Bourbonniere M, Strumpf NE. Enhancing geriatric nursing competencies for RNs in nursing homes. Res Gerontol Nurs 2008; 1:171-5. [PMID: 20077961 DOI: 10.3928/19404921-20080701-03] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The purpose of this review was to determine the best method to deliver education that strengthens geriatric nursing competencies in RNs working in nursing homes to achieve excellent outcomes for a complex population. On the basis of the evidence reviewed, recommendations are made related to the kind of learning activities, structure of educational sessions, and instructor qualifications and consultation activities.
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Affiliation(s)
- Meg Bourbonniere
- Center for Practice Excellence, Rhode Island Hospital, 593 Eddy Street, Providence, RI 02903, USA.
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Brazil K, Vohra JU. Identifying educational needs in end-of-life care for staff and families of residents in care facilities. Int J Palliat Nurs 2005; 11:475-80. [PMID: 16215526 DOI: 10.12968/ijpn.2005.11.9.19782] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
AIM the purpose of this article is to describe educational needs in end-of-life (EoL) care for staff and families of residents in long-term care (LTC) facilities in the province of Ontario, Canada. Barriers to providing end-of-life care education in LTC facilities are also identified. DESIGN, SETTING AND PARTICIPANTS cross-sectional survey of directors of care in all licensed LTC facilities in the province of Ontario, Canada. RESULTS directors of care from 426 (76.9% response rate) licensed LTC facilities completed a postal-survey questionnaire. Topics identified as very important for staff education included pain and symptom management and communication with family members about EoL care. Priorities for family education included respecting the residents' expressed wishes for care and communication about EoL care. Having sufficient institutional resources was identified as a major barrier to providing continuing education to both staff and families. CONCLUSION through examining educational needs in EoL care this study identified an environment of inadequate staffing and over-burdened care providers. The importance of increased staffing concomitant with education is a priority for LTC facilities.
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Affiliation(s)
- Kevin Brazil
- Department of Clinical Epidemiology and Biostatistics, McMaster University, and St Joseph's Health System Research Network, 105 Main Street East, Level P1, Hamilton, Ontario, Canada L8N 1G6, UK.
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