Knowledge translation

The human cervix: Comprehensive review of innervation and clinical significance

Detailed knowledge regarding the innervation and histology of the human cervix is crucial given the surgical removal of this tissue for conditions such as cervical dysplasia. Recent evidence implicates the cervix in the sexual response, making it pertinent to characterize this region to elucidate its role. Despite this, literature describing the overall innervation of the cervix from anatomical and histological perspectives is lacking. The aim of this review was to consolidate descriptions pertaining to human cervix innervation and discuss possible mechanisms of dysfunction, as an unintended result of cervix removal. A detailed literature search of relevant articles describing human cervix innervation was conducted. 1597 articles were screened based on the keywords searched. Only 16 articles, containing information regarding specific evidence of the innervation of the human cervix, were included and categorized based on parameters of innervation (method, type, location). The published evidence demonstrates that the human cervix has sympathetic, parasympathetic, and sensory innervation, but does not characterize changes after surgical procedures. Despite the gaps in knowledge, it is relevant that associations linking clinical procedures, involving cervical removal and adverse sexual health outcomes, become an important focus for discussions between physicians and patients. Future work is needed to better detail the affected innervation as well as the neural pathway-specific relationship to symptoms of sexual dysfunction.

Evidence-Based Analysis of Protected Mealtime Policies on Patient Nutrition and Care

Malnutrition in hospitalized patients remains a significant problem. Protected Mealtimes is a complex, inter-professional ward-based intervention that was first introduced in the United Kingdom to address this issue. Now implemented internationally, the approach still remains in key policy documents including the National Health Service Essence of Care. This review aims to synthesize the nutrition, satisfaction and quality of life patient/resident outcomes that arise from the implementation of Protected Mealtimes in hospitals and residential aged care facilities and to consider fidelity issues that have been reported in previous research. A defined search strategy was implemented in seven databases to identify full text papers of original research that evaluated Protected Mealtimes implementation. After screening, data were extracted from eight studies (7 quantitative and 1 qualitative study) that were conducted in hospitals. There was no research identified from the aged care sector. There were few positive outcomes that resulted from Protected Mealtimes implementation, many fidelity issues with the intervention were reported. It is apparent that Protected Mealtimes provide few, if any, benefits for hospitalized patients. It is a complex, multi-pronged initiative that has limited fidelity and limited outcomes. As such, we recommend that disinvestment by policy makers for hospitals should be considered, with the implementation of other evidence based mealtime initiatives. We provide no recommendation for disinvestment in the aged care sector, since the approach has not been evaluated against any of the eligible outcomes of this review.

Knowledge translation: A concept analysis

AIM

The aim of this article is to clarify the concept of knowledge translation (KT) to close the gap that exists between research knowledge and actionable nursing practice.

BACKGROUND

KT addresses the research to practice gap that exists in healthcare. KT is often confused with other terms and needs to be defined further as a concept for clarification and application in nursing practice.

DESIGN

Concept analysis using the Walker and Avant method.

DATA SOURCES

Databases searched were OVID, CINAHL, ProQuest, Mendeley, Western Libraries, and Google Scholar. Keywords used were "knowledge translation", "knowledge", "translation", "evidence-based practice", "research dissemination". Abstracts were reviewed for relevance, and 27 articles available in full-text and in English from 2000 to 2018 were retained. Online dictionaries included Merriam-Webster. The ancestry method was also used to retrieve relevant articles.

RESULTS

KT is one of many terms used to describe the concept of moving research to actionable practice in healthcare. Six attributes of KT were identified: collaboration, action, receptivity, process, translation, and improved healthcare outcomes.

CONCLUSIONS

Nurses are responsible to provide the best care to their patients, and effectively using KT in nursing practice can ensure better outcomes for patients.

Nutrition Knowledge Translation Performance in Health Professionals: Findings from the 2017 Unified Forces Preventive Nutrition Conference (UFPN)

Background: Dietitians and other health care professionals must be able to translate findings from clinical trials into best treatment practices, a skill termed “knowledge translation”. This skill requires knowledge of treatment guidelines as well as the science underpinning treatment recommendations. Unsatisfactory knowledge translation of medical nutrition therapy (MNT) has been documented. Methods: Individuals registered to attend a leading national nutrition conference were asked to participate in an online cross-sectional survey. Participants were asked to provide demographic and professional information, answer questions on nutrition knowledge and to choose a clinical action plan in response to dietitian-designed case vignettes describing research outcomes. Responses were compared by profession and participation in research activities. Results: Of 3000 registered conference attendees, 299 individuals replied: 79.0% dietitians, 93.3% female, with a mean household income matching the 5th decile of income, 60.7% indicated a single employment setting, 20.7% reported participating in research. Almost 74% of respondents indicated that they would make clinical recommendations based on findings of an in vitro study. In one vignette, a patient with a disease previously not encountered by the respondent required a clinical treatment plan. Only 53% of participants chose to seek formal nutrition guidelines. Fewer than 15% of participants could identify the pathway for fat during weight loss. Differences in knowledge translation skills by research participation were not detected. Conclusions: Our findings reveal a deficit in knowledge translation proficiency in a convenience sample of dietitians and other health professionals, highlighting the need to develop these skills.