how would you describe “translating research into practice” to a colleague?
This weeks Reed & Sharer Ch 6 explored the DNP Project: Translating Research into Knowledge for Practice, how would you describe “translating research into practice” to a colleague? and What are characteristics of a DNP project that enable generation of practice-relevant knowledge?
Also, Ch 7; Mindfulness and Knowldge development in Nursing Practice, the chapter outlined a guide for insight meditation leading to mindfulness practice that can be followed by DNP and PhD nurses. How might you use insight meditation in your own practice to move nursing knowledge forward in a new way?
Reed & Shearer describe in Chapter 6, what translating research into practice is. If I were to explain this to a colleague, I would tell them that translating research into practice is to use evidence-based research to drive changes in current nursing practices to improve patient safety. Research evidence alone is insufficient for effective practice. It is important to utilize resources such as the patient and their family to know what knowledge and values they uphold to appropriately treat them (Reed & Shearer, 2018). Patient safety is my number one concern. I remember at the beginning of Covid-19, my hospital was not prone positioning their non-intubated patients at first. After receiving evidence-based research on how patients with Covid-19 exhibiting respiratory distress symptoms and were at risk for intubation, benefited from prone positioning. Therefore, my hospital started implementing this evidence-based research into our practice, which has helped improve oxygen saturation in Covid-19 patients.
According to Kitson & Harvey (2016), novice, experienced, and expert DNPs have demonstrated important and balancing parts that allow a successful translation of evidence into everyday practice to provide proper care for patients. The DNP project is a mechanism for teaching nursing practice knowledge to generations to promote research and improve clinical outcomes (Reed & Shearer, 2018). Knowledge translation involves the nurse’s use of research and practice-based, ethical, and personal. Three examples of knowledge translation models are Knowledge to Action Framework, Project Process Model, and SQUIRE (Reed & Shearer, 2018). An advantage of the Knowledge to Action Framework is that this framework combines both the research process and the practice dimension. These two tops are critical in the knowledge translation of clinical scholarship (Reed & Shearer, 2018). Furthermore, all these models integrate practice-based research and practice-based evidence to enhance patient outcomes and health care system change (Reed & Shearer, 2018). It is important that these models all help improve patient safety.
Practicing mediation can lead to mindfulness practice for both DNP and PhD nurses. According to Reed & Shearer (2018), mindfulness has garnered increased attention and supporting evidence across health-related disciplines. Mindfulness can be described as paying attention in a particular way, on purpose, in the moment, and non-judgmentally (Reed & Shearer, 2018). I enjoyed reading how meditation can help a person gain control. It is important to put aside negative thoughts and control brain chatter. I need to work more on this. It is important to focus on the positive. If you focus on the positive, it can help you gain more self-control and be more content with yourself. Prior to this reading, I did not know about insight mediation. I feel that this can help me destress after work and help me focus on the good in my life. After hard shifts, I am going to incorporate into this into my daily routine to help me be a better version of myself.
References
Kitson, A. L., & Harvey, G. (2016). Methods to succeed in effective knowledge translation in
clinical practice. Journal of Nursing Scholarship, 48(3), 294–302. https://doi.org/10.1111/jnu.12206
Reed, P. G., & Shearer, N. B. (2018). Nursing knowledge and theory innovation: Advancing the
science of practice (2nd ed.). New York, NY: Springer Publishing Company, LLC.
In this week’s readings, Reed and Shearer (2018) place emphasis on the DNP project and translating research into practice. If I had to describe this simply to a colleague, I would say that it is a method of applying evidence based research and knowledge into real world practice, therefore, improving patient care and outcomes. Reed and Shearer (2018) note that knowledge creation and application are cyclical and always changing based on critiques and new knowledge generation. The methodology behind the DNP project is reflective of the scientific method and aims to answer 3 questions: “What are you trying to accomplish? How will you know that a change is an improvement? What change can be made that will result in an improvement?” (Reed & Shearer, 2018, p.100). Additionally, some characteristics of a DNP project that enables generation of practice relevant knowledge can be found in figure 6.1, as shown by this figure, there are several elements needed to achieve this outcome. This design places emphasis on the metaparadigm, four domains of knowledge, theoretical models EBP and the DNP project. Each layer is fluid and nonlinear, they must all be interconnected and are reliant of the others for knowledge generation and application to practice.
In chapter 7, Reed and Shearer place emphasis on the benefits of meditation and mindfulness in relation to nursing knowledge generation. Mindfulness can be defined simply as, “an expanded awareness characterized by a purposeful and nonjudgmental attending to the present moment” (Reed & Shearer, 2018, p.108). A statement from Gunaratana (2002) resonates with me, “I want to understand the true nature of life. I want to know what this experience of being alive really is. I want to apprehend the true and deepest qualities of life, and I don’t want to just accept somebody else’s explanation. I want to see it for myself.” (Reed & Shearer, 2018, p.109). By opening one’s self up to insightful meditation we are able to experience and engage in what life has to offer, fully, in all aspects. Insightful mediation allows a nurse to practice “in the present”, this means that they are not solely focusing on being mindful which can take away from patient care, instead their mindset has already adapted and they are just practicing mindful, evidence based nursing. Additionally, insightful meditation and mindfulness allows a nurse to exhibit control resulting in self-efficacy, time and space that encourages development of new ideas and knowledge, and improved care by increasing awareness of the needs of others (Reed & Shearer, 2018).
The article from Kitson and Harvey (2016) discussed the importance of facilitators in regards to knowledge application to practice. Each participant – facilitator – is assigned a role and task. Figure 1 was really helpful in visualizing how the process works, it shows the process and an ongoing spiral trend with all elements “flowing” into the next. This is a fluid and non-linear design, as we have seen with many other methodologies so far in this course. I have experience with using a similar blueprint for knowledge application to clinical practice. My unit encourages every staff nurse and leader to engage in best practice driven initiatives in collaboration with our surgeons. For example, we recently expanded our clinical case load as well as the acuity and diversity of surgical cases. This caused a lot of gaps in knowledge and EBP. Each nurse worked closely with a surgeon and their team to learn what each patient of a specific surgical case required and then that nurse in turn provided teaching and guidance for the rest of our co-workers. Personally, I think this methodology is great, it gets everyone involved and makes each nurse feel engaged and appreciated while encouraging knowledge generation.
Resources:
Kitson, A. L., & Harvey, G. (2016). Methods to Succeed in Effective Knowledge Translation in Clinical Practice. Journal of Nursing Scholarship, 48(3), 294. https://doi-org.umasslowell.idm.oclc.org/10.1111/jnu.12206
Reed, P. & Shearer, N. (2018). Nursing Knowledge and Theory Innovation: Advancing the science of practice (2nd edition). Springer Publishing Company. Kindle Edition.
The Doctor of Nursing Practice (DNP) is the highest level of formal education for advanced nursing practice aspiring to equip practice nurses with opportunities to transcend current barriers and affirmatively impact health care while bridging research and practice (Reed & Shearer, 2018, p. 93). DNP project provides challenges as opportunities for DNP-prepared nurses to engage in practice-based research, use evidence-based practice skillsets to improve health care and health care outcomes, and reduce the time lag between knowledge discovery and its implementation in practice, and knowledge translation (KT) addresses these challenges interacting with resources including patient and family knowledge and values, other stakeholders, contextual factors, and nurses’ expertise and patterns of knowing in translating research knowledge for practice (Reed & Shearer, 2018, p. 95). KT is the generic term used to describe the process by which knowledge moves from where it was first created and refined to where it has to get to in order to make an impact on clinical practice and patient care (Kitson & Harvey, 2016, p. 294) and facilitation is a key ingredient for the smooth KT process. An experienced DNP-prepared nurse can assist the KT process as an expert facilitator and can work as a strategic leader who mentors other novice facilitators and facilitate working with the clinical team and other stakeholders, to work out what the nature of the new knowledge is that is being translated into practice. (Kitson & Harvey, 2016, p. 295).
DNP scholars engaged in practice-relevant research, experimental learning, collaboration, and contributed knowledge development and improved outcomes by the transferability of findings. DNP graduates work closely in health care setups and are experienced facilitators that evolved them as clinical scholars who “uses evidence-based practice skills to translate current best evidence to improve health care and health care outcomes, thereby transforming systems of care” (Reed & Shearer, 2018, p. 98). In Ch 6, the authors presented three models to guide characteristics of DNP projects. The “Knowledge to Action Framework” model incorporates both scientific research and evidence-based practice to generate, refine and translate the practice knowledge and presents DNP project characteristics which include identifying the problem, reviewing and selecting knowledge to implement, adapting knowledge to the local context, accessing knowledge use determinants, implementing interventions, evaluating outcomes, and determining strategies for ensuring sustained knowledge use (Reed & Shearer, 2018, p. 98-99). In addition, the DNP project changes, or intervention should answer the model for improvement (MFI) questions like, “What are you trying to accomplish?”, “How will you know that a change is an improvement?”, and “What change can be made that will result in an improvement?”, and quality improvement (QI) guideline to provide a template for reporting research findings regarding practice knowledge and changes that improve healthcare and healthcare outcomes, like: “Why did you start this QI project?”, “What did you do?”, “What did you find?”, and “What does this mean?” (Reed & Shearer, 2018, p. 100-101).
Insight meditation, the oldest Buddhist meditation practice, fosters mindfulness which focuses on breathing and awareness of “being in the body, with a mind” (Reed & Shearer, 2018, p. 110). Mindfulness practice and perspective is a reflective process and extremely beneficial to nurses and can help them develop skills to manage clinical stress and improve their health; increase overall attention, serenity, improve concentration, empathy, and presence with patients and families, and can increase understanding of clinical patterns and their meanings – as grounded in the expert nurses’ mindful awareness of their own beliefs and values, assessments and decisions, and knowledge and experiences (Reed & Shearer, 2018, p. 108). I witnessed numerous incidents during the Covid-19 pandemics that have affected medical professionals emotionally, mentally, physically and are on the verge of professional burnout. I have been practicing yoga, insight meditation, for a long time and I believed it has helped me in many ways, like, improving work-life balance, managing stress, helping me to recover from Covid infection in no time, and so on. Meditation helps to develop compassion and nurses cherished the qualities of empathy, self-compassion, equanimity, and mindfulness may contribute to better patient outcomes and quality in nursing practice and can enrich the nursing practice and increase opportunities for nurses to develop theoretical ideas out of their professional practice (Reed & Shearer, 2018, p. 118).
References
Reed, P. G., & Shearer, N. B. (2018). Nursing Knowledge and Theory Innovation: Advancing the Science of Practice (2nd ed.). New York, NY: Springer Publishing Company.
Kitson, A. L., Harvey, G. (2016). Methods to succeed in effective knowledge translation in clinical practice. Journal of Nursing Scholarship, 48(3), 294-302. https://doi.org/10.1111/jnu.12206
The translation of research into practice is the cornerstone of any DNP program. It is through this knowledge translation that DNP-prepared nurse will have the opportunity to move past current barriers and positively impact health care while bridging research and practice (Reed & Shearer, 2017). If I were explaining this concept to a colleague, I would first begin by explaining why this is so important. With the development of DNP programs came the increased need for knowledge dissemination. A goal of the practice doctorate is to reduce the time lag between the discovery of knowledge and its implementation in practice (Reed & Shearer, 2017). With this being said, in order to develop evidence-based practice, we first need research that generates evidence to inform practice. It is this transferability of knowledge developed through practice that contributes to improved outcomes and best practice.
The DNP project provides students with an opportunity to develop clinical scholarship by applying the tools and knowledge they’ve acquired through their education to the knowledge innovation needed in the 21st century (Reed & Shearer, 2017). There are many different models that may be used to help guide the DNP project. However, regardless of the model selected, there are certain characteristics that must be met for the DNP project to be successful. First, the DNP project should include processes essential to both scientific research and evidence-based practice. This will ensure knowledge is generated, critiqued, refined and translated into practice. Secondly, the question asked in the DNP project should be clear on what it aims to accomplish. This will guide the information gathered and ascertain the data generated is relevant to the proposed issue. Thirdly, the theoretical perspective the DNP student chooses to frame the focus of their project should be directly correlated to the issue/concern at hand. This will provide a foundation from which the DNP project will stem from. Lastly, it should be confirmed that the knowledge generated is transferable to practice. The DNP student should consider the recipients of this knowledge and how they will respond to the changes required to implement this change (Kitson & Harvey, 2016).
Mindfulness is expanded awareness marked by a purposeful and nonjudgmental focus on the present moment. Mindfulness practice among nurses allows for increased understanding of clinical patterns and their meanings while granting the nurse an opportunity to consider his/her own values and beliefs and knowledge and experiences (Reed & Shearer, 2017). I believe the use of insight meditation can be very beneficial to nurses. In this practice, the meditator concentrates on his/her breathing, making them more receptive to experiences without judgement or bias. As nurses, we are often faced with many difficulties that can cloud the mind and limit the amount of information we are able to take in. I know from my experiences, staffing shortages and limited resources can make patient care difficult and time-consuming. This often left little time for any new process improvements, creating pushback from myself and fellow colleagues on knowledge dissemination such as putting a new evidence-based guideline or protocol into practice. By utilizing the tools learned through insight meditation, we would be able to refocus and reprogram our minds, allowing for concentration on what is truly important. This resetting of thoughts can help to calm the mind and approach the situation from a different, more positive perspective. Research has also shown that regular practice of mindfulness has positive physiolocal effects on the body including reduced cortisol levels, improved immune response and reduced blood pressure and chronic pain (van der Riet et al., 2018). There have also been reported effects on mood often leading to reduced anxiety, stress and depression creating an overall sense of well-being. These effects can lead to decreased burnout, allowing nurses to remain on the frontlines where they are needed to put knowledge into practice.
References
Kitson, A. L., & Harvey, G. (2016). Methods to Succeed in Effective Knowledge Translation in Clinical Practice. Journal of Nursing Scholarship, 48(3), 294–302. https://doi.org/10.1111/jnu.12206
Reed, P. G., & Shearer, N. B. C. (2017). Nursing Knowledge and Theory Innovation. Springer Publishing.
van der Riet, P., Levett-Jones, T., & Aquino-Russell, C. (2018). The effectiveness of mindfulness meditation for nurses and nursing students: An integrated literature review. Nurse Education Today, 65, 201–211. https://doi.org/10.1016/j.nedt.2018.03.018
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