The role of DNP for translating evidence into practice
Introduction
Translational research means different things to different people. Most people use the term in reference to the bench-to-bedside concept where knowledge is harnessed from basic sciences to produce devices, new drugs and treatment options aimed at improving the health of the patients. This discussion therefore delineates on the concept of transnational research putting into perspective the role of Doctoral Nurse Practice (DNP) in translating evidence into practice. It further provides a discussion on the aspect of inter-professional collaboration and teamwork.
Background
Transnational research is a concept that involves transferring of knowledge and discovery gained from basic sciences and applying the same in clinical and community setting. The phrase ‘bench-to-bedside’ and bedside to community research (Woolf, 2009) summarize translational research. Medical practitioners translate the scientific research knowledge to useful use in the quest to enhance healthcare. This concept has evolved with time and it encompasses a continuum that is bidirectional. It is described into phases, ‘T-phases’. T1 phase is the enterprise where knowledge is translated from basic sciences to the development of new treatment while T2 research is where the findings from clinical trials are translated into everyday practice (UC San Diego, 2013). Therefore, the goals of this kind of translational research are to develop knowledge and then transform it into tangible use aimed at improving the lives of the patients.
Development of translational research has taken some time. The National Institutes of Health (NIH) made this kind of research its major priority making it grow and develop. The NIH formed various centers and institutes that saw the launching of the clinical and translational science award (CTSA) program in 2006. The CTSA grant compelled many other people to form institutions such as universities to compete for the same. Apart from academic centers, disease related organizations, industries, foundations and individual hospitals and health systems embraced translational research programs that have contributed in its growth and development (Woolf, 2009). Because of the continued benefit from this kind of research, it has been found essential in enhancing the health of the patients despite huge budget for financing its operations.
Translational research is important in providing quality care in various ways. It allows translation of research into practice and in this, it ensures that new treatments are developed and the research knowledge available reaches the population or the patients for whom they are intended. It further ensures that these are implemented correctly (Titler, 2007). Translational research furthermore, helps to fill the gaps and improve quality by improving accessibility, reorganizing and coordinating of subsystems of care. It also helps clinicians, patients to change their behavior and enable them to make more informed choices through provision of reminders, point of care decision support tools and as well they strengthen the patient clinician relationship. If the relationship between the clinicians and the patients is positive, then it becomes easier and the quality of care provided also improves. Consequently, this kind of research is valuable in provision of proper healthcare.
Doctor of nursing practice (DNP) main goal is to translate evidence into practice in the quest to improve the quality of care and safety of their patients. They also enhance positive patient’s outcomes (Woolf, 2009). These healthcare professionals are exposed to training programs that equips them with relevant skills and knowledge to expedite these services well. They must impact on the practice, be in a position to design and implement programs geared at improving the health and healthcare delivery, apply informatics skills and data management skills to evaluate outcomes and as well influence policy. For them to expedite these services appropriately they need to follow the various steps of research translation- evidence based practice.
The first step is to prepare adequately. The purpose of the consulting evidence need to be identified at this stage (National Collaborating Center for Methods and Tools, 2013). Furthermore factoring in the contextual factors that may influence the implementation process is essential. The second step is validation, which entails assessment of the evidence to affirm the overall credibility, applicability and operational details with assumptions that a weak study may become beneficial by providing useful information as additional evidence. Finding or testing for credibility of the source is essential because it will have an impact on the overall processes (National Collaborating Center for Methods and Tools, 2013). The third step is comparative evaluation/decision making. DNP have the responsibility to make concise decision pertaining the evidence they are presented. The evidence across all the validated sources is compared and determination of the desirable or feasible findings is selected. The applicability of the decision selected should be verified. The option selected needs to have the highest overall strength compared to other alternatives.
In making decision, the DNP makes a decision out of the choices available to them. One of them is to make a decision to use the research findings by accepting and putting the knowledge into effects and moving forward by adopting appropriate types of uses. The DNP can also consider gathering more information before acting upon the available evidence (Scott-Findlay & Golden-Biddle, 2005). The third option in making decision is delay using the findings incase more research is required to be conducted on some aspects. The last decision option is to reject or fail to use the research finding because they might not be measuring up to the standards.
Stage four is translation or application of the study function or putting into action to trigger change. The summary statements from stage three are used to help provide a mechanism for implementation and synthesizing of the information. The last step is evaluation where expected outcomes are clarified relative to purposes of seeking or researching the evidence and establishing whether the evidence is to be directly used or not. Costs-benefit of various evaluation benefits are also put into consideration. Evaluation is of importance because it ensures that the evidence is tested and works effectively to ensure that the evidence is put into practice.
Some of the roles that DNP does is putting into consideration, these steps includes demonstration of accountability in their areas of specialty in accordance to the accepted standards of patient care and safety. They also translate the research findings into evidence-based practices at the healthcare systems as well as individual system levels in the quest to enhance and improve the quality of healthcare (Byles, 2011). They also use information technology in their evaluation of delivery of health care to people and as well as internal and community systems. They also must demonstrate high or advanced knowledge and skills in their planning and delivery of health and illness management in a certain nursing specialized area.
Inter-professional collaboration and teamwork is essential in the delivery of healthcare and in impacting on the patient care. When professionals work together in healthcare organizations, the potential of achieving high reliability and results is high. Due to the above, cooperation is imperative in healthcare providers that want to ensure patient care (Queen’s University, 2013). Effective teamwork in healthcare deterred or affected by miscommunication with other professionals and misunderstanding or roles and responsibilities. This then causes many of the health providers to work independently a practice that hinder positive performance. Some of the common barriers to inter-professional collaboration and teamwork include status, personal values and expectations, personal differences, culture and ethnic, historical inter-professional and intra-professional rivalries and differences in language among others (Queen’s University, 2013). However, these differences can be solved if the health professional have a common goal in their service d pro-vision. Regardless of these differences, the importance of inter-professional teams in healthcare has been increasing because of various reasons. Some of the reasons include, increase in co-morbidities, increased complexity and specialization care and global workforce shortage among others.
In conclusion, translation research has gained approval in the last few years because of the immense benefits it has had on the healthcare. This kind of research is categorized into two dimensions; the first one is concerned with knowledge acquisition and the second with translation of the knowledge and outcomes to improve the quality of life through provision of quality care. DNP has various roles when it comes to translating research. They provide fundmanetal healthcare services by applying their skills and knowledge inn expediting their roles. They also adhere to various stages of research translation evidence based practice. Teamwork and inter-professional is also important factor in the management and provision of healthcare. When health providers collaborate, the chances of being reliable are higher. It is thus essential, that healthcare providers , DNP included endeavor to use the evidence they have to provide better healthcare to impact on the quality of life of the all the people.
References
Byles, J. (2011). Examination of the utility of the promoting action on Research implementation in health services framework for implementation of evidence based practice in residential aged care settings. Journal of Advanced Nursing, 67, 2139-2150.
Queen’s University. (2013). Interprofessional Collaborative Practice (IPC)/Teamwork & Patient Safety. Retrieved form:
http://healthsci.queensu.ca/education/oipep/oipep_resources/issues_in_health_care/patien t_safety_in_health_care/module_4_managing_a_just_culture_of_safety/interprofessional _collaborative_practice_ipc_t
National Collaborating Center for Methods and Tools. (2013). Stetler model of evidence based practice. Retrieved from: http://www.nccmt.ca/registry/view/eng/83.html
Scott-Findlay, S., & Golden-Biddle, K. (2005). Understanding how organizational culture shapes research use, Journal of Nursing Administration, 35(7-8), 359-365
Titler, M. (2007). Translating research into practice. American Journal of Nursing, 107(6), 26- 33.
UC San Diego. (2013). Clinical and translational research institute. Retrieved from: http://ctri.ucsd.edu/about/Pages/AboutTranslationalResearch.aspx
Woolf, S. (2009). The Meaning of Translational Research and Why It matters, JAMA, 299(2): 211-213. <http://www.uams.edu/archd/Docs/Sung%20Jama%20TranslationalResearch%20Article .pdf>
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