A comprehensive overview of implementation science in nursing
Evidence-based practice (EBP) is no longer a buzzword in nursing circles. Through EBP, nurses can bridge the theory-to-practice gap and deliver advanced patient care using the most recent healthcare findings. EBP requires research to help nurses learn more about specific health protocols for various situations.
Nurses can make informed decisions and find effective treatment techniques through comprehensive research. Regardless of their healthcare institution, nurses use EBP by initially collecting the patient’s medical history and taking vital signs to identify the issue. Once the information has been collected, nurses will analyze the evidence, apply the findings to clinical practice, and assess the results to find ways to improve treatment.
By combining research, expertise, and clinical experience, EBP empowers nurses to find proven treatments that increase patient recovery. It is because, rather than a standardized approach, EBP allows nurses to use their scientific knowledge to determine the best care models. However, for EBP to work, nurses must understand the underlying discipline that surrounds it, known as implementation science.
What is implementation science in nursing?
Implementation science is a framework for integrating EBP in nursing. It tackles the methods for promoting research findings and evidence in nursing policies and practice. Healthcare practitioners can use implementation science to address the difficulties of transmitting health research advancements to practice more quickly.
This, in turn, bridges the service-to-science gap and allows nurses to integrate the best evidence with clinical expertise to ensure positive patient outcomes. It is worth noting that implementation science can be applied by any discipline related to improving human health and well-being through the delivery of services. It also shares several characteristics with the rigorous strategy of clinical research.
Nevertheless, implementation science is unique in that it attends to factors in addition to the effectiveness of the clinical innovation itself, including determining and resolving barriers and facilitators to the uptake of evidence-based clinical innovations. Moreover, implementation science differs from intervention research since it concentrates on the strategies used to implement EBPs instead of intervention effectiveness.
However, for an intervention or practice to be evidence-based, it must be supported by sufficient evaluative proof. Outcome information should be assessed after an EBP has been applied with fidelity to the implementation design and intervention. For EBP to reach its expected outcomes, constant verification and ongoing feedback should be conducted for evidence-based programs to work in the real world.
Doing so empowers nurses to close the gap between what they know and what they do by determining and solving the barriers that slow or halt the uptake of verified medical interventions. According to Science Direct, implementation remains the most challenging component of EBP. By incorporating implementation science strategies, nurses can facilitate successful EBP uptake in clinical settings and reduce practice variations.
Despite efforts to promote evidence-based nursing, there is a rift between clinical practice and research findings. With much of the solid evidence in medical care being theoretical, nursing research has insufficient impact and relevance when trying to implement new research, resulting in this evidence-to-clinic gap. Taking advantage of implementation science allows nurses to bridge this gap and energize the translational pipeline. It is because embracing implementation science allows them to reinvigorate and power the entire profession toward a new research paradigm with a significant potential impact on patient care.
Critical elements of implementation science
Implementation science comprises several core components. These implementation drivers extend to the nurse, the healthcare staff, and the organization delivering the intervention, together with support and training, to translate the intervention with fidelity at multiple degrees.
Evidence is the core of implementation science. For clinical practice and public health, the evidence includes intersecting proof of burden and etiology, the effectiveness of interventions, and dissemination and implementation.
However, for healthcare leaders to intersect these gaps, they must reconsider how the evidence is identified, improve their understanding of the contextual effects of implementation, and sharpen their concentration on health equity. Moreover, they must also conduct more policy implementation research and evaluation to learn from different audience and stakeholder perspectives.
Dissemination of effectiveness research
Dissemination researchers and practitioners must thoroughly consider strategies for translating evidence into practice to optimize health outcomes. While significant effort has gone into developing nursing guidelines, science reveals little about the relative effectiveness of communicating them to practicing nurses to ensure they are incorporated into practice.
As part of the implementation science process, healthcare leaders conduct evaluative research into various dissemination methods and implementation guidelines to meet the demand for clinical effectiveness. Attention to these fundamental concepts is critical in evaluating the successes and failures of an EBP nursing program. Furthermore, disseminating effective research can raise awareness and foster collaboration among colleagues to ensure the implementation of EBP and move the practice forward.
Comparative effectiveness research
Comparative effectiveness research involves developing and synthesizing evidence that contrasts the pros and cons of alternative strategies to prevent, diagnose, and monitor a health condition or improve care delivery. Its primary goal is to help nurses and policymakers make educated decisions to improve healthcare at the individual and population levels.
Integration of treatments and interventions
Once staff members adopt EBP, the implementation science framework can integrate proposed treatments and interventions at multiple levels for real-world application. With a better understanding of implementation science, nurses can improve their capacity for and share combined knowledge to integrate treatments and interventions using EBP and overcome specific barriers.
For this to work, nurses must understand the variables related to core components that may explain particular outcomes. After all, a lack of attention to these implementation drivers can lead to a premature end to the adoption of a practice. It means providing enough flexibility in implementation fidelity to leave room for innovation and the translation of research to different disciplines, practice settings, and populations.
Audit and feedback
Continuous evaluation of performance indicators is also conducted to aggregate data into reports during the practice change. It allows leaders to uncover inconsistencies in the descriptions of interventions and their content and hash out any issues should there be a lack of clarity regarding the intervention target. By incorporating these measures, you can gain insights into why some implementation strategies work in some settings and the mechanisms underlying the effectiveness of these schemes.
How can nurses use implementation science to advance nursing?
Nurses interested in implementation science can position themselves as future global leaders who can improve patient outcomes and lower healthcare costs. Recent data shows the US spends nearly 18% of its gross domestic product on healthcare, significantly higher than any other developed nation. What makes it worse is that the nation ranks among the lowest in patient outcomes.
As the healthcare sector strives to limit expenses and improve care quality, implementation of science becomes key to shifting toward best practices and embracing new processes. However, to reap the benefits of implementation science, nurses must first understand how to apply basic science techniques to advance the profession. It allows them to take their laboratory findings in systems biology, immunology, and genetics to the next level and develop them for use in real-world healthcare.
Create clinically relevant queries
While fundamental science is at the center of therapeutic innovations, nurses must learn how to create relevant and strategic questions to move the findings out of the laboratory and into the clinic. Doing so empowers nurses to conduct a more efficient application of research findings and accelerate translating research into action. By understanding the basic research underlying discoveries and the clinical landscape, nurses can frame the appropriate queries and determine the critical resources needed to steer the process forward.
Establish multidisciplinary collaborations
Nurses must facilitate collaborations with experts involved in different stages of the drawn-out process of translating implementation science into discoveries and practices that can be used in the clinic. Although there is a significant gap between fundamental discovery research and efforts to use knowledge in clinical care, a multidisciplinary strategy can address this barrier and develop innovative ways to transform the practice, ultimately improving health outcomes for different populations. Furthermore, working with researchers, funders, policymakers, epidemiologists, and other clinicians interested in outcomes can help uncover nursing advances that can be brought to fruition more effectively.
Relate research to cases
Nurses can use clinical findings and studies in the laboratory to increase their understanding of what happened and uncover new treatments. Tying together case studies, clinical research, and essential observations enables nurses to develop new care approaches to improve outcomes. Moreover, implementation science also helps nurses tailor their approaches to specific patient goals to achieve the goal of more precise, predictable, and robust nursing care.
Communicate research for collaboration
Nursing research is moving faster than at any time in history. So, it is no surprise that nurses must learn to be skilled and adapt quickly to innovations and technologies. By communicating research across multiple departments, nurses can provide new perspectives and insights into implementation science and address the needs of diverse clinical settings.
Adopting an implementation science continuum gives nursing management a structure to benchmark their progress toward advancing the profession. Doing so lets them strengthen nursing research, incorporate patient needs, and support adopting the best medical and health practices.
How can nurses learn more about implementation science?
Although implementation science is relatively new, it has taken center stage in uncovering new therapies, medical procedures, and diagnostics. So, nursing leaders must take steps to increase or advance knowledge through systematic investigation and learn more about implementation science to remain competitive in a cutthroat field.
Join healthcare-focused groups
Belonging to a professional organization allows nurses to learn and become more involved with implementation science. As mentioned above, implementation science is a new concept, meaning there is plenty of wiggle room to take advantage of it. Moreover, professional nursing organizations also understand the industry’s challenges and work with public officials to advocate for policy changes.
In addition, most professional nursing organizations partner with investigators and scientists, launching significant efforts to translate research into practice. While implementation science is groundbreaking, getting everyone on board requires more significant incentives and structural support. Joining a professional nursing group lets you get the structure and support you need to gain clarity around critical concepts involving nurses’ research participation.
Take advanced nursing courses
Taking comprehensive online nursing Ph.D. programs from leading academic institutions such as Wilkes University is another way for nurses to understand how implementation science accelerates research discoveries that impact healthcare practices. Depending on your chosen academic institution, you will take courses that provide an overview of the basic definitions and key concepts related to clinical and implementation science. You will also learn about the different phases of implementation science and the barriers that halt progress across the spectrum.
While working towards your degree, you’ll conduct thorough observational studies, proof-of-concept research, clinical trials, and several case studies to prepare for nursing research and leadership roles. Studying nursing is also a smart choice since most of your classes will concentrate on theory, statistics, analysis, and other elements of nursing research and education, which can be beneficial in understanding the complexities of implementation science. Each academic institution has specific requirements when applying for a Ph.D. nursing program, such as a 3.0 undergraduate GPA or 3.5 graduate GPA, an undergraduate nursing degree, a resume, transcripts of records, and graduate record examination scores for non-graduate degree holders.
Complete a mentored career development program
A mentored career development program is an excellent option for existing nurses to learn more about implementation science. More often than not, a career development program requires you to spend at least three years working under the supervision of a skilled and experienced mentor. It allows you to improve your research skills and understand the inner workings of leading a research team.
Furthermore, a mentored career development program will offer you a comprehensive understanding of physiology, human anatomy, and the health conditions impacting your patients. Using their high-level knowledge, mentors will offer ways on how you can assess patients properly, develop comprehensive treatment plans, and conduct extensive clinical research to understand the appropriate methods for addressing medical conditions.
Advancing the nursing practice through implementation science
As the nursing industry undergoes a systemic change impacting the overall patient experience, nurse leaders must seek to produce more meaningful and applicable results that directly benefit human health. By taking advantage of implementation science, nurse leaders can translate fundamental scientific discoveries more quickly and efficiently into practice and make specific changes that move the profession forward.