Objective: To develop an index that reflects level of adoption of an evidence-based practice (EBP) guideline for acute pain management in elders.
Design: This work is part of an experimental study to test the effects of a translating research into practice intervention. Items/indicators (N=50) were generated from the EBP guideline, analyzed by 5 experts, reduced to 32, and grouped into care categories of minimal, good and excellent care.
Sample: This initial instrument was applied to data abstracted from 2110 medical records of patients greater than 65 years of age, admitted to a study hospital (N=12) for hip fracture to determine initial utility.
The major concept is level of adoption of an EBP guideline, measured by an overall index that reflects level of evidence-based (EB) care received by elders in acute pain.
Methods: The initial categorization as minimal, good and excellent care provided little utility to reflect level of EB care. Indicators were revised, reduced to 18 critical indicators, and reviewed by the panel of experts. If a patient received care that meets the criteria for a given indicator, the indicator is assigned a value of 1, and if care does not meet the specified criteria, the indicator is assigned a value of 0. Values assigned to 18 indicators are summed to derive a score of EB care with a range of 0 to 18. The index was applied to the above sample.
Findings: This summative index demonstrates variability (SD of 3.1 to 5.0) of EB care and is a finer discrimination of care received as compared to the original tool. This index discriminates (p<.001) the level of EB care patients received in the experimental and control group.
Implications: A summative index has great utility for translation research that tests interventions for promoting adoption of EBP guidelines.
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