The Ottawa Model of Research Use: Lessons Learned From a Nurse-Led Hypertension Pilot Study

Background: Cardiovascular disease accounts for 27% of all deaths from non-communicable diseases (NCDs) in Uganda. It is estimated that the hypertension prevalence rates in Uganda range from 22.5% to 30.5%. Hypertension is a risk factor in the development of atherosclerosis the underlying pathological process that leads to heart attacks (coronary heart disease) and strokes (cerebrovascular disease).  Most of these deaths are due to modifiable risk factors. Information on the best strategies to address the burden of disease from hypertension through knowledge translation in Uganda is still lacking and requires a concerted effort between health care professionals and public policy officials. Knowledge Translation (KT) is a tool increasingly being used to coordinate and assess strategies to improve health outcomes. This study illustrates the effectiveness of implementing CVD-Risk management guidelines developed by the World Health Organization/International Society of Hypertension (WHO/ISH) among nurses working in an outpatient clinic in Uganda using the Ottawa Model of Research Use as a practice translation model.

Methods: A descriptive and feasibility pilot study using the Ottawa Model of Research Use (OMRU) as the guiding framework involving a convenient sample of nurses was completed in 2013. The six step approach of the OMRU was used to assess barriers and facilitators, monitor interventions and evaluate outcomes of this KT pilot study. Primary outcomes data were collected using pre-post interventions tests that assessed nurses’ knowledge, skills and attitudes about hypertension risk assessment and management before and after implementing a three month educational intervention using the WHO-ISH training manual as a resource. Outcomes data were entered and analyzed using the SPSS16. 0 version. Paired t-tests were run on outcomes data and reported.

Results: There was significant improvement in knowledge, skills and attitudes after three months of implementing multimodal educational strategies using the WHO/ISH training manual in this knowledge to practice translation study. Other outcomes observed but not intended were: improved team members’ perceptions, health system’s change and increased number of self-referrals from nearby health centers.

Conclusions: The Ottawa Model of Research Use provided the framework for implementing a successful nurse-led care intervention in hypertension management with improved knowledge, skills and attitudes among nurses.  Knowledge translation (KT) Models need to be integrated in health professional education to promote use of evidence based practice for better patient outcomes.