Insights Into Global Collaboration for Building Capacity, Scholarship, and Impact in Evidence-Based Nursing

The advancement of evidence-based nursing to demonstrate how global collaboration contributes in practical ways to building capacity, scholarship and impact in evidence-based nursing. Previous case exemplars have shown capacity for nurses to engage in best practice is increased through the sharing of resources and methods based upon a standard model for evidence-based healthcare. (Lockwood & Lee, 2015) The rapid global growth of evidence-based nursing practice has been facilitated by the Joanna Briggs Institute Model as a framework for identifying and evaluating resources for practice, as well as for guiding complex implementation studies.(Campbell JM, 2015; Munn et al., 2015) To demonstrate how global collaboration based upon this model has impacted evidence-based nursing, this presentation will discuss and present a) how the growth of a global collaboration is demonstrated through its core achievements b) that capacity building in scholarship has emerged though global collaboration, and c) how global collaboration has created opportunity for local, national and international impact.

Body

1. History of JBI/JBC and its growth of the last 20 years with the development of regional groups/how JBI works/how regions have developed and grown as part of the JBC

This section presents an overview of the history of JBI/JBC, showing key steps in the growth of the collaboration, using quotes and practical examples to illustrate the objective.

In 1995 the global healthcare movement for evidence-based practice (EBP) was emergent, methods and resources were in development, but Medicine and Midwifery were the most advanced groups, nursing lacked groups operating globally with a focus on EBP in nursing practice. The Joanna Briggs Institute (JBI) launched as a collaboration in 1995 to address this gap and to focus on implementation, not just accumulation of evidence. Commencing with centres in Australia, Hong Kong and New Zealand, all with a focus on developing evidence for best practice in nursing. Queens University, Canada joined in 2004, by which time there were also centres in Thailand, South Africa, the UK, China and Spain. Indiana, New Jersey and Oklahoma joined in 2005. Nursing was becoming a mainstream force in methods and methodology for EBHC, based upon a standard model, and shared resources and knowledge to draw on the collective international power of nurse clinicians, academics and researchers from around the world. (Jordan, Lockwood, Aromataris, & Munn, 2016) Setting up the mechanisms, decision making processes and governance around engagement with professional nursing practice was a key driver for global growth and impact.

When centres in South Africa and Asia joined, the notion that western evidence was good enough proved false, research questions from African and Asian nurses knowledge and practice needs were different. One important impact of this global nursing collaboration was JBI and the JBC advocated for qualitative evidence, practical application to clinical care and policy and ensuring tools and resources for EBP were suited to a global collaboration. This was evidence in the translation of JBI evidence in to different languages, and the types of systematic review questions that were now being developed, and the number of systematic reviews being produced internationally though collaboration.

1. Scholarship of synthesis that has emerged from the collaboration (methods groups, monographs, GRADE, GIN)

This section highlights how capacity has been increased, and continues to increase through collaboration; in particular some of the cultural and scholarly strengths from different regions are to be highlighted.

As an established global collaboration, JBI has had the effect of increasing nursing visibility with other global and national groups, adding value to regional collaborations through the skills and resources acquired in the scholarship of synthesis, and through participation in methodology groups. Evidence of scholarship in methodology and methods of systematic reviews, includes the production of high quality reviews, and the publication of systematic reviews with a focus on nursing care. The development of qualitative synthesis methodology to inform clinical practice was a JBI innovation, with the software for meta-aggregation launched in 2001. The impact globally on other methodologies has been significant as JBI developed the methodology for synthesis of qualitative studies focused on answering questions about nurses and patients’ experiences of healthcare, developing recommendations informed by practice theory. This has led to huge increases in conduct of qualitative systematic reviews, and of the science and scholarship associated with qualitative synthesis, including JBI/JBC representation and contributions via a GRADE Centre, to Guidelines International Network (G-I-N) and the Cochrane Collaboration, in addition to novel developments in systematic review methodology. (Lockwood, Munn, & Porritt, 2015)

iii. How has engagement in collaboration let to local, national, international influence and impact.

This section of the presentation will illustrate through practical examples how and why local, national and international impact for evidence-based nursing has been achieved through global collaboration.

The JBI model is the heart of our global collaboration, and provides a framework for evidence synthesis, transfer (education) and implementation.(Jordan et al., 2016) As such, it informed the development and global launch of the Clinical Fellowship Program – which enables clinicians to develop and implement findings from a best practice study, with evidence from systematic reviews guiding the implementation process. It is a unique global program, informed by international evidence yet effective within a diverse range of local contexts.

In Australia, a series of projects on evidence-based criteria-led discharge aimed to enable participants to explore strategies to promote evidence utilization and application as it relates to Criteria Led Discharge (CLD) and to collaboratively develop understandings related to clinical leadership and change management in healthcare. Seven hospitals and two regional health services participated, and the results of this project will be presented as evidence of local impact from collaboration in systematic reviews for nursing practices.

In Canada, the Queen’s Collaboration for Health Care Quality: A JBI Centre of Excellence (QcHcQ) established in 2004, created a National Community of Practice for support and mentorship of additional developing JBI Centres throughout the country. This ongoing support has enticed the engagement of faculty as well as graduate students in the process of evidence synthesis as part of their dissertation work. It is evident from the high level of articulation of the issues explored in comprehensive exams and the clarity of problem definition in dissertation manuscripts that this process of evidence synthesis has contributed to a rise in the level of scholarship of those in graduate studies.

At an international level, collaboration between QcHcQ and the Consortium for Advanced Research and Training in Africa (CARTA) will sponsor the training of library scientists from nine universities in Africa and will result in mentorship of these librarians as they support their research teams through the process of evidence synthesis. It is anticipated and hoped with the engagement in evidence synthesis that likewise, the level of scholarship can be raised in these African centres.

Conclusions

Global collaboration as demonstrated in this presentation is an efficient and effective model for scholarship, for evidence-based nursing and for impact of nursing evidence on clinical practice. Local collaboration has resulted in context specific evidence, yet the framework of a model for evidence-based healthcare has been successful in ensuring engaged groups model for growth while maintaining a core focus on a well-defined mission and vision for evidence-based nursing.