Paper
Wednesday, July 21, 2004
This presentation is part of : Implementation of Research Evidence Into Practice: International Perspectives and Initiatives
Translating Research into Practice: A United States Perspective
Marita Titler, PhD, RN, FAAN, Department of Nursing Services and Patient Care, Department of Nursing Services and Patient Care, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
Objective: This paper overviews the state of the science of translation research in the United States, using examples to illustrate major findings.

Design/Methods: A variety of electronic and manual search strategies were used to access studies, including studies funded by federal agencies. Translating research into practice (TRIP) studies were reviewed, critiqued, and synthesized to summarize research methods and findings.

Variables: Study purpose, methods, TRIP interventions tested, adherence to evidence-based practices (EBPs), and effect on patient outcomes were compared across TRIP studies. Findings from each study were summarized.

Findings: Most studies focused on clinical versus organizational EBPs. Descriptive, cross-sectional, and experimental methods have been employed. Lack of comparison groups in some studies poses threats to internal validity. A variety of single and multifaceted TRIP interventions have been tested. Both qualitative and quantitative methods have been used. Improved patient outcomes and adherence to EBPs are demonstrated when multifaceted TRIP interventions are employed. TRIP science has evolved from demonstration projects to TRIP intervention testing. Few studies have used randomized clinical trials to test TRIP interventions. Several methodological challenges (e.g. methods of measuring adherence, organization context) remain in TRIP science.

Conclusions/Implications: More experimental designs are needed to test TRIP interventions, and more studies on organizational variables are necessary. Methods for measuring TRIP intervention “dose” are lacking. Factors that impact use of EBPs include complexity of the EBP topic, organizational context, single versus multifaceted TRIP interventions, methods of communicating the EBPs to healthcare providers, and integration of the evidence into organizational structures and processes (e.g. documentation systems). Given the state of the science in the U.S., priority should be on conducting experimental studies to test the effective of TRIP interventions and to gaining a better understanding about what TRIP interventions work in what context and with what types of clinical and administrative topics.

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Sigma Theta Tau International
July 21, 2004