The nurse's changing role in clinical research.

The possibility of systematically sharing clinical data more quickly and effectively has increased its potential to be used in research and, as a result of changes in policy over the last decade, all nurses can now be involved in clinical research. To do this, they must think actively about the quality of data they gather, as it becomes increasingly visible to more users and can be used many times for multiple purposes. This article outlines how the research environment has changed and the implications for clinical practice.

Dashboards for improving patient care: review of the literature.

AIM: This review aimed to provide a comprehensive overview of the current state of evidence for the use of clinical and quality dashboards in health care environments. METHODS: A literature search was performed for the dates 1996-2012 on CINAHL, Medline, Embase, Cochrane Library, PsychInfo, Science Direct and ACM Digital Library. A citation search and a hand search of relevant papers were also conducted. RESULTS: One hundred and twenty two full text papers were retrieved of which 11 were included in the review. There was considerable heterogeneity in implementation setting, dashboard users and indicators used. There was evidence that in contexts where dashboards were easily accessible to clinicians (such as in the form of a screen saver) their use was associated with improved care processes and patient outcomes. CONCLUSION: There is some evidence that implementing clinical and/or quality dashboards that provide immediate access to information for clinicians can improve adherence to quality guidelines and may help improve patient outcomes. However, further high quality detailed research studies need to be conducted to obtain evidence of their efficacy and establish guidelines for their design.

International priorities for research in nursing informatics for patient care.

The Nursing Informatics International Research Network (NIIRN) is a group of experts who are collaborating on the development of internationally relevant research programs for nursing informatics. In this paper we outline key findings of a survey exploring international research priorities for nursing informatics. The survey was available online during May-August 2012. Respondents were asked to rate each of 20 listed research topics in terms of respondent's views of its priority for nursing informatics research. 468 completed surveys were received representing respondents from six World Health Organization regions. The two most highly ranked areas of importance for research were development of systems to provide real time feedback to nurses and assessment of the impact of HIT on nursing care and patient outcomes. The lowest ranked research topics were theory development and integrating genomic data into clinical information systems. The identification of these priorities provides a basis for future international collaborative research in the field of nursing informatics.

Working with industry to improve IT.

Information technology plays an increasingly important role in healthcare, with nurses split over whether this is to the benefit or detriment of nursing care. This article discusses how NHS nurses can work with those developing the technology. This approach will ensure that what is developed will be relevant to nursing care and that both nurses and patients gain the maximum benefit from advances in health technology.

Involving nurses in developing new technology.

Throughout history, nurses have been accepting of change and adapted to new ways of working. Despite this, nursing has a reputation of being obstructive to change, particularly around technology. Healthcare technology implementation is not always successful and we argue that this is because nurses and other frontline workers are not involved enough in the change process. Nurse leaders need to be actively involved in the debate over appropriate technology and resources.

Partnering industry to develop clinical information systems.

Over the past six months, the nursing team from the Department of Health's Informatics Directorate has been working with colleagues in industry to promote and share learning and understanding of issues surrounding the nursing profession. Team members were asked among other things to identify key questions senior nursing colleagues and suppliers should ask one another when considering the implementation of a new system for recording clinical information and extracting pertinent data. This article aims to encourage collaborative working and understanding of the importance of senior nurse involvement in choosing and delivering the right system for staff and patients.

Strategic leadership skills for nursing informatics.

Nurses need to integrate information and information technology into routine practice and embrace opportunities to manage care in new ways. This article describes a programme that aims to help senior nurses develop strategic leadership skills in the area of informatics.

Exploring knowledge exchange: a useful framework for practice and policy.

Knowledge translation is underpinned by a dynamic and social knowledge exchange process but there are few descriptions of how this unfolds in practice settings. This has hampered attempts to produce realistic and useful models to help policymakers and researchers understand how knowledge exchange works. This paper reports the results of research which investigated the nature of knowledge exchange. We aimed to understand whether dynamic and fluid definitions of knowledge exchange are valid and to produce a realistic, descriptive framework of knowledge exchange. Our research was informed by a realist approach. We embedded a knowledge broker within three service delivery teams across a mental health organisation in the UK, each of whom was grappling with specific challenges. The knowledge broker participated in the team's problem-solving process and collected observational fieldnotes. We also interviewed the team members. Observational and interview data were analysed quantitatively and qualitatively in order to determine and describe the nature of the knowledge exchange process in more detail. This enabled us to refine our conceptual framework of knowledge exchange. We found that knowledge exchange can be understood as a dynamic and fluid process which incorporates distinct forms of knowledge from multiple sources. Quantitative analysis illustrated that five broadly-defined components of knowledge exchange (problem, context, knowledge, activities, use) can all be in play at any one time and do not occur in a set order. Qualitative analysis revealed a number of distinct themes which better described the nature of knowledge exchange. By shedding light on the nature of knowledge exchange, our findings problematise some of the linear, technicist approaches to knowledge translation. The revised model of knowledge exchange which we propose here could therefore help to reorient thinking about knowledge exchange and act as a starting point for further exploration and evaluation of the knowledge exchange process.

Making more of IT. Interview by Lynne Pearce.

Susan Hamer is at the forefront of helping nurses to see the benefits of information technology to their practice.

Get connected.

THIS SUMMER, i had a 'light bulb moment' while attending the european Health management Association's annual conference in Lahti, Finland.

Get connected.

As MANAGERS, we tend to look forward, to plan and to anticipate where the next challenges are likely to come from. finding time to reflect on events is therefore difficult.

Developing a framework for transferring knowledge into action: a thematic analysis of the literature.

OBJECTIVES: Although there is widespread agreement about the importance of transferring knowledge into action, we still lack high quality information about what works, in which settings and with whom. While there are a large number of models and theories for knowledge transfer interventions, the majority are untested, meaning that their applicability and relevance is largely unknown. This paper describes the development of a conceptual framework of translating knowledge into action and discusses how it can be used for developing a useful model of the knowledge transfer process. METHODS: A narrative review of the knowledge transfer literature identified 28 different models which explained all or part of the knowledge transfer process. The models were subjected to a thematic analysis to identify individual components and the types of processes used when transferring knowledge into action. The results were used to build a conceptual framework of the process. RESULTS: Five common components of the knowledge transfer process were identified: problem identification and communication; knowledge/research development and selection; analysis of context; knowledge transfer activities or interventions; and knowledge/research utilization. We also identified three types of knowledge transfer processes: a linear process; a cyclical process; and a dynamic multidirectional process. From these results a conceptual framework of knowledge transfer was developed. The framework illustrates the five common components of the knowledge transfer process and shows that they are connected via a complex, multidirectional set of interactions. As such the framework allows for the individual components to occur simultaneously or in any given order and to occur more than once during the knowledge transfer process. CONCLUSION: Our framework provides a foundation for gathering evidence from case studies of knowledge transfer interventions. We propose that future empirical work is designed to test and refine the relevance, importance and applicability of each of the components in order to build a more useful model of knowledge transfer which can serve as a practical checklist for planning or evaluating knowledge transfer activities.

Knowledge brokering: exploring the process of transferring knowledge into action.

BACKGROUND: There are many theories about knowledge transfer but there are few clear descriptions of knowledge transfer interventions or the processes they involve. This failure to characterise structure and process in proposed KT interventions is a major barrier to the design and implementation of evaluations of particular KT strategies. This study is designed to provide a detailed description of the processes involved in a knowledge transfer intervention and to develop and refine a useful model of the knowledge transfer process. METHODS AND DESIGN: This research is taking a sociological approach to investigating the process of knowledge transfer. The approach is designed to articulate the broad components of the knowledge transfer process and to test these against evidence from case study sites. The research falls into three phases. First, we have carried out a literature review to produce a theoretical framework of the knowledge transfer process. This involved summarising, thematically analysing and synthesising evidence from the literature. Second, we are carrying out fieldwork in a mental health setting based on the application of a knowledge brokering intervention. The intervention involves helping participants identify, refine and reframe their key issues, finding, synthesising and feeding back research and other evidence, facilitating interactions between participants and relevant experts and transferring information searching skills to participants. Finally, we are using the observations of the knowledge broker and interviews with participants to produce narratives of the brokering process. The narratives will be compared in order to identify evidence which will confirm, refute or revise each of the broad components of the knowledge transfer process. This comparison will enable us to generate a refined framework of knowledge transfer which could be used as a basis for planning and evaluating knowledge transfer interventions. DISCUSSION: This study will provide an opportunity for a detailed description of a knowledge transfer intervention and the processes which are involved. Our approach is also designed to enable us to develop and refine a useful model of the knowledge transfer process. We believe that it will significantly enhance the growing body of knowledge about knowledge transfer.

Knowledge Brokering: The missing link in the evidence to action chain?

Transferring health care research into policy and practice is a messy and complex process which both policymakers and researchers can struggle with. A potential solution is to use individuals or organisations as knowledge brokers. Using a range of literature, this paper explains the theory behind knowledge brokering, identifies three models of brokering and explores the challenges of brokering. We suggest that clarifying these factors is a significant step towards planning well designed and rigorously evaluated brokering interventions. We also suggest that a clearly defined theoretical framework could help us to find out more about how brokering works and its effectiveness.