Abstract:
BACKGROUND:Fecal incontinence has a high prevalence in the nursing home population which cannot be explained by co-morbidity or anatomic and physiological changes of aging alone. Our hypothesis is that fecal incontinence can be prevented, cured, or ameliorated by offering care staff knowledge of best practice. However, it is not clear which educational model is most effective. To assess the effect of two educational programs for care staff, we planned a three armed cluster-randomized controlled trial. There is a lack of research reporting effects of interventions targeting improved continence care processes in older patients. Thus, to improve the quality of the planned trial, we decided to carry out a pilot study to investigate the feasibility of the planned design, the interventions (educational programs) and the outcome measures, and to enable a power calculation. This paper reports the results from the pilot study. METHODS:Three nursing homes, representing each arm of the planned trial, were recruited. Criteria for assessing success of feasibility were pre-specified. Methods, outcome measures, acceptability, and adherence of the components of the intervention were evaluated by descriptive statistical analyses and qualitative content analysis of one focus group interview (n = 7) and four individual interviews. RESULTS:The main study is feasible with one major and some minor modifications. Due to challenges with recruitment and indications supporting the assumption that a single intervention with one workshop is not sufficient as an implementation strategy, the main study will be reduced to two arms: a multifaceted education intervention and control. The components of the multifaceted intervention seemed to work well together and need only minor modification. Important barriers to consider were sub-optimal use of skill-mix, problems of communicating important assessments and care plans, and isolated nurses with an indistinct nurse identity. CONCLUSIONS:Overall, the main study is feasible. The pedagogical approach needs to consider the identified barriers. Thus, it is essential to empower nurses in their professional role, to facilitate clinical reasoning and critical thinking among care staff, and to facilitate processes to enable care staff to find, report, and utilize information in the electronic patient record. TRIAL REGISTRATION:ClinicalTrials.gov: NCT01939821.
journal_name
Implement Scijournal_title
Implementation science : ISauthors
Blekken LE,Nakrem S,Gjeilo KH,Norton C,Mørkved S,Vinsnes AGdoi
10.1186/s13012-015-0263-8subject
Has Abstractpub_date
2015-05-23 00:00:00pages
72issn
1748-5908pii
10.1186/s13012-015-0263-8journal_volume
10pub_type
杂志文章,多中心研究,随机对照试验abstract:BACKGROUND:There is little information about the functions and behavior change techniques (BCTs) needed to implement shared decision making (SDM) in clinical practice. To guide future implementation initiatives, we sought to develop a BCT taxonomy for SDM implementation interventions. METHODS:This study is a secondary...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-020-01015-w
更新日期:2020-08-20 00:00:00
abstract:BACKGROUND:The Graded Repetitive Arm Supplementary Program (GRASP) is a hand and arm exercise programme designed to increase the intensity of exercise achieved in inpatient stroke rehabilitation. GRASP was shown to be effective in a randomised controlled trial in 2009 and has since experienced unusually rapid uptake in...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-014-0090-3
更新日期:2014-08-12 00:00:00
abstract:BACKGROUND:In 2004, Gabbay and le May showed that clinicians generally base their decisions on mindlines-internalised and collectively reinforced tacit guidelines-rather than consulting written clinical guidelines. We considered how the concept of mindlines has been taken forward since. METHODS:We searched databases f...
journal_title:Implementation science : IS
pub_type: 杂志文章,评审
doi:10.1186/s13012-015-0229-x
更新日期:2015-04-09 00:00:00
abstract::Complex behaviour change interventions are not well described; when they are described, the terminology used is inconsistent. This constrains scientific replication, and limits the subsequent introduction of successful interventions. Implementation Science is introducing a policy of initially encouraging and subsequen...
journal_title:Implementation science : IS
pub_type: 社论
doi:10.1186/1748-5908-4-40
更新日期:2009-07-16 00:00:00
abstract:BACKGROUND:Counselling on health-related lifestyles is key to the prevention and management of chronic diseases. After comprehensive study of determinants of its delivery in general practice and strategies to improve, we composed a tailored improvement program, which included communication skills training, online patie...
journal_title:Implementation science : IS
pub_type: 杂志文章,随机对照试验
doi:10.1186/s13012-016-0460-0
更新日期:2016-08-11 00:00:00
abstract:BACKGROUND:Evidence-based practice (EBP) implementation represents a strategic change in organizations that requires effective leadership and alignment of leadership and organizational support across organizational levels. As such, there is a need for combining leadership development with organizational strategies to s...
journal_title:Implementation science : IS
pub_type: 杂志文章,随机对照试验
doi:10.1186/s13012-017-0562-3
更新日期:2017-03-03 00:00:00
abstract:BACKGROUND:Cardiovascular risk management is largely provided in primary healthcare, but not all patients with established cardiovascular diseases receive preventive treatment as recommended. Accreditation of healthcare organizations has been introduced across the world with a range of aims, including the improvement o...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-7-94
更新日期:2012-10-04 00:00:00
abstract:BACKGROUND:Antiretroviral therapy (ART) for HIV-infected persons and pre-exposure prophylaxis (PrEP) for uninfected persons are extraordinarily effective strategies for HIV prevention. In Africa, the region which shoulders the highest HIV burden, HIV care is principally delivered through public health HIV care clinics,...
journal_title:Implementation science : IS
pub_type: 杂志文章,随机对照试验
doi:10.1186/s13012-018-0809-7
更新日期:2018-09-04 00:00:00
abstract::Following publication of the original article [1], the authors reported an error in one of the authors' names. In this Correction the incorrect and correct author name are shown. The original article has been corrected. ...
journal_title:Implementation science : IS
pub_type: 杂志文章,已发布勘误
doi:10.1186/s13012-019-0862-x
更新日期:2019-02-08 00:00:00
abstract:BACKGROUND:Care management in primary care can be effective in helping patients with chronic disease improve their health status. Primary care practices, however, are often challenged with its implementation. Incorporating care management involves more than a simple physical process redesign to existing clinical care r...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-015-0316-z
更新日期:2015-08-21 00:00:00
abstract:BACKGROUND:Practice guidelines (PGs) are systematically developed statements intended to assist in patient and practitioner decisions. The AGREE II is the revised tool for PG development, reporting, and evaluation, comprised of 23 items, two global rating scores, and a new User's Manual. In this study, we sought to dev...
journal_title:Implementation science : IS
pub_type: 杂志文章,随机对照试验
doi:10.1186/1748-5908-6-81
更新日期:2011-07-26 00:00:00
abstract:BACKGROUND:Evaluating the impact of recommendations based upon health technology assessment (HTA) represents a challenge for both HTA agencies and healthcare policy-makers. Using a psychosocial theoretical framework, this study aimed at exploring the factors affecting physician intention to adopt HTA recommendations. T...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-1-8
更新日期:2006-03-31 00:00:00
abstract:BACKGROUND:Electronic guideline-based decision support systems have been suggested to successfully deliver the knowledge embedded in clinical practice guidelines. A number of studies have already shown positive findings for decision support systems such as drug-dosing systems and computer-generated reminder systems for...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-4-82
更新日期:2009-12-30 00:00:00
abstract:BACKGROUND:A large proportion of artemisinin-combination therapy (ACT) anti-malarial medicines is consumed by individuals that do not have malaria. The over-consumption of ACTs is largely driven by retail sales in high malaria-endemic countries to clients who have not received a confirmatory diagnosis. This study aims ...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-020-01077-w
更新日期:2021-01-20 00:00:00
abstract:BACKGROUND:Integrated knowledge translation (IKT) refers to collaboration between researchers and decision-makers. While advocated as an approach for enhancing the relevance and use of research, IKT is challenging and inconsistently applied. This study sought to inform future IKT practice and research by synthesizing s...
journal_title:Implementation science : IS
pub_type: 杂志文章,评审
doi:10.1186/s13012-016-0399-1
更新日期:2016-03-17 00:00:00
abstract:BACKGROUND:The knowledge exchange literature suggests that policy dialogues are intended to enhance short-, medium- and long-term capacities of individuals, organizations and health systems to use evidence to inform policy-making. Key features of effective dialogues have been suggested, but the linkages between these f...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-017-0627-3
更新日期:2017-07-28 00:00:00
abstract:BACKGROUND:Ageing has become a worldwide reality and presents new challenges for the health-care system. Research has shown that potentially inappropriate prescribing, both potentially inappropriate medications and potentially prescribing omissions, is highly prevalent in older people, especially in the nursing home se...
journal_title:Implementation science : IS
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1186/s13012-016-0394-6
更新日期:2016-03-11 00:00:00
abstract:BACKGROUND:Violence against women (VAW) is a major public health problem. Translation of VAW research to policy and practice is an area that remains understudied, but provides the opportunity to examine knowledge translation and exchange (KTE) processes in a complex, multi-stakeholder context. In a series of studies in...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-6-102
更新日期:2011-09-06 00:00:00
abstract:BACKGROUND:The fields of implementation and improvement sciences have experienced rapid growth in recent years. However, research that seeks to inform health care change may have difficulty translating core components of implementation and improvement sciences within the traditional paradigms used to evaluate efficacy ...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-018-0770-5
更新日期:2018-05-29 00:00:00
abstract:BACKGROUND:To improve hypertension care for ethnic minority patients of African descent in the Netherlands, we developed a provider intervention to facilitate the delivery of culturally appropriate hypertension education. This pilot study evaluates how the intervention affected the attitudes and perceived competence of...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-5-35
更新日期:2010-05-14 00:00:00
abstract::In October 2006, the Chief Medical Officer (CMO) of England asked Professor Sir John Tooke to chair a High Level Group on Clinical Effectiveness in response to the chapter 'Waste not, want not' in the CMOs 2005 annual report 'On the State of the Public Health'. The high level group made recommendations to the CMO to a...
journal_title:Implementation science : IS
pub_type: 社论
doi:10.1186/1748-5908-4-18
更新日期:2009-04-07 00:00:00
abstract:BACKGROUND:Sub-Saharan Africa (SSA) is facing a double burden of disease with a rising prevalence of non-communicable diseases (NCDs) while the burden of communicable diseases (CDs) remains high. Despite these challenges, there remains a significant need to understand how or under what conditions health interventions i...
journal_title:Implementation science : IS
pub_type: 杂志文章,评审
doi:10.1186/s13012-016-0392-8
更新日期:2016-03-23 00:00:00
abstract:BACKGROUND:In the 21st century, government and industry are supplementing hierarchical, bureaucratic forms of organization with network forms, compatible with principles of devolved governance and decentralization of services. Clinical networks are employed as a key health policy approach to engage clinicians in improv...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-7-108
更新日期:2012-11-02 00:00:00
abstract:BACKGROUND:Organizational factors are considered to be an important influence on health workers' uptake of interventions that improve their practices. These are additionally influenced by factors operating at individual and broader health system levels. We sought to explore contextual influences on worker motivation, a...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-4-43
更新日期:2009-07-23 00:00:00
abstract:BACKGROUND:Evidence-based health promotion programs developed and tested in the general population typically exclude people with disabilities. To address this gap, a set of methods and criteria were created to adapt evidence-based health promotion programs for people with disabilities. In this first study, we describe ...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-014-0100-5
更新日期:2014-08-14 00:00:00
abstract:BACKGROUND:There is a need to unpack the empirical, practical, and personal challenges within participatory approaches advocated to optimize implementation. The unpredictable, chaotic nature of participatory approaches complicates application of implementation theories, methods, and strategies which do not address rese...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-020-01002-1
更新日期:2020-09-03 00:00:00
abstract:BACKGROUND:It is difficult to foster research utilization among allied health professionals (AHPs). Tailored, multifaceted knowledge translation (KT) strategies are now recommended but are resource intensive to implement. Employers need effective KT solutions but little is known about; the impact and viability of multi...
journal_title:Implementation science : IS
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1186/1748-5908-8-132
更新日期:2013-11-13 00:00:00
abstract:BACKGROUND:Osteoarthritis is a leading cause of pain and disability worldwide. Despite research supporting best practice, evidence-based guidelines are often not followed. Little is known about the implementation of non-surgical models of care in routine primary care practice. From a knowledge mobilisation perspective,...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-020-01055-2
更新日期:2020-10-28 00:00:00
abstract:BACKGROUND:Patients with chronic illness typically receive ambulatory treatment from multiple health professionals. Connectedness between these professionals may influence their clinical decisions and the coordination of patient care. We aimed to describe and analyze connectedness in a regional network of health profes...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-6-67
更新日期:2011-07-03 00:00:00
abstract:BACKGROUND:Despite the potential to reach at-risk children in childcare, there is a significant gap between current practices and evidence-based obesity prevention in this setting. There are few investigations of the impact of implementation strategies on the uptake of evidence-based practices (EBPs) for obesity preven...
journal_title:Implementation science : IS
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1186/s13012-017-0624-6
更新日期:2017-07-18 00:00:00