How Does the Facilitation Effort of Clinical Educators Interact With Aspects of Organizational Context to Affect Research Use in Long-term Care? Evidence From CHAID Analysis.


Journal

Journal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing
ISSN: 1547-5069
Titre abrégé: J Nurs Scholarsh
Pays: United States
ID NLM: 100911591

Informations de publication

Date de publication:
11 2021
Historique:
revised: 27 02 2021
received: 08 10 2020
accepted: 11 06 2021
pubmed: 1 8 2021
medline: 19 3 2022
entrez: 31 7 2021
Statut: ppublish

Résumé

Organizational context influences the effect of facilitation efforts on research use in care settings. The interactions of these factors are complex. Therefore, the use of traditional statistical methods to examine their interrelationships is often impractical. Big Data analytics can automatically detect patterns within the data. We applied the chi-squared automatic interaction detection (CHAID) algorithm and classification tree technique to explore the dynamic and interdependent relationships between the implementation science concepts-context, facilitation, and research use. Observational, cross-sectional study based on survey data collected from a representative sample of nursing homes in western Canada. We assessed three major constructs: (a) Conceptual research utilization (CRU) using the CRU scale; (b) facilitation of research use measured by the frequency of contacts between the frontline staff and a clinical educator, or person who brings new ideas to the care unit; and (c) organizational context at the unit level using the Alberta Context Tool (ACT). CHAID analysis was performed to detect the interactions between facilitation and context variables. Results were illustrated in a classification tree to provide a straightforward visualization. Data from 312 care units in three provinces were included in the final analysis. Results indicate significant multiway interactions between facilitation and various aspects of the organizational context, including leadership, culture, evaluation, structural resources, and organizational slack (staffing). Findings suggested the preconditions of the care settings where research use can be maximized. CHAID analysis helped transform data into usable knowledge. Our findings provide insight into the dynamic relationships of facilitators' efforts and organizational context, and how these factors' interplay and their interdependence together may influence research use. Knowledge of the combined effects of facilitators' efforts and various aspects of organizational context on research use can contribute to effective strategies to narrow the evidence-practice gap in care settings.

Identifiants

pubmed: 34331390
doi: 10.1111/jnu.12690
doi:

Types de publication

Journal Article Observational Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

762-771

Informations de copyright

© 2021 Sigma Theta Tau International.

Références

Andrew, N. E., Middleton, S., Grimley, R., Anderson, C. S., Donnan, G. A., Lannin, N. A., Stroil-Salama, E., Grabsch, B., Kilkenny, M. F., & Squires, J. E. (2019). Hospital organizational context and delivery of evidence-based stroke care: A cross-sectional study. Implementation Science, 14(1), 1-12.
Anne-Lacey, E. (1994). Research utilization in nursing practice: A pilot study. Journal of Advanced Nursing, 19(5), 987-995. https://doi.org/10.1111/j.1365-2648.1994.tb01178.x
Berger, A. M., & Berger, C. R. (2004). Data mining as a tool for research and knowledge development in nursing. CIN: Computers, Informatics, Nursing, 22(3), 123-131.
Berta, W., Cranley, L., Dearing, J. W., Dogherty, E. J., Squires, J. E., & Estabrooks, C. A. (2015). Why (we think) facilitation works: Insights from organizational learning theory. Implementation Science, 10(1), 1-13.
Chamberlain, S. A., Hoben, M., Squires, J. E., Cummings, G. G., Norton, P., & Estabrooks, C. A. (2019). Who is (still) looking after mom and dad? Few improvements in care aides’ quality-of-work life. Canadian Journal on Aging, 38(1), 35-50. https://doi.org/10.1017/S0714980818000338
Cranley, L. A., Cummings, G. G., Profetto-McGrath, J., Toth, F., & Estabrooks, C. A. (2017). Facilitation roles and characteristics associated with research use by healthcare professionals: A scoping review. British Medical Journal Open, 7(8), e014384.
Cranley, L., Weeks, L., Lo, T., Norton, P., & Estabrooks, C. (2020). Making quality improvement data meaningful for long-term care administrators. Innovation in Aging, 4(Supplement 1), 182. https://doi.org/10.1093/geroni/igaa057.590, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7740375/
Damschroder, L. J., & Hagedorn, H. J. (2011). A guiding framework and approach for implementation research in substance use disorders treatment. Psychology of Addictive Behaviors, 25(2), 194.
Eldh, A. C., Ehrenberg, A., Squires, J. E., Estabrooks, C. A., & Wallin, L. (2013). Translating and testing the Alberta context tool for use among nurses in Swedish elder care. BMC Health Services Research, 13(1), 1-10.
Estabrooks, C. A., Midodzi, W. K., Cummings, G. G., & Wallin, L. (2007). Predicting research use in nursing organizations: A multilevel analysis. Nursing Research, 56(4), S7-S23.
Estabrooks, C. A., Morgan, D. G., Squires, J. E., Boström, A.-M., Slaughter, S. E., Cummings, G. G., & Norton, P. G. (2011). The care unit in nursing home research: Evidence in support of a definition. BMC Medical Research Methodology, 11(1), 46.
Estabrooks, C. A., Squires, J. E., Cummings, G. G., Birdsell, J. M., & Norton, P. G. (2009). Development and assessment of the Alberta context tool. BMC Health Services Research, 9(1), 1-12. https://doi.org/10.1186/1472-6963-9-234
Estabrooks, C. A., Squires, J. E., Cummings, G. G., Teare, G. F., & Norton, P. G. (2009). Study protocol for the translating research in elder care (TREC): Building context - An organizational monitoring program in long-term care project (project one). Implementation Science, 4(1), 1-13. https://doi.org/10.1186/1748-5908-4-52
Estabrooks, C. A., Squires, J. E., Hayduk, L., Morgan, D., Cummings, G. G., Ginsburg, L., Stewart, N., McGilton, K., Kang, S. H., & Norton, P. G. (2015). The influence of organizational context on best practice use by care aides in residential long-term care settings. Journal of the American Medical Directors Association, 16(6), 537-e1.
Hall, J., & Sammons, P. (2013). Mediation, moderation & interaction: Definitions, discrimination & (some) means of testing. In T. Teo (Ed.), Handbook of quantitative methods for educational research (pp. 267-286). Brill Sense.
Harvey, G., & Kitson, A. (2015a). Implementing evidence-based practice in healthcare: A facilitation guide. Routledge. https://www.routledge.com/Implementing-Evidence-Based-Practice-in-Healthcare-A-Facilitation-Guide/Harvey-Kitson/p/book/9780415821926
Harvey, G., & Kitson, A. (2015b). PARIHS revisited: From heuristic to integrated framework for the successful implementation of knowledge into practice. Implementation Science, 11(1), 1-13. https://doi.org/10.1186/s13012-016-0398-2
Helfrich, C. D., Damschroder, L. J., Hagedorn, H. J., Daggett, G. S., Sahay, A., Ritchie, M., Damush, T., Guihan, M., Ullrich, P. M., & Stetler, C. B. (2010). A critical synthesis of literature on the promoting action on research implementation in health services (PARIHS) framework. Implementation Science, 5(1), 82.
Hill, D. A., Delaney, L. M., & Roncal, S. (1997). A chi-square automatic interaction detection (CHAID) analysis of factors determining trauma outcomes. Journal of Trauma and Acute Care Surgery, 42(1), 62-66.
Kajermo, K. N., Boström, A. M., Thompson, D. S., Hutchinson, A. M., Estabrooks, C. A., & Wallin, L. (2010). The BARRIERS scale - the barriers to research utilization scale: A systematic review. Implementation Science, 5(1), 1-22. https://doi.org/10.1186/1748-5908-5-32
Kaplan, H. C., Froehle, C. M., Cassedy, A., Provost, L. P., & Margolis, P. A. (2013). An exploratory analysis of the model for understanding success in quality. Health Care Management Review, 38(4), 325-338.
Kitson, A., Harvey, G., & McCormack, B. (1998). Enabling the implementation of evidence based practice: A conceptual framework. Quality in Health Care, 7(3), 149-158.
Lo, T., Hoben, M., Norton, P. G., Teare, G. F., & Estabrooks, C. A. (2018). Importance of clinical educators to research use and suggestions for better efficiency and effectiveness: Results of a cross-sectional survey of care aides in Canadian long-term care facilities. British Medical Journal Open, 8(7), e020074.
Lunt, M. (2015). Introduction to statistical modelling 2: Categorical variables and interactions in linear regression. Rheumatology, 54(7), 1141-1144.
Maslach, C., Jackson, S. E., & Leiter, M. P. (1996). Maslach burnout inventory manual (3rd ed.). Consulting Psychologist Press.
McCormack, B., Kitson, A., Harvey, G., Rycroft-Malone, J., Titchen, A., & Seers, K. (2002). Getting evidence into practice: The meaning of context. Journal of Advanced Nursing, 38(1), 94-104.
Oyeyemi, G., Adewara, A., Adebola, F., & Salau, S. (2010). On the estimation of power and sample size in test of independence. Asian Journal of Mathematics & Statistics, 3(3), 139-146.
Rosenfeld, P., Kobayashi, M., Barber, P., & Mezey, M. (2004). Utilization of nurse practitioners in long-term care: Findings and implications of a national survey. Journal of the American Medical Directors Association, 5(1), 9-15.
Rycroft-Malone, J. (2004). The PARIHS framework - A framework for guiding the implementation of evidence-based practice. Journal of Nursing Care Quality, 19(4), 297-304.
Squires, J. E., Estabrooks, C. A., Gustavsson, P., & Wallin, L. (2011). Individual determinants of research utilization by nurses: A systematic review update. Implementation Science, 6(1), 1-20. https://doi.org/10.1186/1748-5908-6-1.
Squires, J. E., Estabrooks, C. A., Hayduk, L., Gierl, M., & Newburn-Cook, C. V. (2014). Precision of the conceptual research utilization scale. Journal of Nursing Measurement, 22(1), 145-163.
Squires, J. E., Estabrooks, C. A., Newburn-Cook, C. V., & Gierl, M. (2011). Validation of the conceptual research utilization scale: An application of the standards for educational and psychological testing in healthcare. BMC Health Services Research, 11(1), 107. https://doi.org/10.1186/1472-6963-11-107
Squires, J. E., Hayduk, L., Hutchinson, A. M., Mallick, R., Norton, P. G., Cummings, G. G., & Estabrooks, C. A. (2015). Reliability and validity of the Alberta context tool (ACT) with professional nurses: Findings from a multi-study analysis. PLoS ONE, 10(6), e0127405.
Squires, J. E., Hutchinson, A. M., Bostrom, A.-M., Deis, K., Norton, P. G., Cummings, G. G., & Estabrooks, C. A. (2012). A data quality control program for computer-assisted personal interviews. Nursing Research and Practice, 2012, 303816.
Stevenson, J. C., Mahoney, E. R., Walker, P. L., & Everson, P. M. (2009). Prediction of sex based on five skull traits using decision analysis (CHAID). American Journal of Physical Anthropology, 139(3), 434-441. https://doi.org/10.1002/ajpa.21042
Translating Research in Elder Care. (2019a). TREC measurement system. 2021, January 22. Retrieved from https://trecresearch.ca/research/trec_measurement_system
Translating Research in Elder Care. (2019b). Vision and mission. Retrieved January 22, 2021 from https://trecresearch.ca/about
Varin, M. G. D., Stacey, D., Baumbusch, J. L., Estabrooks, C., & Squires, J. E. (2019). Predictors of nurses' research use in Canadian long-term care homes. Journal of the American Medical Directors Association, 20(9), 1185.e9-1185.e18.
Younas, A. (2020). Identifying international barriers and facilitators to research utilization. Nursing, 50(7), 63-67.

Auteurs

Tkt Lo (T)

Investigator, Translating Research in Elder Care (TREC), Edmonton Clinic Health Academy, University of Alberta, Edmonton, Alberta, Canada.

Sheila A Boamah (SA)

Assistant Professor, Faculty of Health Sciences, School of Nursing, McMaster University, Hamilton, Ontario, Canada.

Jeffrey W Poss (JW)

Associate Professor, School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada.

Gary F Teare (GF)

Scientific Director, Program Knowledge, Evidence and Innovation, Provincial Population and Public Health, Alberta Health Services, Calgary, Alberta, Canada.

Peter G Norton (PG)

Professor Emeritus Family Medicine, Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.

Carole A Estabrooks (CA)

Professor, Faculty of Nursing, Edmonton Clinic Health Academy, University of Alberta, Edmonton, Alberta, Canada.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH