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Practice Gap (practice + gap)
Selected AbstractsGuidelines to Practice Gap in the Use of Glycoprotein IIb/IIIa Inhibitors: From ISAR-REACT to Overreact?JOURNAL OF INTERVENTIONAL CARDIOLOGY, Issue 2 2009G. VISWANATHAN M.R.C.P. Adjunctive use of glycoprotein IIb/IIIa inhibitors (GPI) is associated with favorable outcomes following percutaneous coronary intervention (PCI). Guidelines for use of GPI have been published by various national societies including National Institute of Clinical Excellence (NICE), United Kingdom. The latter has not been updated since publication. The impact of contemporary trials such as ISAR-REACT (which showed no benefit of abciximab and 600 mg of clopidogrel compared with 600 mg of clopidogrel alone, in elective patients) on adherence to NICE guidelines is unknown. Methods: We audited use of GPI against NICE guidelines following publication in May 2002. Data were collected from 1,685 patients between September and November in years 2002, 2003, 2004, and 2007. Results: In 2002 and 2003, only 10.2% and 11.8%, respectively, of patients were noncompliant to NICE guidelines. Over time, there was an increase in patients not given GPI despite meeting NICE criteria. After publication of ISAR-REACT, the comparative figures for noncompliance in 2004 and 2007 were 40.0% and 44.5%. A similar pattern was seen in patients with diabetes; in 2002 and 2003 noncompliance was 16.7% and 11.1%, respectively, and in 2004 and 2007 noncompliance was 38.0% and 44.7%, respectively. Qualitatively, similar findings were recorded in patients with NSTE-ACS. The overall noncompliance to NICE guidelines increased from 11.0% to 42.1% (P < 0.0001) after the ISAR-REACT study. Conclusions: We found a decline in compliance to NICE guidelines on GPI usage during PCI. This was likely influenced by contemporary trials demonstrating little or no benefit of GPI in patients undergoing elective PCI who are adequately pretreated with clopidogrel. Our findings suggest the need for a mechanism whereby regular updates to guidelines can be disseminated following new trial evidence. [source] Reshaping the Forces that Perpetuate the Research-Practice Gap: Focus on New FacultyNEW DIRECTIONS FOR HIGHER EDUCATION, Issue 110 2000Carol L. Colbeck If the research-practice gap is to be bridged, the forces that shape faculty, such as socialization, tenure, and promotion, as well as the relationship between scholars and practitioners must be altered. [source] Closing the Research to Practice Gap: Redefining FeasibilityCLINICAL PSYCHOLOGY: SCIENCE AND PRACTICE, Issue 2 2008Stacy L. Frazier Recent attention to closing the research to practice gap reflects a new paradigm in which community partners assume more active roles in intervention research. Funders are shaping this new genre of collaborative research, and yet still require letters of support from investigators documenting access to sites as evidence of feasibility. Defining feasibility by access, however, derives from a basic research model that translates poorly to a collaborative one. At the same time, university,community collaboration within externally funded research poses a number of ethical challenges. We encourage a redefinition of feasibility that prioritizes collaboration by reconstructing the purpose and content of letters of support and by encouraging investigators to build into studies sufficient time and specific plans for building sustainable partnerships. [source] Closing Evidence to Practice Gaps in Emergency Care: The Australian ExperienceACADEMIC EMERGENCY MEDICINE, Issue 11 2007BAppSci, ICUCert, Susan Huckson RN The National Institute of Clinical Studies (NICS) was established in 2000 by the Australian government to improve health care by closing evidence-practice gaps. Improving emergency care through use of evidence is a priority area of work for NICS. This article describes the NICS Emergency Care Program and the current application of a "Community of Practice" to support emergency clinicians to implement best practices research. This approach combines aspects of evidence implementation science, quality improvement techniques, and knowledge management within a social network model to provide a mechanism for rapid sharing of explicit and tacit knowledge. Through the Community of Practice, the clinical community guides the priorities for the Emergency Care Program and is actively engaged in the development and implementation of initiatives. [source] Evidence-based practice and the professionalization of dental hygieneINTERNATIONAL JOURNAL OF DENTAL HYGIENE, Issue 4 2004Sandra J Cobban Abstract: The application of knowledge is fundamental to human problem solving. In health disciplines, knowledge utilization commonly manifests through evidence-based decision making in practice. The purpose of this paper is to explore the development of the evidence-based practice (EBP) movement in health professions in general, and dental hygiene in particular, and to examine its relationship to the professionalization agenda of dental hygiene in Canada. EBP means integrating practitioner expertise with the best available external evidence from research. Proponents of EBP believe that it holds promise for reducing a research,practice gap by encouraging clinicians to seek current research results. Both the Canadian and American Dental Hygienists Associations support practice based on current research evidence, yet recent studies show variation in practice. Professionalization refers to the developmental stages through which an organized occupation passes as it develops traits that characterize it as a profession. The status conferred by professionalization privileges a group to make and monitor its own decisions relative to practice. Dental hygiene's success in acquiring attributes of a profession suggests that transformation to a profession is occurring. This paper compares the assumptions and challenges of both movements, and argues the need for a principal focus on the development of a culture of evidence-based dental hygiene practice. [source] Clinical education facilitators: a literature reviewJOURNAL OF CLINICAL NURSING, Issue 6 2005Veronica Lambert BNS Aims and objectives., The aim of this literature review, set within an Irish context, is to present a broad overview of former and existing clinical support personnel, explore the concept of facilitation and examine what is known about the role of the clinical education facilitator. Background., The importance of providing a supportive clinical environment to enhance clinical teaching and learning is strongly portrayed in the literature. While the past two decades have borne witness to various clinical support personnel, the literature identifies conflicting demands that these personnel face. No suggestions are advanced as to how to overcome these difficulties, which inevitably influence the quality and quantity of their clinical teaching role. An identifiable gap exists over who has prime responsibility for clinical teaching. It is timely that alternative possibilities for organizing clinical teaching are investigated. A new post emerging in practice settings is that of the clinical education facilitator who is meant to be the key linchpin in clinical areas for reducing the theory,practice gap. Method., Relevant literature for this review was sourced using the computerized databases CINAHL, Medline and Synergy. Manual searching of relevant nursing journals and sourcing of secondary references extended the search. Government reports and other relevant documents were obtained through pertinent websites. Results., Papers that explicitly examined the concept of facilitation and explored the posts of clinical education facilitators were included; six research papers were accessed and reviewed. In addition seven non-empirical papers were included. Conclusions., It is clear that considerable lack of role clarity resides over what constitutes clinical facilitation and the role of the clinical facilitator. Thus, it is paramount to strengthen this support role with Irish empirical evidence. Relevance to clinical practice., A major advantage in having a ward-based clinical education facilitator is the benefit of having access to someone who can concentrate solely on clinical education and support with attempts to narrow the theory,practice divide. [source] Lecturer practitioners in UK nursing and midwifery: what is the evidence?JOURNAL OF CLINICAL NURSING, Issue 7 2004A systematic review of the research literature Background., Lecturer practitioner roles have been widely established in the UK, and are seen as having the ability to overcome the theory,practice gap in nursing, as well as offering other benefits including functioning as a link between education and practice. Aims and objectives., This article systematically reviews the research literature on UK lecturer practitioner roles in nursing and midwifery, in order to construct a picture of the themes that emerge from their national implementation. Conclusions., Only eight published research studies meeting the inclusion criteria were identified in journals, and five more included from the ,grey literature', totalling 13 suitable research reports. Of these 13 papers, six involved nurses and midwives. Key themes from the literature are outlined and discussed. There is an overwhelming preference for qualitative methodologies, although there is a strong argument for quantitative work in mixed-methods studies. Relevance to clinical practice. Lecturer practitioner roles can make an important contribution to nursing and midwifery education, but this is problematic. It is essential that managers clarify the purpose, responsibilities, support and review of lecturer practitioner roles if they are to be successful. [source] Evidenced-based clinical practice guideline for management of newborn painJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 4 2010Kaye Spence Aim: To facilitate the uptake of evidence and to reduce the evidence practice gap for management of newborn pain through the development of a clinical practice guideline. Method: An audit of practice and an appraisal of clinical practice guidelines were undertaken to establish current practices and guideline availability for the management of newborn pain in 23 hospitals in Australia. Guidelines were appraised using the Appraisal of Guidelines for Research and Evaluation instrument. A literature search was undertaken to acquire the evidence for best practice for management of newborn pain. Results: Neonatal units in 17 hospitals had clinical practice guidelines. Each was peer reviewed and assessed according to the domains of the Appraisal of Guidelines for Research and Evaluation instrument. There was lack of consistency across the guidelines. As a result, a best practice guideline was developed based on current best evidence and the Royal Australian College of Physicians recommendations. To facilitate an ongoing compliance with the guideline, an audit tool was included together with algorithms for procedural pain and pain assessment. Conclusion: The clinical practice guideline can be used by clinicians in varying settings such as the neonatal intensive care and special care unit. The document can be used to support existing practices or challenge clinicians to close the evidence practice gap for the management of newborn pain. [source] Reshaping the Forces that Perpetuate the Research-Practice Gap: Focus on New FacultyNEW DIRECTIONS FOR HIGHER EDUCATION, Issue 110 2000Carol L. Colbeck If the research-practice gap is to be bridged, the forces that shape faculty, such as socialization, tenure, and promotion, as well as the relationship between scholars and practitioners must be altered. [source] To Be More Useful: Embracing Interdisciplinary Scholarship and DialogueNEW DIRECTIONS FOR HIGHER EDUCATION, Issue 110 2000Clifton F. Conrad A learning community that involves all the stakeholders,policymakers, faculty, administrators, and academic leaders,is an avenue for moving beyond the research-practice gap. [source] Reflections of occupational therapists working as members of a research teamAUSTRALIAN OCCUPATIONAL THERAPY JOURNAL, Issue 2 2005Marcia Finlayson Aim:,This qualitative study explored the effects of clinician participation in a randomised clinical trial on subsequent practice. Method:,Eight occupational therapists responded to open-ended questions delivered by email about their reflections on participating in clinical research and its impact on their practice. Qualitative analysis uncovered therapists' motivation to participate in research, what they felt that they gained, and if and how research participation influenced practice. Results:,Clinicians learned about research, practice, and their own clinical biases through their participation in clinical research. Conclusion:,Our findings suggest that participation in research may contribute to shrinking the research-practice gap. [source] Bridging the educational research-teaching practice gapBIOCHEMISTRY AND MOLECULAR BIOLOGY EDUCATION, Issue 1 2010Tools for evaluating the quality of assessment instruments Abstract Student assessment is central to the educational process and can be used for multiple purposes including, to promote student learning, to grade student performance and to evaluate the educational quality of qualifications. It is, therefore, of utmost importance that assessment instruments are of a high quality. In this article, we present various tools that instructors could use, both to improve instrument design and validity before presentation to students and, to evaluate the reliability and quality of the assessment after students have answered the questions. In keeping with our goals of the Bridging-the-Gap series, we also present various ideas from the educational literature regarding the evaluation of assessment quality and end with a list of criteria that instructors could use to guide their evaluation process. [source] Management and Business Ethics: A Critique and Integration of Ethical Decision-making ModelsBRITISH JOURNAL OF MANAGEMENT, Issue 3 2003Dean Bartlett This paper critically reviews the literature relating to the management of ethics within organizations and identifies, in line with other authors, a gap between theory and practice in the area. It highlights the role of management (both as an academic discipline and from a practitioner perspective) in bridging this gap and views managers, with their sense of individual ethical agency, as a key locus of ethics within organizations. The paper aims to address the theory,practice gap by surveying the business ethics literature in order to identify, draw together and integrate existing theory and research, with a particular emphasis upon models of ethical decision-making and their relationship to work values. Such an endeavour is necessary, not only because of the relative neglect of management practice by business ethics researchers, but also because of the current lack of integration in the field of business ethics itself. The paper outlines some of the main methodological challenges in the area and suggests how some of these may be overcome. Finally, it concludes with a number of suggestions as to how the theory,practice gap can be addressed through the development of a research agenda, based upon the previous work reviewed. [source] | |||||||||||||