Aims and objectives: To describe the process of implementing evidence-based practice (EBP) in a clinical nursing setting. Background: EBP has become a major issue in nursing, it is insufficiently integrated in daily practice and its implementation is complex. Design: Participatory action research. Method: The main participants were nurses working in a lung unit of a rural hospital. A multi-method process of data collection was used during the observing, reflecting, planning and acting phases. Data were continuously gathered during a 24-month period from 2010 to 2012, and analysed using an interpretive constant comparative approach. Patients were consulted to incorporate their perspective. Results: A best-practice mode of working was prevalent on the ward. The main barriers to the implementation of EBP were that nurses had little knowledge of EBP and a rather negative attitude towards it, and that their English reading proficiency was poor. The main facilitators were that nurses wanted to deliver high-quality care and were enthusiastic and open to innovation. Implementation strategies included a tailored interactive outreach training and the development and implementation of an evidence-based discharge protocol. The academic model of EBP was adapted. Nurses worked according to the EBP discharge protocol but barely recorded their activities. Nurses favourably evaluated the participatory action research process. Conclusions: Action research provides an opportunity to empower nurses and to tailor EBP to the practice context. Applying and implementing EBP is difficult for front-line nurses with limited EBP competencies. Relevance to clinical practice: Adaptation of the academic model of EBP to a more pragmatic approach seems necessary to introduce EBP into clinical practice. The use of scientific evidence can be facilitated by using pre-appraised evidence. For clinical practice, it seems relevant to integrate scientific evidence with clinical expertise and patient values in nurses’ clinical decision making at the individual patient level.
Urban farming projects often involve the (temporarily) redevelopment of urban space by local co-productions of citizens and/or entrepreneurs. To realize their ambitions these coalitions often need support of public (government) resources such as time, money, space and regulation (Green Deal Stadslandbouw, 2013). This paper asks the question to what extent the development of urban farming projects can be understood as an example of planning through direct citizen participation/ participatory governance (e.g. Cornwall, 2004; Roberts, 2004) and what this means for the role of the municipal planning professional or civil servant in making these projects successful. Literature on the role of the municipal planner or civil servant in urban farming projects mainly concerns the role as enabler of projects given the many difficulties for projects. However, when looked at the development of urban farming as an example of citizen participation/ participatory governance and the transfer of social functions towards society other roles and tasks of planners seem to be important to make urban farming successful. This discussion paper looks to the role of planners and civil servants in some related government domains such as landscape (e.g. Van Dam et al. 2008, 2010, 2011) and neighbourhood development (e.g. Frieling et al., 2014) to complement our understanding of the role of planners in making urban farming projects successful. With this analysis the paper sets the scene for further research into tools for the planning professional or civil servant to support urban farming. In the paper the situation in Amsterdam serves as an example.
Significant factors in the success or failure of energy transition arise from the spatial potential of places and their communities. Scenario planning appears to be an appropriate design instrument to enable architects to unveil, conceptualise, imagine, test and communicate this potential to stakeholders. This paper critically refelcts on the scenario as an architectural design instrument. Inscribed with political intentions, scenario planning may be a far from neutral design instrument. Instead of triggering communities to explore local energy potential, a scenario may have a normative effect on a community's imagination. The paper aims to define guidelines for the deployment of scenarios in an open, participatory planning process. To mediate in a local participatory planning process, we argue, scenarios should be situational, dynamic and open-ended, allowing or even triggering communities to (re)define the issues relevant to a place during the ongoing process of energy-transition. How, when and where should scenarios be deployed in order to enable communities to understand and develop their local energy potential?
DISTENDER will provide integrated strategies by building a methodological framework that guide the integration of climate change(CC) adaptation and mitigation strategies through participatory approaches in ways that respond to the impacts and risks of climatechange (CC), supported by quantitative and qualitative analysis that facilitates the understanding of interactions, synergies and tradeoffs.Holistic approaches to mitigation and adaptation must be tailored to the context-specific situation and this requires a flexibleand participatory planning process to ensure legitimate and salient action, carried out by all important stakeholders. DISTENDER willdevelop a set of multi-driver qualitative and quantitative socio-economic-climate scenarios through a facilitated participatory processthat integrates bottom-up knowledge and locally-relevant drivers with top-down information from the global European SharedSocioeconomic Pathways (SSPs) and downscaled Representative Concentration Pathways (RCPs) from IPCC. A cross-sectorial andmulti-scale impact assessment modelling toolkit will be developed to analyse the complex interactions over multiple sectors,including an economic evaluation framework. The economic impact of the different efforts will be analyse, including damage claimsettlement and how do sectoral activity patterns change under various scenarios considering indirect and cascading effects. It is aninnovative project combining three key concepts: cross-scale, integration/harmonization and robustness checking. DISTENDER willfollow a pragmatic approach applying methodologies and toolkits across a range of European case studies (six core case studies andfive followers) that reflect a cross-section of the challenges posed by CC adaptation and mitigation. The knowledge generated byDISTENDER will be offered by a Decision Support System (DSS) which will include guidelines, manuals, easy-to-use tools andexperiences from the application of the cases studies.
