Om goede en verantwoorde zorg te kunnen bieden, streeft de paramedicus naar evidence-based practice. Evidence-based practice is het zorgvuldig, expliciet en oordeelkundig gebruik van het huidige beste bewijsmateriaal en evidence om beslissingen te nemen met individuele patiënten om de zorgverlening te verbeteren. De praktijk van evidence-based practice impliceert het integreren van individuele professionele kennis van de paramedicus met de wens en voorkeur van de patiënt en het beste externe bewijsmateriaal dat vanuit systematisch onderzoek beschikbaar is. De voorkeuren, wensen en verwachtingen van de patiënt spelen bij de besluitvorming een centrale rol.
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Om goede en verantwoorde zorg te kunnen bieden, streeft de paramedicus naar evidence-based practice. Evidence-based practice is het zorgvuldig, expliciet en oordeelkundig gebruik van het huidige beste bewijsmateriaal en evidence om beslissingen te nemen met individuele patiënten om de zorgverlening te verbeteren. De praktijk van evidence-based practice impliceert het integreren van individuele professionele kennis van de paramedicus met de wens en voorkeur van de patiënt en het beste externe bewijsmateriaal dat vanuit systematisch onderzoek beschikbaar is. De voorkeuren, wensen en verwachtingen van de patiënt spelen bij de besluitvorming een centrale rol.
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This paper presents a method for Universities of Applied Sciences (UAS) to account for the impact of research. The 36 UAS in The Netherlands aim to contribute to global challenges and pressing social issues through practice-based research. Given this aim UAS have a strong responsibility to account for the impact of their research and to show that the public research money is well spent. This paper shows that none of the existing methods for assessing the impact of research are suitable for the research conducted at Dutch UAS. It offers an alternative approach based on narratives supported by empirical evidence.
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Praktijkonderzoek over integratie van practice based evidence en evidence based practice, nderzoeksresultaten toepassen in de praktijk,verbeteren in en door de praktijk.
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This study explores the evaluation of research pathways of self-management health innovations from discovery to implementation in the context of practice-based research. The aim is to understand how a new process model for evaluating practice-based research provides insights into the implementation success of innovations. Data were collected from nine research projects in the Netherlands. Through document analysis and semi-structured interviews, we analysed how the projects start, evolve, and contribute to the healthcare practice. Building on previous researchevaluation approaches to monitor knowledge utilization, we developed a Research Pathway Model. The model’s process character enables us to include and evaluate the incremental work required throughout the lifespan of an innovation project and it helps to foreground that innovation continues during implementation in real-life settings. We found that in each researchproject, pathways are followed that include activities to explore a new solution, deliver a prototype and contribute to theory. Only three projects explored the solution in real life and included activities to create the necessary changes for the solutions to be adopted. These three projects were associated with successful implementation. The exploration of the solution in a real-life environment in which users test a prototype in their own context seems to be a necessaryresearch activity for the successful implementation of self-management health innovations.
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This thesis describes an Action Research (AR) project aimed at the implementation of Evidence Based Practice in a mental health nursing setting in the Netherlands. The main research question addressed in this thesis is: In what way is Action Research with an empowering appropriate to implement Evidence Based Practice in a mental health nursing setting in the Netherlands and what is the effect of this implementation on the care experienced by the client, the nursing interventions and the context in this setting compared to a comparative setting? To answer this main research question, the following questions derived from it were addressed: What is Evidence Based Practice? What is known about implementing evidence-based practice in nursing through Action Research? Which factors have to be dealt with in a mental health nursing setting, so the implementation of EBP with AR with an empowering intent will be more successful? Which factors have to be dealt with in a mental health nursing setting, so the implementation of EBP with AR with an empowering intent will be successful? How is EBP implemented through AR with an empowering intent and what are the outcomes for the use of evidence, the context and the facilitation in the setting? What is the effect of the implementation of EBP in mental health nursing using AR with an empowering intent on the care experienced by the client, the nursing interventions and the context compared to a comparison setting? The first two questions were answered by a search of the literature while the remaining questions were answered during the AR study conducted in two mental health organisations in the Netherlands.
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This study explores the evaluation of research pathways of self-management health innovations from discovery to implementation in the context of practice-based research. The aim is to understand how a new process model for evaluating practice-based research provides insights into the implementation success of innovations. Data were collected from nine research projects in the Netherlands. Through document analysis and semi-structured interviews, we analysed how the projects start, evolve, and contribute to the healthcare practice. Building on previous research evaluation approaches to monitor knowledge utilization, we developed a Research Pathway Model. The model’s process character enables us to include and evaluate the incremental work required throughout the lifespan of an innovation project and it helps to foreground that innovation continues during implementation in real-life settings. We found that in each research project, pathways are followed that include activities to explore a new solution, deliver a prototype and contribute to theory. Only three projects explored the solution in real life and included activities to create the necessary changes for the solutions to be adopted. These three projects were associated with successful implementation. The exploration of the solution in a real-life environment in which users test a prototype in their own context seems to be a necessary research activity for the successful implementation of self-management health innovations.
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DOEL. Dit artikel beoogt een kritische analyse te geven van de manier waarop het begrip Evidence Based Practice in de literatuur doorgaans wordt ingevuld, waarna mogelijkheden worden geschetst de in het artikel geconstateerde bezwaren te ondervangen. METHODE. Er is literatuuronderzoek gedaan naar de manier waarop EBP in de literatuur wordt ingevuld. RESULTAAT. Hoewel in de literatuur met betrekking tot EBP wordt aangegeven dat het handelen van professionals gebaseerd zou moeten zijn op een integratie van wetenschappelijk onderzoek, klinische expertise en cliëntenvoorkeuren, krijgt de bron van het wetenschappelijk onderzoek de meeste nadruk. Binnen dit wetenschappelijk onderzoek wordt kwantitatief onderzoek bovendien doorgaans hoger gewaardeerd dan kwalitatief onderzoek. De andere kennisbronnen (deskundigheid van de cliënt en expertise van de verpleegkundige) die bij EBP worden onderscheiden, blijven veelal onderbelicht. DISCUSSIE EN CONCLUSIE. De manier waarop EBP meestal wordt ingevuld en geïmplementeerd brengt een aantal beperkingen met zich mee. Voorbeelden hiervan zijn de beperkte aandacht voor: de kern van het verplegen, de interactie tussen de cliënt en de verpleegkundige, de context of de cultuur waarin de zorgverlening plaatsvindt, het benutten van de ervaringsdeskundigheid van de cliënt en de expertise van de verpleegkundige zelf. In het artikel worden suggesties gegeven om deze beperkingen te ondervangen, zodat EBP inderdaad de integratie wordt van de verschillende kennisbronnen die in de literatuur worden onderscheiden en EBP met mogelijk meer succes kan worden geïmplementeerd.
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This study aimed to examine which kind of support through professional development activities is offered to teacher educators in the (Dutch) teacher education institutes for primary and secondary education regarding conducting practice-based research and supervising students’ research. Two online surveys were executed among deans and teacher educators to examine their views on institutional policies supporting professional development; the offered activities; their evaluation on the activities and teacher educators further needs for professional development. Results show that little attention is paid to professional development activities and if attention is paid it concerns mainly courses or supervised peer-exchange groups. However, support for professional development of teacher educators in conducting research and supervising students’ research is considered important. Most activities are executed isolated in each institute. A need for more collaboration between institutes on contributing to teacher educators’ professional development and collaboration at a national level is considered important.
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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.
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Als hulpverlener en als docent is het belangrijk dat je op de hoogte bent van de laatste ontwikkelingen in je vakgebied. Het laatste decennium wordt veel aandacht besteed aan de wetenschappelijke onderbouwing van diverse beroepen in de gezondheidszorg, de zorg dient 'evidence based' te zijn. In dit artikel wordt geschetst wat de uitgangspunten van de opleidingen zijn en volgens welke methodiek de implementatie wordt aangepakt.
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