Increasing value and reducing waste by optimizing the development of complex interventions: Enriching the development phase of the Medical Research Council (MRC) Framework

Bleijenberg, Nienke; Ginkel, Janneke M. de Man‐van; Trappenburg, Jaap C.A.; Ettema, Roelof; Sino, Carolien; Heim, Noor; Hafsteindóttir, Thóra B.; Richards, David; Schuurmans, Marieke J.

doi:10.1016/j.ijnurstu.2017.12.001

Cited by 214 publications

(283 citation statements)

References 43 publications

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“…The complexity of NHs, which is affected by multiple elements, structures, and hierarchies, means that the Complex Interventions Research Framework appears to be more appropriate in this research field (Mardis et al, ). In fact, several components, interdependent from each other are embodied in the NH process; therefore, using Complex Intervention Research Frameworks can support researchers in making appropriate methodological and practical decisions while developing, implementing, and evaluating (Bleijenberg et al, ) interventions promoting PS through handovers.…”

Section: Discussionmentioning

confidence: 99%

Nursing handovers and patient safety: Findings from an umbrella review

Bressan

Mio

Palese

2019

Journal of Advanced Nursing

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Aims To summarise available reviews on nursing handover (NH) and patient safety (PS), providing a set of evidence‐based recommendations for clinical practice and research. Design Umbrella review. Data sources We systematically searched PubMed, CINAHL, and Cochrane Library CENTRAL databases up to October 2018. Review methods Retrieved reviews were critically evaluated using the Checklist for Systematic Review and Research Syntheses. Then, an iterative approach and two different frameworks were adopted to categorize the findings in: (a) practice; and (b) research recommendations. Results A total of 17 reviews were included: among them, 16 reported a range of recommendations for clinical practice to promote PS by reducing adverse events. For what concerns research, 16 reviews recommended specific strategies to improve and strengthen research and its quality in the field of NHs and PS. Conclusion Changing nursing handover practices to increase PS is complex: it means changing the culture, roles and behaviour of any given clinical nursing setting. To be effective, the change requires a tailored approach, time and implementation strategies including education and support. Future studies should address the flexibility required by handovers in daily practice and the multiple needs with the aim of increasing the robustness of the available evidence on NHs. These should also embrace the Complex Interventions Research Framework. Impact Several reviews have been performed as summaries of research and practice evidence on NHs, but no summary of the established clinical and research recommendations on NHs and PS has been provided to date. Standardized handovers supported by technological solutions, facilitating face‐to‐face contact between nurses, possibly alongside bedside reports, can improve PS. Well‐designed longitudinal studies, on a wide scale, in different settings, based on a strong rationale and focused on measuring the association between handover and patients’ safety issues are recommended.

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Section: Discussionmentioning

confidence: 99%

Nursing handovers and patient safety: Findings from an umbrella review

Bressan

Mio

Palese

2019

Journal of Advanced Nursing

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“…Multimorbidity is now the norm, and as we have shown in a previous review (Richards et al., ) successful nursing interventions are not likely to be those that focus on narrow diagnostic conditions but on complex multiple interventions to address the multimorbid states that many of us will experience in our older age. We recommend that nurses make much greater use of research frameworks such as that proposed by the MRC (Craig et al., ) and developed by others (Bleijenberg et al., ; Richards & Rahm‐Hallberg, ) to assist them in designing studies in these areas.…”

Section: Implications For Research and Practicementioning

confidence: 99%

“…During the last decade and a half, the nursing and applied health services research community has acknowledged that research into interventions to improve health care and patient well‐being requires considerable methodological innovation (Bleijenberg et al., ). In two highly influential publications (Craig et al., ; Medical Research Council, ), the UK Medical Research Council (MRC) posited the idea that most if not all healthcare interventions are “complex” (an activity that contains a number of component parts with the potential for interactions between them which, when applied to the intended target population, produces a range of possible and variable outcomes) and that their investigation requires equally complex research methods.…”

Section: Introductionmentioning

confidence: 99%

The Second Triennial Systematic Literature Review of European Nursing Research: Impact on Patient Outcomes and Implications for Evidence‐Based Practice

Richards

Hanssen

Borglin

2018

Worldviews Ev Based Nurs

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European research in nursing remains overwhelmingly descriptive. We call on nursing researchers globally to raise the level of evidence and, therefore, the quality of care and patient outcomes. We urge them to replicate our study in their regions, diagnose reasons for the lack of appropriate research, identify solutions, and implement a deliberate, targeted, and systematic global effort to increase the number of experimental, high quality, and relevant studies into nursing interventions. We also call on journal editors to mandate an improvement in the standards of research reporting in nursing journals.

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“…A multifaceted approach is recommended to remove all barriers within a particular context to change current behaviour into the desired behaviour (Bartholomew et al, ; Craig et al, ; Miegel & Wachtel, ). To act upon the experienced barriers for oral care among hospitalised patients, a context analysis is needed (Bartholomew et al, ; Bleijenberg et al, ; Craig et al, ). This paper aims to provide insight into the context of oral care among hospitalised patients through exploring experiences in oral care from both nurses’ and patients’ perspectives in a hospital setting and examining oral health problems among hospitalised patients.…”

Section: Introductionmentioning

confidence: 99%

“…Complex interventions can be developed and evaluated following the four phases of the Medical Research Council (MRC) framework (Craig et al, ). The development of an intervention requires a clear view of the context (Bartholomew et al, ; Bleijenberg et al, ). During an analysis of the context, an health problem is assessed including behavioural and environmental causes (Bartholomew et al, ).…”

Section: Introductionmentioning

confidence: 99%

A context analysis on how oral care is delivered in hospitalised patients: A mixed‐methods study

Noort

Witteman

Hertog-Voortman

et al. 2019

Journal of Clinical Nursing

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Aims and Objectives:To analyse oral care delivery in one hospital through exploring experiences from both nurses' and patients' perspectives and examining patients' oral health.Background: Oral health problems are associated with undernutrition and other general health outcomes. Although oral care belongs to the essentials of nursing, it is often neglected. Improving oral health may require behaviour change of both nurses and patients. Defining tailored strategies need a clear view on the context. Design:A context analysis in one hospital using a convergent parallel mixed-methods design was reported following the EQUATOR guidelines using two checklists:COnsolidated criteria for REporting Qualitative research (qualitative research) and STROBE (observational research).Methods: Semi-structured interviews were conducted with 19 nurses and 11 patients. The topic list was based on the Integrated Change Model. Prospective oral examination was performed among 91 surgical patients using the Oral Health Assessment Tool (OHAT).Results: Nurses acknowledged that they did not prioritise oral care in daily practice. Furthermore, they lacked knowledge and skills to identify and provide care for oral problems. Nurses mentioned helpful resources to perform oral care, like standardised language and instruments. However, they had no access to or were unaware of them. Patients admitted that they did not prioritise oral care due to their sickness during hospitalisation, were unaware of the importance of oral care, but felt responsible for their oral care. The most prominent oral problems identified with the OHAT were unclean mouths (n = 75, 82%), unhealthy gum and tissues (n = 55, 60%) and dry mouth (n = 42, 46%). Conclusions:This context analysis identified inadequate oral care due to lack of positive attitude and knowledge in both nurses and patients, skills for nurses, and resources. S U PP O RTI N G I N FO R M ATI O NAdditional supporting information may be found online in the Supporting Information section. How to cite this article: van Noort HHJ, Witteman BJM, den Hertog-Voortman R, Everaars B, Vermeulen H, Huismande Waal G. A context analysis on how oral care is delivered in hospitalised patients: A mixed-methods study. J Clin Nurs.

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Increasing value and reducing waste by optimizing the development of complex interventions: Enriching the development phase of the Medical Research Council (MRC) Framework

Cited by 214 publications

References 43 publications

Nursing handovers and patient safety: Findings from an umbrella review

Nursing handovers and patient safety: Findings from an umbrella review

The Second Triennial Systematic Literature Review of European Nursing Research: Impact on Patient Outcomes and Implications for Evidence‐Based Practice

A context analysis on how oral care is delivered in hospitalised patients: A mixed‐methods study

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