The PARIHS Framework—A Framework for Guiding the Implementation of Evidence-based Practice

Rycroft‐Malone, Jo

doi:10.1097/00001786-200410000-00002

Cited by 710 publications

(799 citation statements)

References 9 publications

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“…Organizational context refers to "...the environment or setting in which people receive healthcare services, or in the context of getting research evidence into practice, the environment or setting in which the proposed change is to be implemented" [1] (page 299). Health services researchers are increasingly aware of the central role that organizational context plays in knowledge translation (the uptake of research evidence) by healthcare providers, and the potential role of context in improving patient, staff, and system outcomes.…”

Section: Introductionmentioning

confidence: 99%

Advancing the argument for validity of the Alberta Context Tool with healthcare aides in residential long-term care

Estabrooks

Squires

Hayduk

et al. 2011

BMC Med Res Methodol

116

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BackgroundOrganizational context has the potential to influence the use of new knowledge. However, despite advances in understanding the theoretical base of organizational context, its measurement has not been adequately addressed, limiting our ability to quantify and assess context in healthcare settings and thus, advance development of contextual interventions to improve patient care. We developed the Alberta Context Tool (the ACT) to address this concern. It consists of 58 items representing 10 modifiable contextual concepts. We reported the initial validation of the ACT in 2009. This paper presents the second stage of the psychometric validation of the ACT.MethodsWe used the Standards for Educational and Psychological Testing to frame our validity assessment. Data from 645 English speaking healthcare aides from 25 urban residential long-term care facilities (nursing homes) in the three Canadian Prairie Provinces were used for this stage of validation. In this stage we focused on: (1) advanced aspects of internal structure (e.g., confirmatory factor analysis) and (2) relations with other variables validity evidence. To assess reliability and validity of scores obtained using the ACT we conducted: Cronbach's alpha, confirmatory factor analysis, analysis of variance, and tests of association. We also assessed the performance of the ACT when individual responses were aggregated to the care unit level, because the instrument was developed to obtain unit-level scores of context.ResultsItem-total correlations exceeded acceptable standards (> 0.3) for the majority of items (51 of 58). We ran three confirmatory factor models. Model 1 (all ACT items) displayed unacceptable fit overall and for five specific items (1 item on adequate space for resident care in the Organizational Slack-Space ACT concept and 4 items on use of electronic resources in the Structural and Electronic Resources ACT concept). This prompted specification of two additional models. Model 2 used the 7 scaled ACT concepts while Model 3 used the 3 count-based ACT concepts. Both models displayed substantially improved fit in comparison to Model 1. Cronbach's alpha for the 10 ACT concepts ranged from 0.37 to 0.92 with 2 concepts performing below the commonly accepted standard of 0.70. Bivariate associations between the ACT concepts and instrumental research utilization levels (which the ACT should predict) were statistically significant at the 5% level for 8 of the 10 ACT concepts. The majority (8/10) of the ACT concepts also showed a statistically significant trend of increasing mean scores when arrayed across the lowest to the highest levels of instrumental research use.ConclusionsThe validation process in this study demonstrated additional empirical support for construct validity of the ACT, when completed by healthcare aides in nursing homes. The overall pattern of the data was consistent with the structure hypothesized in the development of the ACT and supports the ACT as an appropriate measure for assessing organizational context in nursing homes. ...

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Section: Introductionmentioning

confidence: 99%

Advancing the argument for validity of the Alberta Context Tool with healthcare aides in residential long-term care

Estabrooks

Squires

Hayduk

et al. 2011

BMC Med Res Methodol

116

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“…Organization and leadership form the cornerstones for successful implementation. [23] Transformational leadership could help improve the structure of the model by formally incorporating the system's basic functions into each nurse's role description, and this could help create a culture and context that promotes primary nursing. Dobson et al have shown that primary nursing is the most effective way to provide nursing care within haemodialysis care.…”

Section: Discussionmentioning

confidence: 99%

The primary nursing care delivery system within a haemodialysis context – experiences of haemodialysis primary nurses in Sweden

Johansson

Lundström²,

Heiwe

2015

Clinical Nursing Studies

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Background: Primary nursing is a widespread organisational system for nursing that aims to reduce fragmentation of patient care. The system is implemented in haemodialysis care, but the system was not originally designed for this type of clinical practice. This study explored the model's adaptation to a haemodialysis setting as well as its emotional impact on the primary nurses. Methods: Nurses were recruited through criteria-based sampling until saturation. Data were collected through semi-structured interviews, and a contextual analysis within a phenomenographic approach was used to process the data. Results: Primary nurses' pedagogical role needs to be clarified, and the nurses have to be aware that they should provide education to the patients. The outcome space contained experiences of flexible, unclear duties, a sense of sole and overriding responsibility for all aspects of the patient's well-being and management, and unclear professional boundaries. The role was experienced as emotionally demanding. Conclusions: The primary nursing system needs to be adapted to haemodialysis nursing. Regular counselling should be used as an intervention to improve the primary nurses' emotional situation.

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“…Studies grapple with issues such as the support, empowerment and opportunity they provide/do not provide (Haugh and Laschinger, 1996;Almost and Spence-Laschinger, 2002;Tourangeau et al, 2009), or their social functioning and what makes them psychologically healthy or unhealthy (Leveck and Jones, 1996;Dendaas, 2004Dendaas, , 2010Lavoie-Tremblay et al, 2008;Vessey et al, 2009), or how their architecture and design features can impact care and outcomes (Williams, 2001;Parker et al, 2004;Becker, 2007;Marquardt and Schmieg, 2009). Similarly, nursing environment has also emerged in discussions of leadership capacity, such as settings for practice enhancement and development strategies (McCormack and McCance, 2011;McCormack et al, 2013), as 'contexts' -with political, economic and social variability -that help or hinder research knowledge translation (Kitson et al, 1998;Rycroft-Malone, 2004;Rycroft-Malone et al, 2013) and in specific forms as high performing and attractive 'magnet' institutions (Scott et al, 1999;Buchan, 1999;Upenieks, 2003). Continuing this latter theme, nursing environment has also been mobilised in debates on the 'best places' to care, as in the case of institutionalized settings versus homes (West et al, 2000;Watty et al, 2003;Parratt and Fahy, 2004), and through debates on the nature and importance of physical proximity and presence in caring interactions and relationships (Osterman and Schwartz-Barcott, 1996;Melnechenko, 2003;MacKinnon et al, 2005), particularly given the emergence of nursing in cyberspace in the last two decades (Hern et al, 1997;Cudney and Weinert, 2000).…”

Section: The Second Wave: Environment As a Broad Empirical Concernmentioning

confidence: 99%

Transfusing our lifeblood: Reframing research impact through inter-disciplinary collaboration between health geography and nurse education

Kyle

Atherton

Kesby

et al. 2016

Social Science & Medicine

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Geographers have long grappled with how their research can positively impact individuals, communities and society. Demonstrating research impact is an increasingly important aspect of academic life internationally. In this paper we argue that agendas for encouraging 'impact' would be well-served if impact through teaching was identified and stimulated more explicitly, and if academics better recognised and seized the opportunities that already exist for such impact. We take engagement between health geography and nurse education as an example of how social scientists could demonstrate research impact through inter-disciplinary involvement in the education of health care professionals, and specifically student nurses. We begin by showing how the UK's Research Excellence Framework (widely regarded as the key reference point for research performance management regimes internationally) has tended to produce an undervaluation of impact via education in many disciplines. A comprehensive overview of international scholarship at the intersection between geography and nursing is then presented. Here we trace three 'waves of enquiry' that have focused on research interactions before calling for a fourth focused on critical pedagogy. To illustrate the possibilities of this fourth wave, we sketch a case study that outlines how engagement with research around blood donation could help provide a foundation for critical pedagogy that challenges student nurses to practice reflexively, think geographically and act justly. Finally, we call for closer engagement between health geography and nurse education, by encouraging educators to translate, teach, and transfuse ideas and people between health geography and nurse education. In so doing, we argue that work at this interface can be mutually beneficial and demonstrate impact both within and beyond research assessment rubrics. Hence, our ideas are relevant beyond nurse education and geography insofar as this paper serves as an example of how reframing research impact can recover the importance of impact through education.

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The PARIHS Framework—A Framework for Guiding the Implementation of Evidence-based Practice

Cited by 710 publications

References 9 publications

Advancing the argument for validity of the Alberta Context Tool with healthcare aides in residential long-term care

Advancing the argument for validity of the Alberta Context Tool with healthcare aides in residential long-term care

The primary nursing care delivery system within a haemodialysis context – experiences of haemodialysis primary nurses in Sweden

Transfusing our lifeblood: Reframing research impact through inter-disciplinary collaboration between health geography and nurse education

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