NURS 8114 Translation Models and Frameworks

Nurses possess distinctive qualifications to identify implementation strategies for enhancing nursing care across various practice settings (Boehm, Stolldorf, & Jeffery, 2020). Implementation science in nursing refers to a systematic and interdisciplinary approach to bridge the gap between research findings and their practical application in healthcare settings (Jones-Schenk & Bleich, 2019). It focuses on facilitating the integration of evidence-based practices into routine clinical care to improve patient outcomes (Jones-Schenk & Bleich, 2019). Likewise, evidence-based practice uses current information from research and knowledge gained from everyday living to make excellent clinical decisions (Stewart, Chambless, & Stirman, 2018).

Knowledge-to-action translation science (Knowledge-to-Action (KTA) is when “planned action theories are used to develop deliberate activities that facilitate change” (White, Dudley-Brown, & Terhaar, 2019, p.44). The Knowledge-to-Action framework is widely used in healthcare settings to guide the implementation of evidence-based practices and improve patient care. It emphasizes the importance of engaging critical stakeholders of different professions and, not only in healthcare, to use a systematic approach to move knowledge into action effectively (White, Dudley-Brown, & Terhaar, 2019). The Knowledge-to-Action framework provides a structured approach to closing the gap between knowledge creation and its practical application in the workplace.

In nursing, KTA is pivotal for addressing practice issues and ensuring that evidence-based research informs and improves patient care, such as the practice issue of treating patients respectfully. By applying KTA in nursing, practitioners can bridge the gap between research and practice, leading to enhanced patient care, improved outcomes, and a more evidence-based approach to healthcare delivery. Nurses can use the knowledge gained from daily living and research as a map to teach them how to respect their patients. Healthcare professionals must apply the knowledge and evidence they gain into action to improve current and future practices to lead to positive patient and societal outcomes.

NURS 8114 Translation Models and Frameworks

NURS 8114 Translation Models and Frameworks

Knowledge to Action Science Model

Conceptual frameworks are an integral tool in healthcare facilities, used to develop pathways to convert theories into working and effective practice. Knowledge translation has been defined as “the dynamic and iterative process that includes the synthesis, dissemination, exchange and ethically sound application of knowledge to improve health, provide more effective health services and products, and strengthen the health care system” (Straus, Tetroe & Graham, 2009). The Knowledge to Action science model involves exactly as its title states – the application of knowledge to improve patient care and outcomes.

Relevance of the Knowledge to Action Science Model

Regarding my practice problem of nurses obtaining euvolemic weight upon discharge of the CHF admitted patient [as part of discharge teaching], the best science translation model to achieve this outcome would be the Knowledge to Action Model. Given that the crux of care for the CHF admitted patient is reduction of intravascular fluid volume [to minimize symptoms], along with the already implemented nursing task of monitoring and documenting daily fluid balance and weight, it stands to reason that obtaining one final recorded [euvolemic] weight before discharge should not prove too daunting of a task.

Implementation of this framework will initially require acknowledgement of a practice gap in addition to statistical documentation of its merit toward patient outcomes. The practice gap has already been identified – accurate recording of fluid volume status and daily weight is not being performed, and euvolemic weight recording is not being performed at discharge. However, the fault in this cannot solely rely on the nursing staff. The nursing staff must have adequate equipment to perform the assigned task. [For the incapacitated patient], bed scales must be fully functional, and standing scales must also be equally functional and in sufficient supply. Improved job performance and patient care hinges on the nurses’ perception of a safe and empowering work environment (Wei et al., 2018), and that environment is inclusive of necessary equipment.

Conclusion

Obtaining this diagnostic data of euvolemic weight at discharge will aid in safe and appropriate medication reconciliation at discharge. Additionally, it will provide the patient a point of reference for continued weight monitoring post discharge at the next level of care (e.g. home, LTAC, SNF or rehab), which can alert the patient/clinical staff to weight gain possibly indicative of CHF exacerbation – at which time the appropriate provider can be notified for adjustments in diuretic therapy to avert hospital readmission.

References

Straus, S. E., Tetroe, J., & Graham, I. (2009). Defining Knowledge Translation. CMAJ : Canadian Medical Association Journal, 181(3-4), 165–168.

Wei, H., Sewell, K. A., Woody, G., & Rose, M. A. (2018). The State of the Science of Nurse Work Environments in the United States: A Systematic Review. International Journal of Nursing Sciences, 5(3), 287–300.

Collaboration offers the advantage of other experiences and viewpoints to confirm or challenge your own. Discussions can do the same and for some topics, getting early feedback is especially valuable. This Discussion is one such example. As you dig into the science of translation and select a framework or model for your proposed EBP QI project, you can look to your class colleagues for a check on your choice and your reasoning.

Photo Credit: steheap / Adobe Stock

To prepare:

• Review the Week 5 Learning Resources. Pay particular attention to the featured frameworks/models, below, in the White, Dudley-Brown, and Terhaar text.
• Identify the translation science framework or model that is most relevant to your practice problem from among the following three models and consider your reasoning:
  • Roger’s Diffusion of Innovations (pp. 36–39);
  • Knowledge-to-Action (pp. 42–45);
  • Theory of Reasoned Action (pp. 66–67).
• Assess your understanding of “translation science” and how you would explain it in the context of evidence-based practice and quality improvement.

With these thoughts in mind …

By Day 3 of Week 5

Post an explanation of the translation science framework or model that you selected and explain why it is most relevant to your practice problem. Be specific and provide examples.

Read a selection of your colleagues’ posts.

By Day 6 of Week 5

Respond to at least two colleagues on 2 different days, with preference to colleagues who selected different translation science frameworks or models from the one you chose. Recommend another framework/model they might consider and/or clarify their explanation of translation science. Cite sources to support your posts.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 5 Discussion Rubric

Post by Day 3 of Week 5 and Respond by Day 6 of Week 5

To Participate in this Discussion:

Week 5 Discussion

Module 3 Assignment: Exploring EBP Quality Improvement

Continue to develop the Module 3 Assignment you began in Week 4. This week, identify or confirm the translation science framework or model you would use to implement an EBP Quality Improvement project to address a hypothetical practice problem.

Be aware that you are not limited to the three frameworks/models you examined for the Week 5 Discussion. Select the translation science framework/model that is the best fit for your practice problem and be prepared to explain your reasoning.

There is no submission this week.

Photo Credit: [Steve Hix/Fuse]/[None]/Getty Images

Submit your Assignment by Day 7 of Week 6.

Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates/general#s-lg-box-20293632). All papers submitted must use this formatting.

What’s Coming Up in Week 6?

Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images

Next week you will complete your Module 3 Assignment, which requires a written paper describing the three sites you are exploring for a future EBP QI project and the PowerPoint presentation you would make to stakeholders at one of those sites. Although you will not make your presentation as part of this course, your work now can support a future presentation. Approach your preparation with the seriousness that a presentation to a Quality Improvement office or executive administrators, as well as senior nursing staff, would demand.

There is no Discussion, so that you can devote the week to completing the Assignment. Refer to the Module 3 Assignment Rubric for grading expectations.

Next Week

To go to the next week:

Week 6

Week 5: Introduction to the Science of Translation, I

From your experience, what are the roadblocks to change? What keeps stale practices in place when fresh approaches are needed? And when innovations are introduced, what influences how they are viewed and accepted? What conditions can create subpar results or mediocre outcomes?

When considering how to initiate and lead an evidence-based practice quality improvement project, these are not academic questions. The success of an initiative can depend on understanding the variables involved in introducing a practice change. As science supports finding the evidence, other applications of theory provide insight into “the interrelationships and complex organizational dimensions that are relevant to the translation of research or new knowledge into practice” (White, Dudley-Brown, & Terhaar, 2019, p. 34)—and, importantly, routes to action.

This week you will explore translation frameworks and models, with the goal of identifying one that is the best fit for your Module 3 EBP QI project.

Learning Objectives

Students will:

• Evaluate translation science frameworks and models for application to practice problems
• Apply implementation science frameworks/models for evidence-based practice quality improvement projects

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Learning Resources

Required Readings (click to expand/reduce)

White, K. M., Dudley-Brown, S., & Terhaar, M. F. (Eds.). (2019). Translation of evidence into nursing and healthcare (3rd ed.). Springer.

• Chapter 2, “The Science of Translation and Major Frameworks” (pp. 27–58)
  (Review from Week 4)
• Chapter 3, “Change Theory and Models: Framework for Translation” (pp. 59–73)

Boehm, L. M., Stolldorf, D. P., & Jeffery, A. D. (2020). Implementation science training and resources for nurses and nurse scientists. Journal of Nursing Scholarship, 52(1), 47–54. https://doi.org/10.1111/jnu.12510

(Review from Week 4)

Dunagan, P. B. (2017). The quality improvement attitude survey: Development and      preliminary psychometric characteristics. Journal of Clinical Nursing, 26(23–24), 5113–5120. https://doi.org/10.1111/jocn.14054

(Review from Week 4)

Hammersla, M., Belcher, A., Ruccio, L. R., Martin, J., & Bingham, D. (2021). Practice and quality improvement leaders survey of expectations of DNP graduates’ quality improvement expertise. Nurse Educator [Epub ahead of print]. https://doi.org/10.1097/NNE.0000000000001009

(Review from Week 4)

Jones-Schenk, J., & Bleich, M. R. (2019). Implementation science as a leadership and doctor of nursing   practice competency. The Journal of Continuing Education in Nursing, 50(11), 491–492. https://doi.org/10.3928/00220124-20191015-03

(Review from Week 4)

Powell, B. J., Waltz, T. J., Chinman, M. J., Damschroder, L. J., Smith, J. L., Matthieu, M. M., Proctor, E. K., & Kirchner, J. E. (2015). A refined compilation of implementation strategies: Results from the Expert Recommendations for Implementing Change (ERIC) project. Implementation Science, 10:21. https://doi.org/10.1186/s13012-015-0209-1

(Review from Week 4)

Rew, L., Cauvin, S., Cengiz, A., Pretorius, K., & Johnson, K. (2020). Application of project management tools and techniques to support nursing intervention research. Nursing Outlook, 68(4), 396–405. https://doi.org/10.1016/j.outlook.2020.01.007

(Review from Week 4)

Shea, C. M., Jacobs, S. R., Esserman, D. A., Bruce, K., & Weiner, B. J. (2014).                Organizational readiness for implementing change: A psychometric assessment of a new measure. Implementation Science, 9(7), 1–15.

(Review from Week 4)

Walden University Academic Skills Center. (n.d.). How do I create a strong PowerPoint presentation? https://academicanswers.waldenu.edu/faq/72804

(Review from Week 4)

Walden University Academic Skills Center. (n.d.). MS PowerPoint resources: Getting started. https://academicanswers.waldenu.edu/faq/330533

(Review from Week 4)

Document: College of Nursing PowerPoint Template (PPT document)

Document: Handout: Preparing for an EBP QI Presentation to Stakeholders at a Practice Site (Word document)

Required Media (click to expand/reduce)

Walden University. (2021). DNP glossary [Interactive media]. Walden University Blackboard. https://class.waldenu.edu

Optional Resources (click to expand/reduce)

Walden University Writing Center. (n.d.). Webinars: Scholarly writing. https://academicguides.waldenu.edu/writingcenter/webinars/scholarlywriting#s-lg-box-9094031

Walden University Writing Center. (n.d.). Writing as a process. https://academicguides.waldenu.edu/writingcenter/doctoral/capstone/preproposal/writingasaprocess

Rubric Detail

Select Grid View or List View to change the rubric’s layout.

Name: NURS_8114_Week5_Discussion_Rubric

• Grid View
• List View

		Excellent90%–100%	Good80%–89%	Fair70%–79%	Poor0%–69%
Main Posting:Response to the Discussion question is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.		40 (40%) – 44 (44%)Thoroughly responds to the Discussion question(s).Is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources. No less than 75% of post has exceptional depth and breadth. Supported by at least three current credible sources.	35 (35%) – 39 (39%)Responds to most of the Discussion question(s).Is somewhat reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module. 50% of the post has exceptional depth and breadth. Supported by at least three credible references.	31 (31%) – 34 (34%)Responds to some of the Discussion question(s).One to two criteria are not addressed or are superficially addressed. Is somewhat lacking reflection and critical analysis and synthesis. Somewhat represents knowledge gained from the course readings for the module. Cited with fewer than two credible references.	0 (0%) – 30 (30%)Does not respond to the Discussion question(s). Lacks depth or superficially addresses criteria.Lacks reflection and critical analysis and synthesis. Does not represent knowledge gained from the course readings for the module. Contains only one or no credible references.
Main Posting:Writing		6 (6%) – 6 (6%)Written clearly and concisely.Contains no grammatical or spelling errors. Adheres to current APA manual writing rules and style.	5 (5%) – 5 (5%)Written concisely.May contain one to two grammatical or spelling errors. Adheres to current APA manual writing rules and style.	4 (4%) – 4 (4%)Written somewhat concisely.May contain more than two spelling or grammatical errors. Contains some APA formatting errors.	0 (0%) – 3 (3%)Not written clearly or concisely.Contains more than two spelling or grammatical errors. Does not adhere to current APA manual writing rules and style.
Main Posting:Timely and full participation		9 (9%) – 10 (10%)Meets requirements for timely, full, and active participation.Posts main Discussion by due date.	8 (8%) – 8 (8%)Meets requirements for full participation.Posts main Discussion by due date.	7 (7%) – 7 (7%)Posts main Discussion by due date.	0 (0%) – 6 (6%)Does not meet requirements for full participation.Does not post main Discussion by due date.
First Response:Post to colleague’s main post that is reflective and justified with credible sources.		9 (9%) – 9 (9%)Response exhibits critical thinking and application to practice settings.Responds to questions posed by faculty. The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.	8 (8%) – 8 (8%)Response has some depth and may exhibit critical thinking or application to practice setting.	7 (7%) – 7 (7%)Response is on topic and may have some depth.	0 (0%) – 6 (6%)Response may not be on topic and lacks depth.
First Response: Writing		6 (6%) – 6 (6%)Communication is professional and respectful to colleagues.Response to faculty questions are fully answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English.	5 (5%) – 5 (5%)Communication is mostly professional and respectful to colleagues.Response to faculty questions are mostly answered, if posed. Provides opinions and ideas that are supported by few credible sources. Response is written in standard, edited English.	4 (4%) – 4 (4%)Response posed in the Discussion may lack effective professional communication.Response to faculty questions are somewhat answered, if posed. Few or no credible sources are cited.	0 (0%) – 3 (3%)Responses posted in the Discussion lack effective communication.Response to faculty questions are missing. No credible sources are cited.
First Response: Timely and full participation		5 (5%) – 5 (5%)Meets requirements for timely, full, and active participation.Posts by due date.	4 (4%) – 4 (4%)Meets requirements for full participation.Posts by due date.	3 (3%) – 3 (3%)Posts by due date.	0 (0%) – 2 (2%)Does not meet requirements for full participation.Does not post by due date.
Second Response: Post to colleague’s main post that is reflective and justified with credible sources.		9 (9%) – 9 (9%)Response exhibits critical thinking and application to practice settings.Responds to questions posed by faculty. The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.	8 (8%) – 8 (8%)Response has some depth and may exhibit critical thinking or application to practice setting.	7 (7%) – 7 (7%)Response is on topic and may have some depth.	0 (0%) – 6 (6%)Response may not be on topic and lacks depth.
Second Response: Writing		6 (6%) – 6 (6%)Communication is professional and respectful to colleagues.Response to faculty questions are fully answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English.	5 (5%) – 5 (5%)Communication is mostly professional and respectful to colleagues.Response to faculty questions are mostly answered, if posed. Provides opinions and ideas that are supported by few credible sources. Response is written in standard, edited English.	4 (4%) – 4 (4%)Response posed in the Discussion may lack effective professional communication.Response to faculty questions are somewhat answered, if posed. Few or no credible sources are cited.	0 (0%) – 3 (3%)Responses posted in the Discussion lack effective communication.Response to faculty questions are missing. No credible sources are cited.
Second Response: Timely and full participation		5 (5%) – 5 (5%)Meets requirements for timely, full, and active participation.Posts by due date.	4 (4%) – 4 (4%)Meets requirements for full participation.Posts by due date.	3 (3%) – 3 (3%)Posts by due date.	0 (0%) – 2 (2%)Does not meet requirements for full participation.Does not post by due date.
Total Points: 100

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