This study will explore key factors that influence successful implementation of research evidence into practice, focussing on the feasibility and effectiveness of facilitation as an implementation strategy. The study is a pragmatic, randomised, controlled trial with three intervention arms (standard dissemination and two different models of facilitation) in 24 long term nursing sites (6 sites in each of four European countries). The sites implement research-based guidance on continence promotion and receive differing levels of facilitation support to do so. Detailed contextual, process and outcome data, including economic data, will be collected to fully explore the complex processes at work during implementation. A proactive dissemination strategy diffuses study findings to a wider policy and practice community.
The project is underpinned by a conceptual framework, the Promoting Action on Research Implementation in Health Services (PARIHS) framework. This framework proposes that the successful implementation of research evidence into practice is dependent on the complex interplay of the nature of the evidence to be implemented (how robust it is and how it fits with clinical, patient and local experience), the context in which it is to be implemented (the prevailing culture, leadership and commitment to evaluation/learning) and the way in which the process is facilitated (how and by whom).
Research evidence underpins best practice, but is not always used in health care practice. The role of facilitation in promoting uptake of evidence and the effectiveness of different types of facilitation needs further exploration.
This project aims to explore and evaluate facilitation as a process for promoting the uptake of research evidence on continence promotion into clinical practice.
The scientific objectives of the study are to:
We will be able to look at the effectiveness of the different facilitation programmes, and understand the complex process issues involved in implementing evidence in to practice.