XVI Encuentro Internacional de Investigación en Cuidados SESIÓN PLENARIA: Evaluación y acreditación de la investigación en cuidados Ann McMahon: Evaluación y acreditación de la investigación en cuidados en la práctica clínica

1. XVI Eccuentro Internacional de
Investigacion en Cuidados
16th International Nursing Research
Conference
Cartagena, Espana
6-9 November 2012
Evaluation and accreditation of health care
research in clinical practice
Dr Ann McMahon
RCN Research & Innovation Adviser

2. Evaluation and accreditation of
health care research

3. Evaluation and accreditation of
health care research

4. Evaluation and accreditation of
health care research
The purpose of health care is to
improve and sustain public health and wellbeing and
prevent ill health
assure positive patient / service user experiences of health
care systems and services
achieve positive health outcomes and maximise the quality
of life of health service users
assure a peaceful death
This is our common purpose

5. Evaluation and accreditation of
health care research
Assumption: the purpose of health care research is to
generate knowledge to increase understanding of :
the underlying determinants of
optimal health and wellbeing
poor health
the conditions in which
optimal health and wellbeing is realised
poor health is prevented
in order for decision makers to improve and sustain public
health and wellbeing and prevent ill health

6. Evaluation and accreditation of
health care research
Assumption: the purpose of health care research is to
generate knowledge to increase understanding of :
what constitutes an optimal health care experience, in
which conditions and how it is created and sustained
the conditions in which patients are put at risk, and how
risk can be mitigated
in order to make decision that seek to assure positive patient
/ service user experiences of health care services (and do
no harm)

7. Evaluation and accreditation of
health care research
Assumption: the purpose of health care research is to
generate knowledge to increase understanding of :
what interventions work, in which conditions and at
what cost
how ‘what works’ is translated into routine clinical
practice
in order to enable decision makers to achieve positive health
outcomes, maximise the quality of life of health service
users and assure a peaceful death

8. Evaluation and accreditation of
health care research
Research does not
improve and sustain public health and wellbeing and
prevent ill health
assure positive patient / service user experiences of health
care systems and services
achieve positive health outcomes and maximise the quality
of life of health service users
assure a peaceful death
People do

9. Evaluation and accreditation of
health care research in clinical practice
How do we assess the value of health care research in
practice?

10. Accredited research evidence
Cochrane Collaboration (open access)
Cochrane Reviews
How do you know if one treatment will work better than another, or if it
will do more harm than good?
Cochrane reviews are systematic reviews of primary research in human care
and health policy, and are internationally recognised as the highest standard
in evidence based health care. They investigate the effects of interventions
for prevention, treatment and rehabilitation..... .

11. Evaluation and accreditation of
health care research in clinical practice
Accredited evidence
Joanna Briggs Institute (subsciption service)
The Joanna Briggs Institute (JBI) is an international not-for-profit, research and
development organisation based within the Faculty of Health Sciences at the
University of Adelaide, South Australia.
JBI collaborates internationally with over 70 entities across the world. The
Institute and its collaborating entities promote and support the synthesis,
transfer and utilisation of evidence through identifying feasible, appropriate,
meaningful and effective healthcare practices to assist in the improvement of
healthcare outcomes globally
JBI aims to provide the best available evidence to inform
clinical decision-making at the point of care.

12. Evaluation and accreditation of
health care research in clinical practice
demonstrating what works (the pursuit of certainty)
Randomised controlled trials (Gold Standard)
Systematic reviews
Health Technology Assessment (HTA)
- The production of evidence to inform clinical decision
making (EBP)
limitations
Uncertainty (DUETs)
Translation gap

13. Evaluation and accreditation of
health care research in clinical practice
translate knowledge of what works into clinical practice
Translational research is the process of taking current scientific
knowledge and ensuring it is applied in routine clinical care
implementation research (the acknowledgement of complexity)
‘… the scientific study of methods to promote the systematic uptake of
clinical research findings and other evidence-based practices into routine
practice, and hence to improve the quality…..of health care. It includes
the study of influences on healthcare professional and organisational
behaviour.’
Mixed methods
Action research

14. Evaluation and accreditation
of health care research in practice
How do we ensure that health care research is relevant in
clinical practice?
Key messages:
Demand:
public demand and debate / media exposure is important in stimulating the research
agenda, and motivating and engaging practitioners in EBP
credibility is a key driver, with demand needing to come from practitioners to drive /
advance practice standards
Method
the privileging of RCT methodology can be a barrier
important to differentiate between primary research and evaluation of innovation
practitioner scientists need to be embedded in services
Use:
in take up, brevity often plays an important part
getting evidence noticed involved demonstrating how it is applicable
to practice, saves wasted effort, achieves cost savings and fits with
the changing system

15. Evaluation and accreditation
of health care research in practice
Despite these challenges there is evidence of an innovative
culture within today’s health services
for example, in the UK, nurses are testing out innovations
in practice
in the RCN we are working to build nursing capability in
economic assessment
local innovations, themselves driven by evidence of need
in clinical practice and by national policy developments
should be driving national and international research
agendas

16. Evaluation and accreditation
of health care research in practice
The health research and development workforce
Recognise the contribution of all stakeholders and realise
the potential of the multidisciplinary research workforce
build capability in research and development
research training
mentorship
public and patient involvement
assure strong links between research, practice, policy and
research commissioning communities
clinical-academic career framework
Internships
‘sandpit’ events

17. Evaluation and accreditation of
health care research in clinical practice
How do we maximise the value of health care research in
practice?

18. XVI Eccuentro Internacional de
Investigacion en Cuidados
16th International Nursing Research
Conference
Cartagena, Espana
6-9 November 2012
Evaluation and accreditation of health care
research in clinical practice
Dr Ann McMahon
RCN Research & Innovation Adviser