Barriers To Evidence Translation In Addressing Cancer

The Role of Stakeholders in Translation Science

The translation of research evidence into practice often depends on the early identification and engagement of stakeholders. The engagement of stakeholders can be vital, not only because successful practice change depends on their buy-in, leadership, or material support, but also because their insights help enhance the practice scholar’s understanding of the practice problem at the local level. It is key that you identify your practice stakeholders up front and engage them throughout the design of your practice change project.

Engaging stakeholders early on in the articulation of a practice problem contributes to an aligned practice problem in which the interprofessional team and patient gains by this collaborative relationship. Each interaction with stakeholders contributes to the articulation of a compelling practice problem. Interactions with stakeholders benefit from the strategic use of effective communication that include talking points specific to the practice problem. A succinct message while engaging stakeholders assists in keeping the communication focused on the possibilities of translating best available research evidence practice for the intention of influencing practice outcomes.

Translation science respects the identification of stakeholders, and their role is ongoing through each phase of a practice change project. Also, the level of engagement with each stakeholder will assume unique and important roles. This level of engagement includes information giving, information gathering, consultation, participation, and collaboration.

Challenges and Barriers Related to Evidence Translation

Changing established behavior of any kind is difficult. It is particularly challenging in healthcare because of the complex relationships among a wide range of organizations, professionals, and patients. Certain factors may help to foster an environment that is conducive to change. An organization where there is strong leadership and everyone is focused on improving practice outcomes is likely to develop motivated staff with a desire for continuous improvement. However, barriers to changing established practice may prevent or impede progress in all organizations, whatever the culture.

Overcoming Barriers

Equipped with an understanding of the types of barriers faced in healthcare, you now need to identify the barriers that your practicum setting faces. This will involve looking at the specific barriers for different individuals in your organization in relation to a particular piece of evidence-based guidance.

When translating any new research, evidence-based intervention, it is essential to identify the gap between recommended practice and current practice (baseline assessment). Ideally, this assessment will also help to identify the potential and actual barriers to change, allowing you to pinpoint the practical actions needed to translate the research, evidence-based intervention along with the groups of professionals who are key in bridging this gap

Those affected by change may be clinicians, managers, or other support staff, and both individual roles and how people work with others will need to be considered. The potential impact of any new recommendations can be described in terms of type of staff required; number of staff required; training and equipment needed; relevant, established networks, meetings, forums; and ongoing educational initiatives.

Evidence shows that there are many methods that can be used to identify where change is needed and potential barriers to that change. Your choice of method will be guided by local circumstances, including the numbers of professionals involved and the time and resources available. In some situations, more than one approach may be needed.

Interventions to Overcome Barriers

Thus far, we gained an understanding of the barriers faced in healthcare and explored methods to help you identify the barriers you may face when translating a research, evidence-based intervention. Let’s take a look at how you can overcome these barriers using evidence-based methods.

Remember, there is no one method to overcome all the different barriers; different approaches will be effective for different people and different situations. These methods can be used on their own or together; combining methods may have a bigger impact on change.

References

Dang, D., & Dearholt, S. (2018). Johns Hopkins nursing evidence-based practice model and guidelines (3rd ed.). Sigma Theta Tau International.

Magda, M. M., Safaan, N. A., & Okby, O. (2016). Facilitating Factors for Overcoming Barriers Facing Nurses for Research Utilization in Clinical Settings. American Journal of Nursing Research, 4(1), 13-24.

Rhiner, M. (2013). Using implementation science as the core of the Doctor of Nursing Practice inquiry project. Journal of Professional Nursing, (31)3, 200-207. https://doi.org/10.1016/j.profnurs.2014.11.002

Tacia, L., Pheley, A., & Lehto, R. H. (2015). Identifying barriers to evidence-based practice adoption: A focus group study. Clinical Nursing Studies, 3(2) 90-96. https://doi.org/10.5430/cns.v3n2p90

Tucker, S. (2017). People, practices, and places: Realities that influence evidence‐based practice uptake. Worldviews on Evidence‐Based Nursing, 14(2), 87-89. https://doi.org/10.1111/wvn.12216

White, K. M., Dudley-Brown, S., & Terhaar, M. F. (2016). Translation of evidence into nursing and health care (2nd ed.). Springer Publishing Company