Sustainability of Evidence-Based Acute Pain Management Practices for Hospitalized Older Adults

Abstract

Little is known regarding sustainability of evidence-based practices (EBPs) following implementation. This article reports sustainability of evidence-based acute pain management practices in hospitalized older adults following testing of a multifaceted Translating Research Into Practice (TRIP) implementation intervention. A cluster randomized trial with follow-up period was conducted in 12 Midwest U.S. hospitals (six experimental, six comparison). Use of evidence-based acute pain management practices and mean pain intensity were analyzed using generalized estimating equations across two time points (following implementation and 18 months later) to determine sustainability of TRIP intervention effects. Summative Index scores and six of seven practices were sustained. Experimental and comparison group differences for mean pain intensity over 72 hours following admission were sustained. Results revealed most evidence-based acute pain management practices were sustained for 18 months following implementation. Further work is needed to identify factors affecting sustainability of EBPs to guide development and testing of sustainability strategies.

Keywords

sustainability evidence-based practice acute pain management older adults implementation

Get full access to this article

View all access options for this article.

References

Avorn

Fischer

(2010). “Bench to behavior”: Translating comparative effectiveness research into improved clinical practice. Health Affairs, 29, 1891-1900.

Brooks

J. M.

Titler

M. G.

Ardery

Herr

(2009). Effect of evidence-based acute pain management practices on inpatient costs. Health Services Research, 44, 245-263.

Buchanan

Voigtman

Mills

(1997). Implementing the agency for health care policy and research pain management pediatric guideline in a multicultural practice setting. Journal of Nursing Care Quality, 11, 23-35.

Carr

D. B.

Jacox

A. K.

(1997). Acute pain management: Operative or medical procedures and trauma clinical practice guideline. Collingdale, PA: Diane.

Chambers

D. A.

Glasgow

R. E.

Stange

K. C.

(2013). The dynamic sustainability framework: Addressing the paradox of sustainment amid ongoing change. Implementation Science, 8(1), Article 117.

Davies

Edwards

(2013). Sustainability of healthcare innovations. In Straus

Tetroe

Graham

I. D.

(Eds.), Knowledge translation in health care: Moving from evidence to practice (2nd ed., pp. 237-248). Chichester, UK: John Wiley.

Diggle

P. J.

Heagerty

P. J.

Liang

K. Y.

Zeger

S. L.

(2002). Analysis of longitudinal data (2nd ed.). Oxford, UK: Oxford University Press.

Donner

(1985). A regression approach to the analysis of data arising from cluster randomization. International Journal of Epidemiology, 14, 322-326.

Eccles

M. P.

Armstrong

Baker

Cleary

Davies

. . . Sibbald

(2009). An implementation research agenda. Implementation Science, 4(1), Article 18.

10.

Glasgow

R. E.

Chambers

(2012). Developing robust, sustainable, implementation systems using rigorous, rapid and relevant science. Clinical and Translational Science, 5, 48-55.

11.

Grimshaw

J. M.

Eccles

M. P.

Lavis

J. N.

Hill

S. J.

Squires

J. E.

(2012). Knowledge translation of research findings. Implementation Science, 7(1), Article 50.

12.

Higuchi

K. S.

Davies

B. L.

Edwards

Ploeg

Virani

(2011). Implementation of clinical guidelines for adults with asthma and diabetes: A three-year follow-up evaluation of nursing care. Journal of Clinical Nursing, 20, 1329-1338.

13.

Ilott

Gerrish

Pownall

Eltringham

Booth

(2013). Exploring scale-up, spread, and sustainability: An instrumental case study tracing an innovation to enhance dysphagia care. Implementation Science, 8(1), Article 128.

14.

Liang

K. Y.

Zeger

S. L.

(1986). Longitudinal data analysis using generalized linear models. Biometrika, 73, 13-22.

15.

Moore

J. E.

Mascarenhas

Bain

Straus

S. E.

(2017). Developing a comprehensive definition of sustainability. Implementation Science, 12(1), Article 110.

16.

Phillips

D. M.

(2000). JCAHO pain management standards are unveiled. JAMA, 284, 428-429.

17.

Ploeg

Markle-Reid

Davies

Higuchi

Gifford

Bajnok

. . . Bookey-Bassett

(2014). Spreading and sustaining best practices for home care of older adults: A grounded theory study. Implementation Science, 9(1), Article 162.

18.

Proctor

Luke

Calhoun

McMillen

Brownson

McCrary

Padek

(2015). Sustainability of evidence-based healthcare: Research agenda, methodological advances, and infrastructure support. Implementation Science, 10(1), Article 88.

19.

Rogers

E. M.

(2010). Diffusion of innovations. New York, NY: Simon & Schuster.

20.

Scheirer

M. A.

(2013). Linking sustainability research to intervention types. American Journal of Public Health, 103, e73-e80.

21.

Scheirer

M. A.

Dearing

J. W.

(2011). An agenda for research on the sustainability of public health programs. American Journal of Public Health, 101, 2059-2067.

22.

Shediac-Rizkallah

M. C.

Bone

L. R.

(1998). Planning for the sustainability of community-based health programs: Conceptual frameworks and future directions for research, practice and policy. Health Education Research, 13, 87-108.

23.

Shuman

C. J.

Ploutz-Snyder

R. J.

Titler

M. G.

(2017). Development and testing of the Nurse Manager EBP Competency Scale. Western Journal of Nursing Research. doi: 10.1177/0193945917728249

24.

Stacey

Pomey

M. P.

O’Connor

A. M.

Graham

I. D.

(2006). Adoption and sustainability of decision support for patients facing health decisions: An implementation case study in nursing. Implementation Science, 1(1), Article 17.

25.

Stirman

S. W.

Kimberly

Cook

Calloway

Castro

Charns

(2012). The sustainability of new programs and innovations: A review of the empirical literature and recommendations for future research. Implementation Science, 7(1), Article 17.

26.

Titler

M. G.

(2004). Methods in translation science. Worldviews on Evidence-Based Nursing, 1, 38-48.

27.

Titler

M. G.

Everett

L. Q.

(2001). Translating research into practice: Considerations for critical care investigators. Critical Care Nursing Clinics of North America, 13, 587-604.

28.

Titler

M. G.

Herr

Brooks

J. M.

Xie

X. J.

Ardery

Schilling

M. L.

. . . Clarke

W. R.

(2009). Translating research into practice intervention improves management of acute pain in older hip fracture patients. Health Services Research, 44, 264-287.

29.

Titler

M. G.

Herr

Xie

X. J.

Brooks

J. M.

Schilling

M. L.

Marsh

J. L.

(2009). Summative index: Acute pain management in older adults. Applied Nursing Research, 22, 264-273.

30.

Tricco

A. C.

Ashoor

H. M.

Cardoso

MacDonald

Cogo

Kastner

. . . Straus

S. E.

(2016). Sustainability of knowledge translation interventions in healthcare decision-making: A scoping review. Implementation Science, 11(1), Article 55.

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.06 MB

0.01 MB