Quality in Health Care, Vol 7, 149-158

Enabling the implementation of evidence based practice: a conceptual framework

A Kitson, G Harvey and B McCormack
Royal College of Nursing Institute, Royal College of Nursing, London, UK.

The argument put forward in this paper is that successful implementation of research into practice is a function of the interplay of three core elements--the level and nature of the evidence, the context or environment into which the research is to be placed, and the method or way in which the process is facilitated. It also proposes that because current research is inconclusive as to which of these elements is most important in successful implementation they all should have equal standing. This is contrary to the often implicit assumptions currently being generated within the clinical effectiveness agenda where the level and rigour of the evidence seems to be the most important factor for consideration. The paper offers a conceptual framework that considers this imbalance, showing how it might work in clarifying some of the theoretical positions and as a checklist for staff to assess what they need to do to successfully implement research into practice.

Copyright © 1998 Quality in Health Care
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Hawke, F., Burns, J., Landorf, K. B. (2009). Evidence-Based Podiatric Medicine: Importance of Systematic Reviews in Clinical Practice. J. Am. Podiatr. Med. Assoc. 99: 260-266 [Abstract] [Full Text]  
• Forgeron, P. A., Jongudomkarn, D., Evans, J., Finley, G. A., Thienthong, S., Siripul, P., Pairojkul, S., Sriraj, W., Boonyawatanangkool, K. (2009). Children's Pain Assessment in Northeastern Thailand: Perspectives of Health Professionals. Qual Health Res 19: 71-81 [Abstract]  
• Hewison, A. (2008). Evidence-Based Policy: Implications for Nursing and Policy Involvement. Policy Politics Nursing Practice 9: 288-298 [Abstract]  
• Gunningberg, L, Dahm, M F., Ehrenberg, A (2008). Accuracy in the recording of pressure ulcers and prevention after implementing an electronic health record in hospital care. Qual Saf Health Care 17: 281-285 [Abstract] [Full Text]  
• Scott, S. D., Estabrooks, C. A., Allen, M., Pollock, C. (2008). A Context of Uncertainty: How Context Shapes Nurses' Research Utilization Behaviors. Qual Health Res 18: 347-357 [Abstract]  
• Russell, G., Thille, P., Hogg, W., Lemelin, J. (2008). Beyond Fighting Fires and Chasing Tails? Chronic Illness Care Plans in Ontario, Canada. Ann Fam Med 6: 146-153 [Abstract] [Full Text]  
• Masterton, R., Craven, D., Rello, J., Struelens, M., Frimodt-Moller, N., Chastre, J., Ortqvist, A., Cornaglia, G., Lode, H., Giamarellou, H., Bonten, M. J. M., Eraksoy, H., Davey, P. (2007). Hospital-acquired pneumonia guidelines in Europe: a review of their status and future development. J Antimicrob Chemother 60: 206-213 [Abstract] [Full Text]  
• Kresse, M. R., Kuklinski, M. A., Cacchione, J. G. (2007). An Evidence-Based Template for Implementation of Multidisciplinary Evidence-Based Practices in a Tertiary Hospital Setting. American Journal of Medical Quality 22: 148-163 [Abstract]  
• Mccormack, B. (2006). Evidence-based practice and the potential for transformation. Journal of Research in Nursing 11: 89-94  
• Rycroft-Malone, J. (2006). The politics of the evidencebased practice movements: Legacies and current challenges. Journal of Research in Nursing 11: 95-108 [Abstract]  
• Karlsten, R, Strom, K, Gunningberg, L (2005). Improving assessment of postoperative pain in surgical wards by education and training. Qual Saf Health Care 14: 332-335 [Abstract] [Full Text]  
• Rutledge, D. N. (2005). Resources for Assisting Nurses to Use Evidence as a Basis for Home Care Nursing Practice. Home Health Care Management Practice 17: 273-280 [Abstract]  
• Hockley, J., Dewar, B., Watson, J. (2005). Promoting end-of-life care in nursing homes using an 'integrated care pathway for the last days of life'. Journal of Research in Nursing 10: 135-152 [Abstract]  
• Nutley, S., Walter, I., Davies, H. T. O. (2003). From Knowing to Doing: A Framework for Understanding the Evidence-into-Practice Agenda. Evaluation 9: 125-148 [Abstract]  
• McCormack, B. (2003). Knowing and acting -- A strategic practitioner-focused approach to nursing research and practice development. Journal of Research in Nursing 8: 86-100 [Abstract]  
• Rousseau, N., McColl, E., Newton, J., Grimshaw, J., Eccles, M. (2003). Practice based, longitudinal, qualitative interview study of computerised evidence based guidelines in primary care. BMJ 326: 314-314 [Abstract] [Full Text]  
• Rycroft-Malone, J, Kitson, A, Harvey, G, McCormack, B, Seers, K, Titchen, A, Estabrooks, C (2002). Ingredients for change: revisiting a conceptual framework. Qual Saf Health Care 11: 174-180 [Abstract] [Full Text]  
• Garbett, R., McCormark, B. (2002). A concept analysis of practice development. Journal of Research in Nursing 7: 87-100 [Abstract]  
• Wells, D. L., Dawson, P. (2002). A Framework for Developing Nursing Knowledge About the Effects of Dementia on Older Persons' Abilities. Journal of Applied Gerontology 21: 90-102 [Abstract]  
• Iliffe, S., Wilcock, J., Austin, T., Walters, K., Rait, G., Turner, S., Bryans, M., Downs, M. (2002). Dementia Diagnosis and Management in Primary Care: Developing and testing educational models. Dementia 1: 11-23 [Abstract]  
• Wallin, L, Bostrom, A-M, Harvey, G, Wikblad, K, Ewald, U (2002). Progress of unit based quality improvement: an evaluation of a support strategy. Qual Saf Health Care 11: 308-314 [Abstract] [Full Text]  
• Rycroft-Malone, J (2001). Formal consensus: the development of a national clinical guideline. Qual Saf Health Care 10: 238-244 [Abstract] [Full Text]  
• McCormack, B., Wright, J. (1999). Achieving dignified care for older people through practice development: A systematic approach. Journal of Research in Nursing 4: 340-352 [Abstract]