Evidence-based practice (EBP) is the backbone of knowledge for all Doctor of Nursing Practice (DNP)-prepared nurses. As professionals who understand translational research (TR), they incorporate research findings into the design and evaluation of innovative care modules, cost-effective strategies and health policies. In addition, they translate evidence gained through research into practice to improve systems of care and measure outcomes of patients, populations or communities.
TR aims to involve multiple stakeholders in the research and implementation process to build policy, practices, clinical pathways and guidelines. Research discoveries can only make a real difference if they impact care.
What Is Translational Research?
TR is “translating” or “transitioning” results or observations into practical applications. The Centers for Disease Control and Prevention (CDC) defines TR as a process that “explores how scientific work moves into practice and benefits society” and “involves studying processes for putting research outputs into practice or use.” In summary, TR helps incorporate medical breakthroughs into patient care, acting as a “bridge” from basic science to widespread practice.
What Is Meant by Implementation Science?
While translational science is not the same as implementation science, the two are very similar. Implementation science is “a variety of methods of assessment, inquiry, and formal research whose purpose is to systematically assess, build on strengths, and address potential weaknesses within and between the many factors that affect implementation or the phases of implementation.” According to one study from 2020, implementation science focuses on identifying and addressing barriers to facilitate the inclusion of EBP interventions into practice to close the gap between research and practice for more successful integration. In addition, implementation science unpacks the complexity of de-implementing inappropriate interventions that are not EBP.
What Are Examples of De-Implementing Inappropriate Interventions?
Below are two examples of non-EBP interventions that have been accepted practice for some time. These inappropriate interventions continue to be very slow to change in some practice areas, meaning there is room for advancements and improvements in both.
- Meperidine pain medicine. After years of numerous studies and education, the use of meperidine for pain control is decreasing. Research shows that repeat meperidine dosing can produce anxiety, hallucinations, tremors, myoclonus and seizures. Reducing its use for pain control prevents morbidity and possibly decreases hospital length of stay, particularly in older adults. Once a widely prescribed opioid analgesic, it is now recommended for shivering, rigors and short-term pain management in patients who do not tolerate other opioids.
- Neutropenic diet. A no-fresh fruit or fresh vegetable neutropenic diet continues to be standard practice at many cancer centers to prevent infection in patients with cancer with low white blood counts. However, numerous research studies, including those in high-risk stem cell transplant patients, show that neutropenic diets are ineffective and potentially harmful. It causes changes in the gut microbiome that contribute to adverse outcomes. As a result, a neutropenic diet is categorized as “effectiveness unlikely” and not recommended for practice by the Oncology Nursing Society.
Why Is Translation Science Important?
It often takes decades for research findings to be adopted into everyday practice and impact health outcomes, with several innovations never making it into practice. In fact, the 2020 implementation science study notes “that it takes 17–20 years to get clinical innovations into practice; moreover, fewer than 50% of clinical innovations ever make it into general usage.” TR speeds up this process by linking practice, policy and research stakeholders.
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