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Evaluation and Policy in Transforming Nursing

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Presentation on theme: "Evaluation and Policy in Transforming Nursing"— Presentation transcript:

1 Evaluation and Policy in Transforming Nursing
Martha Ann Carey, PhD, RN Kells Consulting, Media, PA, USA 1st International Nursing Conference Kuching, Sarawak, Malaysia 2014

2 Pressures From Advances in health sciences and technology
Increased complexities in morbidities Complicated health care systems Changing women’s roles © Carey 2014

3 To Respond and Manage Change
A broad perspective Global, national, regional Societal norms and expectations, beyond nursing Professional standards Local situation Organizational policies Resources © Carey 2014

4 Transforming or Evolving?
Implies substantial, basic change History of caring Addition of science base, theoretical frameworks, evidence-based practice Evolving Adding to the basic structure Include science/research and caring tradition © Carey 2014

5 Policy High level rules Embedded in legislation or local regulations
Focus on national or broad issues Research results  knowledge  policy Allocation of resources Enables & constrains practice Intended to be of service for the public good © Carey 2014

6 Programs Based on research, generally System level focus
Environment & sustainability Cost benefit © Carey 2014

7 Practice Implementation at local level Possibly evaluation
Monitor performance indicators Focus generally at the patient level © Carey 2014

8 Two Components of Research
Doing research to develop knowledge Quantitative Qualitative Mixed methods Using research results “Translating” Efficacy and effectiveness Adopting vs adapting Fidelity vs salience, rigor AND relevance © Carey 2014

9 Credibility Bestowed by audience
Different audiences hear differently, based on expectations & history Necessary for utilization and sustained support Facilitated by apparent use of agreed upon norms © Carey 2014

10 Evaluation Formative and summative Evaluation and research - overlap
Develop & refine useful practices (i.e., EBP) Evaluation and research - overlap Program evaluation & evaluation research Theories and models, in addition to traditional science methods © Carey 2014

11 Developmental Evaluation
Patton, 2011 As contrasted with formative & summative Complex, uncertainty, innovation Explore dynamics of complex system Stable vs oscillating or continuing Feedback to support development, not focus on the end outcome © Carey 2014

12 Policy - Recent Emphasis
Translation Links science, policies, and programs “Science to service”, “bench to bedside” Community, patient, and family involvement Models are being developed © Carey 2014

13 National Center for Advancing Translational Science (NCATS), NIH
Accelerate the use of scientific discovery Basic science  patient studies  clinical practice Using an integrated approach Common goals Sharing information at each stage ensures Researchers are meeting community health needs Problems in the clinic informs work in the laboratory

14 “Convergence Model” US National Academy of Science
Expanded form of interdisciplinary research Paradigm capable of generating new ideas, discoveries, methodologies Conceptual approaches and tools that stimulate advances in basic research and application Leads to new inventions, innovations, treatment protocols, and strategies for education & training

15 National Academy of Science, 2014

16 Resistance to Change From nurses -“Old School/Old Guard”
Seen as risky, not appropriate Questionable rewards Other professions - “turf” wars © Carey 2014

17 What are Nursing’s Role and Responsibility?
Recognize the opportunity to continue to develop Who to collaborate with, and how to do this Identify resources and plan Include evaluation & dissemination Input to policy © Carey 2014

18 Implications for Nursing
Blend of clinical, organizational, economic, and leadership skills Advanced degree professionals at the clinical level and academic level Critique nursing and other clinical scientific findings, and design care delivery Acceptable and economically feasible Significantly impacts health care outcomes © Carey 2014

19 Balance Caring and Transforming

20 Terima Kasih

21 Patton, M.Q. (2011). Developmental evaluation: Applying complexity concepts to enhance innovation and use. New York, NY: Guilford The National Academies Press at © Carey 2014

22 Power Point file at © Carey 2014

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