TY - JOUR

T1 - Using Nonparticipant Observation as a Method to Understand Implementation Context in Evidence-Based Practice

AU - Eldh, A.C.

AU - Rycroft-Malone, J.

AU - van der Zijpp, T.

AU - McMullan, C.

AU - Hawkes, C.

PY - 2020/6/29

Y1 - 2020/6/29

N2 - Background: The uptake of evidence-based knowledge in practice is influenced by context. Observations are suggested as a valuable but under-used approach in implementation research for gaining a holistic understanding of contexts. Aim: The aim of this paper is to demonstrate how data from observations can provide insights about context and evidence use in implementation research. Methods: Data were collected over 24 months in a randomised trial with an embedded realist evaluation in 24 nursing homes across four European countries; notes from 183 observations (representing 335 hours) were triangulated with interview transcripts and context survey data (from 357 staff interviews and 725 questionnaire responses, respectively). Results: Although there were similarities in several elements of context within survey, interview and observation data, the observations provided additional features of the implementation context. In particular, observations demonstrated if and how the resources (staffing and supplies) and leadership (formal and informal, teamwork, and professional autonomy) affected knowledge use and implementation. Further, the observations illuminated the influence of standards and the physical nursing environment on evidence-based practice, and the dynamic interaction between different aspects of context. Linking Evidence to Action: Although qualitative observations are resource-intensive, they add value when used with other data collection methods, further enlightening the understanding of the implementation context and how evidence use and sharing are influenced by context elements. Observations can enhance an understanding of the context, evidence use and knowledge-sharing triad in implementation research. © 2020 The Authors. Worldviews on Evidence-based Nursing published by Wiley Periodicals LLC on behalf of Sigma Theta Tau International

AB - Background: The uptake of evidence-based knowledge in practice is influenced by context. Observations are suggested as a valuable but under-used approach in implementation research for gaining a holistic understanding of contexts. Aim: The aim of this paper is to demonstrate how data from observations can provide insights about context and evidence use in implementation research. Methods: Data were collected over 24 months in a randomised trial with an embedded realist evaluation in 24 nursing homes across four European countries; notes from 183 observations (representing 335 hours) were triangulated with interview transcripts and context survey data (from 357 staff interviews and 725 questionnaire responses, respectively). Results: Although there were similarities in several elements of context within survey, interview and observation data, the observations provided additional features of the implementation context. In particular, observations demonstrated if and how the resources (staffing and supplies) and leadership (formal and informal, teamwork, and professional autonomy) affected knowledge use and implementation. Further, the observations illuminated the influence of standards and the physical nursing environment on evidence-based practice, and the dynamic interaction between different aspects of context. Linking Evidence to Action: Although qualitative observations are resource-intensive, they add value when used with other data collection methods, further enlightening the understanding of the implementation context and how evidence use and sharing are influenced by context elements. Observations can enhance an understanding of the context, evidence use and knowledge-sharing triad in implementation research. © 2020 The Authors. Worldviews on Evidence-based Nursing published by Wiley Periodicals LLC on behalf of Sigma Theta Tau International

KW - context

KW - evidence

KW - implementation science

KW - knowledge translation

KW - nonparticipant observations

KW - nursing

KW - triangulation

KW - article

KW - controlled study

KW - evidence based practice center

KW - genetic transcription

KW - human

KW - human experiment

KW - interview

KW - leadership

KW - nursing home

KW - professional practice

KW - questionnaire

KW - randomized controlled trial

KW - teamwork

U2 - 10.1111/wvn.12449

DO - 10.1111/wvn.12449

M3 - Journal article

VL - 17

SP - 185

EP - 192

JO - Worldviews on Evidence-Based Nursing

JF - Worldviews on Evidence-Based Nursing

SN - 1545-102X

IS - 3

ER -