Page 552 - Encyclopedia of Nursing Research

TRANSLATIONAL RESEARCH n 519

or additional drug (Institute of Medicine, at least neutralized external environment. To
2003; Mcglynn et al., 2003; Woolf, 2008). The move from single studies to broader impact,
Clinical and Translational Science Awards therefore, one will need to increase synergies T
program, a part of the National Institutes for across studies, bring in the organizational
Health’s effort to catalyze the development of component, consider and potentially mod-
clinical and translational science, was devel- ify the impact of reimbursement, regulation,
oped to assist institutions take a unique, and other environmental factors, and look at
transformative, and integrative academic ways to take findings to scale” (Fraser, 2004).
approach to translational research (National This is still our challenge today in transla-
Institutes of Health, 2010). Focusing on the tional research.
second area of translational research, these A third type of translational research,
programs seek to close the gap and improve or T3, has been described in the literature
quality by improving access, reorganizing and is necessary to evaluate the ongoing
and coordinating systems of care, helping and complex environmental and policy
clinicians and patients to change behaviors measures that affect sustainability of clin-
and make more informed choices, providing ical strategies that have been found safe
reminders and point-of-care decision sup- and efficacious and have successfully been
port tools, and strengthening the patient- implemented (Lean, Mann, Hoek, Elliott, &
clinician relationship (National Institutes of Schofield, 2008). The Agency for Healthcare
Health, 2010). Research and Quality developed the
In October 2003, a 2-day invitational con- partnerships for Quality program to accel-
ference was held at the university of Iowa to erate the translation of research findings
discuss the future of translation science in into practice on a broad scale through pub-
advancing systems to support quality nurs- lic/private partnerships led by organiza-
ing care called “Advancing Quality Care tions well-positioned to reach end-users
through Translation Research.” The confer- and maintain the consistency of emerg-
ence used a definition of translation research ing evidence across the health care system
that has since been used in nursing research: (Donaldson et al., 2007).
“the scientific investigation of methods, There are interesting examples of
interventions, and variables that influence translational research in the literature, but
adoption of evidence-based practices (EBps) most focus on only one type of transla-
by individuals and organizations to improve tional research discussed above. To further
clinical and operational decision making in understand the continuum of translational
health care. This includes testing the effect research, the following example will show
of interventions on promoting and sustain- how an innovation in health care, a scien-
ing the adoption of EBps” (Titler, 2004b). The tific discovery, can be applied and evaluated
conference developed a consensus around to improve outcomes in the care of a patient
the importance of translation of evidence with congestive heart failure (CHF). A T1
and in the summary article of the conference, translation research study would first test a
Fraser (2004) captured the discussion: “The new drug or treatment that has been found to
successful impact requires, at a minimum, a be safe and efficacious in previous discovery
strong evidence base, a well-designed inter- and design a randomized control trial to test
vention and implementation strategy that that drug or treatment in a specific popula-
takes into account the structure, culture, and tion/sample, for example African American
capacities of the organization itself and, if male CHF patients between 40 and 50 years
necessary, succeeds in modifying these as of age in one clinic in a large suburban pri-
part of the intervention, and a supportive or mary care practice. If the drug was found to