This 3-year study will test, using an experimental design, the effectiveness of an interdisciplinary intervention to promote translation of evidence into practice.
Specific aims are:
Aim 1 : To test the effect on nurse and physician behavior of an intervention designed to promote adoption of an evidence based guideline for acute pain management in the elderly.
Aim 2 : To test the effect of an intervention designed to promote adoption in practice of evidence based guidelines on decreasing barriers to use of those guidelines in practice.
Aim 3 : To determine the cost-effectiveness ratios of an intervention designed to promote adoption in practice of an evidence-based guideline for acute pain management in the elderly. Rogers model provides the conceptual framework for the intervention which addresses characteristics of the Evidence-Based Guideline (EBG), the communication process, the users of the guideline, and the social system where it is implemented. The intervention will be tested by implementing an evidence-based guideline for Acute Pain Management in the Elderly. AHCPR guidelines, the National Guideline Clearinghouse, and Evidence-Based Practice Centers will be used in formulation of this EBG. Public-private partnerships have been established with 12 acute care hospitals in the Midwest. A stratified random sampling procedure will be used to assign hospitals to the E and C group. Because hospitals are """"""""social units"""""""", they will be the unit of randomization with nurses, physicians, and medial records of hip fracture patients greater than 65 years of age being the units of analyses. Primary dependent variables are rate and extent of adoption of the EBG, barriers to use of the EBG, and cost-effectiveness ratios of the intervention. Quantitative and qualitative approaches will be used in evaluating intervention effectiveness.
