Evidenced-Based Research Intervention & Discharge of Mental

Evidenced-Based Research Intervention & Discharge of Mental Health Clients



Table of Content

Introduction3

Purpose of the Study4

Scope of the Study5

Literature Review6

Transitional Discharge Model6

Methods8

Design8

Sample9

Procedure10

Data Analysis11

Findings13

Challenges13

Challenges in Roles and Responsibilities13

Challenges in Relationships With Others15

Challenges in the Values and Beliefs of Clients, Staff, and Community16

Challenges in Resources17

Opportunities19

Strategies to Integrate Knowledge Into Practice19

Support from Others19

Support of Practice, Policy, and Education20

Discussion21

Conclusion24

References25

Introduction

Continuing Education and Evidence-Informed Practice

There is little question that continuing education (CE) can make a difference in knowledge and practice. However, although health care facilities may provide and require participation in CE, the new knowledge is not always transferred into practice. A number of barriers to knowledge uptake have been identified in the literature, including the organizational climate, factors involved in the social system at large (Cervero et al., 1986, Edgar et al., 2006, Foglesong et al., 1987, Francke et al., 1997 and Waddell, 1990), rapidly changing clinical environments, increased demands related to acutely ill patients, lack of protected time for educational activities, the culture of nursing service delivery (McAllister & Osbourne, 2006), readiness to change by the individual and the organization (Cockburn, 2004), and the economic and political context (Wensing, 2004).

Multivariate models have been employed to explain the utilization of evidence-based education (Cervero, 1985, Francke et al., 1995 and Stetler, 1994). The model of Cervero (1985) is built upon the assumption that behavioral change occurs within a social system. This important insight is perhaps the most powerful and yet the most frequently overlooked variable in examining effective CE. Francke et al. (1995) adapted and expanded Cervero's model to include variables that may influence behavioral change, suggesting that the characteristics of organizational environments are indeed central to understanding the application of new knowledge.

In the context of organizational environments, the literature revealed that a lack of support by colleagues and supervisors inhibits the application of new learning. Specifically, learners who experienced disapproval and lack of understanding from peers and supervisors or who felt incompetent about newly acquired skills were prevented from making effective behavioral changes (Brown & Rodger, 1999). In questionnaires and focus groups used to evaluate the transfer of a new intervention into practice, a lack of support from peers and time, as well as misconceptions about the intervention, were also identified as barriers to the effectual transfer of knowledge (Cheater, 2001).

The uptake of new knowledge involves many factors including the values, goals, norms, hierarchies, sanctions, rewards (Cervero, 1985 and Scheller, 1993), capacity (Cullen et al., 2005 and Stetler, 2003), and vision of the organization (Cullen et al., 2005).

Purpose of the Study

The purpose of this qualitative study was to explore the experiences of clinical staff who implemented a research intervention: the Transitional Discharge Model (TDM). The TDM provided mental health clients who were hospitalized with peer support and an inpatient staff member to bridge the therapeutic transitioning from hospital staff to the community care provider. Staff from three tertiary care mental health facilities in UK identified their learning needs in regard to providing the ...