Create, Translate, and Implement Evidence into Air Force Healthcare (C2I)
Name: Susan Dukes
Organization: Henry M. Jackson Foundation
Performance Site: Uniformed Services University of the Health Sciences, Wright Patterson Air Force Base-711th Human Performance Wing, Brooke Army Medical Center, Travis AFB
Year Published: 2017
Clinicians and health care leaders are attempting to facilitate the translation of research findings into practice in an effort to improve patient outcomes, enhance the quality of patient care, and lower health care costs. In an effort to advance clinical inquiry, nurses are charged to work to the full extent of their education. PhD-prepared Nurse Scientists are educated to generate new knowledge to advance the science of nursing. Advanced Practice Registered Nurses (APRNs) are prepared to practice at the most advanced level of nursing and to create evidenced-based strategies to improve practice and health care outcomes. Although not educated to conduct original research, APRNs lead the integration of knowledge from diverse sources and are well-suited to guide staff in conducting evidence-based practice (EBP) and quality improvement projects. Building original knowledge specific to military nursing care is essential for EBP and improved patient outcomes. The APRN applies the knowledge generated by the Nurse Scientist in a continuous synergistic approach to knowledge generation, translation, and application. Because the Nurse Scientist and APRN offer different knowledge and skills, there is opportunity to collaborate in conducting research, redesigning care processes, and improving practice. When Nurse Scientists and APRNs work collaboratively to balance the short-term gains of EBP activities and the long-term investment in original research, a program of clinical inquiry is developed which can address the gap between research and practice.The purpose of this study is to launch Centers for Clinical Inquiry (C2Is) at 4 regional hubs within the Air Force Medical Service (AFMS) to create, translate, and implement evidence into practice. This will be done through the following specific aims:1. Incorporate EBP experts (i.e. APRNs with clinical doctorates or Clinical Nurse Specialists (CNSs)) into C2I regional hubs to facilitate translation and implementation of evidence into practice,education, management, policy, and leadership across the AFMS 2. Increase the number of Air Force (AF) Nurse Scientist led inter-disciplinary teams conducting original research pertinent to nursing3. Provide research and EBP consultation to AFMS operational units, Air Force Medical Operations Agency (AFMOA), and Air Staff4. Facilitate the flow of information among point-of-care/medical treatment facility clinicians/leaders and AFMS clinical practice guideline and policy makers in order to standardize evidence-based practices across the AFMS5. Create an AFMS central repository for EBP projects and research studies pertinent to nursing6. Collaborate with Army and Navy research and EBP experts to maximize synergy in fostering unity of effort, standardization across services, and development of Joint efforts (i.e. Joint educational opportunities, clinical practice guidelines, evidence based initiatives, etc.)The development and implementation of C2Is across the Air Force is an innovative approach built upon the civilian and Army clinical inquiry models. This study will put a structure in place to support PhD Nurse Scientists and APRN EBP experts to work to the full extent of their education and work towards bridging the gap between research and evidence-based practice. As an exploratory study, we are attempting to change the direction by which research and EBP have been created, translated, and implemented within the Air Force in the past. Even though this study is focused on the AFMS Strategy, it is also aligned with the Military Health System’s Quadruple Aim of increased readiness, better health, better care, and lower cost. Results of this study could therefore be utilized in additional collaboration with Army and Navy nurse scientists and EBP experts to apply lessons learned while moving forward towards a Joint concept of clinical inquiry across the Military Health System in support of the Quadruple Aim.