Editorial
Transfer of results into clinical practice and citizen participation in health care research
Transferencia de resultados en la práctica clínica y participación ciudadana en la investigación en cuidados
R Camacho-Bejarano
, M Lima-Serrano, H González de la Torre, P Fernández-Ortega, V González-Chordá
Corresponding author
Enfermería Clínica Editorial Committee
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array:1 [ 0 => array:4 [ "autoresLista" => "R Camacho-Bejarano, M Lima-Serrano, H González de la Torre, P Fernández-Ortega, V González-Chordá" "autores" => array:5 [ 0 => array:4 [ "nombre" => "R" "apellidos" => "Camacho-Bejarano" "email" => array:1 [ 0 => "rafaela.camacho@denf.uhu.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "M" "apellidos" => "Lima-Serrano" ] 2 => array:2 [ "nombre" => "H" "apellidos" => "González de la Torre" ] 3 => array:2 [ "nombre" => "P" "apellidos" => "Fernández-Ortega" ] 4 => array:2 [ "nombre" => "V" "apellidos" => "González-Chordá" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Enfermería Clínica Editorial Committee" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Transferencia de resultados en la práctica clínica y participación ciudadana en la investigación en cuidados" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">There is no doubt that the transfer of results from scientific evidence over to clinical practice is essential to guarantee optimal health care for the population and contribute to the efficient use of available resources.</p><p id="par0010" class="elsevierStylePara elsevierViewall">In this sense, health care research must serve as a link between the clinical field (where the questions to be answered through scientific evidence come from), the professionals themselves and the public, through close collaboration that enables synergies to be set up between all the players involved and with the same objective: to achieve safe and quality health care.</p><p id="par0015" class="elsevierStylePara elsevierViewall">There are numerous authors who, over the years, have analysed the factors that influence the acquisition and enhancement of Evidence-Based Practice, and whose contributions in relation to the benefits it offers can be summarised at several levels:<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">▪</span><p id="par0020" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Improvement in quality</span></p></li></ul></p><p id="par0025" class="elsevierStylePara elsevierViewall">The implementation of evidence-based practices (EBPs) enables nurses to apply the most effective and safest interventions, which result in an improvement in the quality of care. According to a study by Melnyk et al. (2021),<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> the integration of EBP into daily practice contributes to the reduction of complications and improves patient satisfaction.<ul class="elsevierStyleList" id="lis0010"><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">▪</span><p id="par0030" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Support for shared decision-making</span></p></li></ul></p><p id="par0035" class="elsevierStylePara elsevierViewall">The use of scientific evidence in clinical practice enables decisions to be based on the results of the most up to date research and both professionals and users can thus become aware of the advantages and disadvantages of the different therapeutic modalities or interventions and adapt their choices to their individual needs through their own knowledge, with the advice of professionals so that shared decision-making is a genuine reality. This philosophy puts users or patients back at the centre of healthcare, giving them back the prominent role that is sometimes difficult to achieve. However, some studies show that there are still numerous limitations when it comes to fully developing shared decision-making, mainly related to the communication skills of professionals, the lack of time and the organisational structure of the services and consultations themselves.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a><ul class="elsevierStyleList" id="lis0015"><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">▪</span><p id="par0040" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Training and professional development</span></p></li></ul></p><p id="par0045" class="elsevierStylePara elsevierViewall">The transfer of scientific evidence also fosters professional development and vice versa, it is essential to facilitate and promote the training of professionals to enable evidence-based practice to become a reality and provide these professionals with resources and time to integrate this into their day-to-day lives. Continuous training in EBP not only improves clinical competencies, but also empowers professionals to actively participate in decision-making in patient care,<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> which is a fundamental aspect in rapidly evolving healthcare environments that must adapt to the new needs and expectations of the population.<ul class="elsevierStyleList" id="lis0020"><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">▪</span><p id="par0050" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Transdisciplinary, interlevel and inter-institutional collaboration</span></p></li></ul></p><p id="par0055" class="elsevierStylePara elsevierViewall">The growing complexity of health care forces us to join forces from different fields and institutions: complex questions require complex approaches and complex interventions that respond to the needs that arise through research.</p><p id="par0060" class="elsevierStylePara elsevierViewall">In this direction, it is essential to increase the research capacity of the teams and strengthen the applicability of the results. To this end, teams must involve the participation of all the different professionals involved in patient care and whose contributions will be essential to achieve a comprehensive and patient-centred approach, thus improving clinical outcomes.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> Within this collaborative philosophy at the clinical and research level, alliances between the health care system and the academic-university environment are essential to achieve the strengthening of research teams and projects when it comes to being able to opt for competitive research projects and to facilitate the transfer of the results back into practice, thus making full use of their possible benefits.</p><p id="par0065" class="elsevierStylePara elsevierViewall">Currently, there are more and more nurse-led initiatives that aim to enable the implementation of scientific evidence in practice and that are beginning to gain protagonism on the national scene<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> (Bernués-Caudillo et al., 2024), however, we continue to face numerous barriers that prevent the integration of evidence into clinical nursing practice from being a daily reality.</p><p id="par0070" class="elsevierStylePara elsevierViewall">In any case, and taking into account the advances, it is advisable to reinforce the strategies that have proved to be effective and that could be encompassed as follows:<ul class="elsevierStyleList" id="lis0025"><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">-</span><p id="par0075" class="elsevierStylePara elsevierViewall">Promoting training at the undergraduate and postgraduate levels and on continuing education courses. The reinforcement of training in competencies related to the use of EBP, from the Bachelor's Degree in Nursing to continuing education courses for professionals, following the same approach, is essential for the application of evidence in daily practice.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p></li><li class="elsevierStyleListItem" id="lsti0030"><span class="elsevierStyleLabel">-</span><p id="par0080" class="elsevierStylePara elsevierViewall">Creating a Culture of Evidence. It is essential to foster an organisational culture that values evidence-based research and practice, which involves the active participation of leaders and managers in the promotion of policies that support the implementation of research results.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a></p></li><li class="elsevierStyleListItem" id="lsti0035"><span class="elsevierStyleLabel">-</span><p id="par0085" class="elsevierStylePara elsevierViewall">Putting in place facilitators for the implementation of the PBE. Using clinical leaders with EBP training as facilitators for the implementation of new initiatives and introduction of specific courses that can help to guide clinicians in decision-making and support teams in integrating evidence into their daily practice.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a></p></li><li class="elsevierStyleListItem" id="lsti0040"><span class="elsevierStyleLabel">-</span><p id="par0090" class="elsevierStylePara elsevierViewall">Provision of resources and promotion of the use of technological support tools. There are currently numerous tools that will facilitate the incorporation of evidence-based clinical practice guidelines and protocols, although it is necessary to promote accessibility to these resources, as well as to ensure the allocation of time and professionals to optimise their use.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a></p></li><li class="elsevierStyleListItem" id="lsti0045"><span class="elsevierStyleLabel">-</span><p id="par0095" class="elsevierStylePara elsevierViewall">Evaluation, monitoring and continuous assessment systems. Establishing systems for evaluating outcomes and providing feedback on the implementation of evidence-based practices enables clinical teams to identify areas for improvement and adjust their approaches as needed.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a></p></li></ul></p><p id="par0100" class="elsevierStylePara elsevierViewall">Another challenge we are currently facing is the integration of citizen participation within health care research. Citizen participation is a crucial component in the dissemination and transfer of research results over to clinical practice, although this should not be limited to only these aspects. Rather, it offers endless opportunities in which clinical research can benefit from the vision of users, from the design of the projects themselves, as in the new trends of citizen participation that advocate a more active role, aiming for that knowledge to revert back directly to the population at large, as active subjects in the research process.</p><p id="par0105" class="elsevierStylePara elsevierViewall">Involving citizens not only improves the adoption of new practices, but also ensures that interventions are tailored to the needs and preferences of the users themselves. In addition, the active participation of citizens in the research process and the implementation of results may increase the acceptance of new clinical practices, as reflected in the study run by McCaffrey et al. (2021<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> which suggests that when patients and communities are part of the process of developing new interventions, these are more likely to be well received.</p><p id="par0110" class="elsevierStylePara elsevierViewall">On the other hand, the integration of the voice of citizens makes it possible to identify needs and priorities that might not be evident to health professionals. This can result in the adaptation of interventions to local realities and also more patient-centred care.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a> Citizen participation in the dissemination of research results can empower patients and communities to make informed decisions about their health<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> (Jones et al., 2022). Finally, the integration of users in the incorporation of EBP creates a real-time feedback system on the effectiveness of the interventions implemented, since they provide valuable information about their experience that can assist in adjusting and improving clinical practices<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> (Brown et al., 2019).</p><p id="par0115" class="elsevierStylePara elsevierViewall">In short, we are facing a new scenario full of challenges but also of new opportunities where nurses have the opportunity to be dynamic elements in the integration of scientific evidence into practice, thus improving the care provided, user satisfaction and health care results, through the active participation of the citizens themselves. Shall we take up the challenge?</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:11 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The state of evidence-based practice in US nurses: a national survey" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "B.M. Melnyk" 1 => "L. Gallagher-Ford" 2 => "L.E. Long" 3 => "E. 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