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Table 6 Illustration of Guide content: description of a core element

From: A Guide for applying a revised version of the PARIHS framework for implementation

Element Conceptual definitions Related observations/tips Measurement
Evidence & EBP Characteristics Evidence = Specified sources of information relevant to a specific EBP, including research/published guidelines, clinical experience, patient experience, and/or local practice information. As "evidence" is socially constructed [4], the perceptions of targeted stakeholders regarding the nature and quality of these varying sources of evidence are key to development of an implementation strategy. Two quantitative measurement instruments have been developed that incorporate major components of PARIHS related to Evidence: ORCA [18] and a survey developed by Bahtsevani and colleagues [35].
     • These sources have presumably been subjected to scrutiny (e.g., by the research team or a national body) and are judged to support or refute effectiveness of a targeted EBP intervention/recommendation.    • This includes perception of the form of the evidence-based clinical recommendation/intervention (i.e., the recommended practice as a guideline, policy, procedure, protocol, program, optional or forced function clinical reminder, decision algorithm, etc.). At times such transformed findings/"evidence" is supplemented with additional content based on the judgment or consensus of its creator (e.g., consider the mixed nature of various guidelines or protocols). Sample qualitative diagnostic questions for use in task-oriented projects are listed for each element/sub-element and are, for the most part, based on adaptations of items from the Kitson et al. Appendix related to Evidence [5]. Their 2008 Appendix is said to outline "diagnostic and evaluative measures," but it is not a formal "tool."
  EBP Characteristics = Attributes describing the nature of the implementable form of the evidence/practice recommendation.    • Perceptions of key stakeholders can be influenced by various attributes [7, 33] related to this EBP and its evidentiary source/s.    • Initial, diagnostic evaluation is herein referenced as the first stage of an implementation project's formative evaluation [20].
  1. PARIHS = Promoting Action on Research Implementation in Health Services; EBP = evidence-based practice; ORCA = Organizational Readiness to Change Assessment.