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Process Evaluation of the Evidence-based Practice Identification and Change Intervention to Improve Neonatal Pain Practices

Pain management in hospitalized infants in the Neonatal Intensive Care Unit continues to be substandard despite the development and availability of evidence-based guidelines. The Evidence-based Practice Identification and Change (Lee et al., 2009) strategy is a multifaceted tailored intervention that has been used to promote evidence-based practice. However, the process of delivering the components of the intervention is not well understood and no valid measure for evaluating the fidelity of intervention implementation exists.
The overall objective was to develop and determine the face validity, content validity, construct validity, feasibility, and clinical utility of the Process Evaluation Checklist. Three prospective studies were conducted. In Study 1, the face and content validity of the Process Evaluation Checklist was determined. In Study 2, the construct validity of the Process Evaluation Checklist was examined by assessing the fidelity of implementing the Evidence-based Practice Identification and Change intervention in a clinical setting. In Study 3, the feasibility and clinical utility of the Process Evaluation Checklist was determined.
Overall, the face and content validity of the Process Evaluation Checklist was achieved. The intervention was implemented with high fidelity, supporting the construct validity of the measure. A Research Practice Council, with assistance from an external facilitator and internal facilitators, implemented multifaceted knowledge translation strategies in the form of constant reminders to improve sucrose administration practices. Post intervention admission orders were significantly more likely to include sucrose, and odds of being administered sucrose were 13 times greater compared to baseline.
Beginning support was provided for the content and construct validity, feasibility, and clinical utility of the Process Evaluation Checklist for use with complex interventions. Using this measure to monitor intervention fidelity in different contexts and with different users over longer periods of time will provide additional support to the validity of the Process Evaluation Checklist.

Identiferoai:union.ndltd.org:TORONTO/oai:tspace.library.utoronto.ca:1807/31979
Date12 January 2012
CreatorsYamada, Janet Toshiko
ContributorsStevens, Bonnie
Source SetsUniversity of Toronto
Languageen_ca
Detected LanguageEnglish
TypeThesis

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