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Evaluating the outcomes of complex nursing initiatives: Insights from the CANO/ACIO National Strategy for Chemotherapy Administration Project
Abstract
Because nursing interventions are typically complex and dynamic, evaluating their impact upon care and care systems is a notoriously daunting challenge. Nursing organizations seeking to evaluate the impact of their efforts are frequently frustrated by the gap between the evaluation research ideal and their available resources. In this paper, we describe a practical and manageable process developed to address such an evaluation challenge. Using a three-step inquiry approach, supported by modest organizational funding and a realistic level of voluntary member time, we were able to generate a meaningful understanding of intersecting outcomes arising from the implementation of CANO/ACIO’s National Strategy for Chemotherapy Administration. On the basis of our experience, we see considerable merit in both process and outcomes of this form of targeted evaluation.
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Aiken, L.H., Sloane, D.M., Bruyneel, L., Van den Heed, E.K., Griffiths, P., Busse, R., … Sermeus, W. (in press). Nurse staffing and education and hospital mortality in nine European countries: A retrospective observational study. The Lancet. http://dx.doi.org/10.1016/S0140-6736(13)62631-8
Atun, R., de Jongh, T., Secci, F., Ohiri, K., & Adeyi, O. (2010). Integration of targeted health interventions into health systems: A conceptual framework for analysis. Health Policy and Planning, 25(3), 104–111.
Bamberger, M., Rugh, J., & Mabry, L. (2012). Real world evaluation: Working under budget, time, data, and political constraints (2nd ed.). Thousand Oaks, CA: Sage.
Best, A., Stokols, D., Green, L.G., Leischow, S., Holmes, B., & Buchholz, K. (2003). An integrative framework for community partnering to translate theory into effective health promotion strategy. American Journal of Health Promotio, 18(2), 168–176.
Bonell, C.P., Hargreaves, J., Cousens, S., Ross, D., Hayes, R., Petticrew, M., & Kirkwood, B.R. (2011). Alternatives to randomisation in the evaluation of public health interventions: Design challenges and solutions. Journal of Epidemiology and Community Health, 65, 582–587.
Brown, J., & Isaacs, D. (2005). The world café. San Francisco: Berrett-Koehler.
Campbell, M., Fitzpatrick, R., Haines, A., Kinmonth, A.L., Sandercock, P., Spiegelhalter, D., & Tyrer, P. (2000). Framework for design and evaluation of complex interventions to improve health. BMJ, 321(7262), 694–696.
Campbell, N.C., Murray, E., Darbyshire, J., Emery, J., Farmer, A., Griffiths, F., … Kinmonth, A.L. (2007). Designing and evaluating complex interventions to improve health care. BMJ, 334(455), doi:http://dx.doi.org/10.1136/bmj.39108.379965.BE
CANO/ACIO. (2009). National strategy for chemotherapy administration phase one final report. Author. Vancouver, BC.
CANO/ACIO. (2011a ). National strategy for chemotherapy administration phase two and three final report. Author. Vancouver, BC.
CANO/ACIO. (2011b). Standards and competencies for cancer chemotherapy nursing practice. Author. Vancouver, BC http://www.cano-acio.ca/~ASSETS/DOCUMENT/NSCA/CANO_Chemotherapy_Standards_ENG_Oct%202012.pdf
CANO/ACIO. (2011c). Standards and competencies for cancer chemotherapy nursing practice toolkit. Author. Vancouver, BC http://www.cano-acio.ca/~ASSETS/DOCUMENT/CANO_NSCA_Toolkit_ENG_Oct%202012_Nov%2026_V2.pdf
Catwell, L., & Sheikh, A. (2009). Evaluating eHealth interventions: The need for continuous systemic evaluation. PLOS Medicine, 6(8), e1000126. doi:1000110.1001371/journal.pmed.1000126
Celik, H., Abma, T.A., Klinge, I., & Widdershoven, G.A.M. (2012). Process evaluation of a diversity training program: The value of a mixed method strategy. Evaluation and Program Planning, 25(1), 54–65.
Doran, D., Mildon, B., & Clarke, S. (2011). Toward a national report card in nursing: A knowledge synthesis. Prepared for the planning committee for a think tank entitled “Toward a National Report Card for Nursing†Nursing Health Services Research Unit/University of Toronto. Toronto, ON http://www.rrsstq.com/stock/fra/publications/P189.pdf
Hartzell, R., Truant, T., Rashleigh, L., McQuestion, M., & Thorne, S. (2012). Canadian Association of Nurses in Oncology National Strategy for Chemotherapy Administration Phase Three Evaluation Strategy Final Report. Canadian Association of Nurses in Oncology/Association canadienne des infirmières en oncologie. Vancouver BC.
Hawe, P., Sheill, A., & Riley, T. (2009). Theorising interventions as events in systems. American Journal of Community Psychology, 43(3–4), 267–276.
Kostaska, A. (2004). Inappropriate use of randomised trials to evaluate complex phenomena: Case study of vaginal breech delivery. BMJ, 329(1039). doi:http://dx.doi.org/10.1136/bmj.1329.7473.1039
Leischow, S.J., Best, A., Trochim, W.M., Clark, P.I., Gallagher, R.S., Marcus, S.E., & Matthews, E. (2008). Systems thinking to improve the public's health. American Journal of Preventive Medicine, 36(2), S196–S203.
Paterson, C., Baarts, C., Launsø, L., & Verhoef, M.J. (2009). Evaluating complex health interventions: a critical analysis of the 'outcomes' concept. BMC Complementary & Alternative Medicine, 9(18). doi:10.1186/1472-6882-1189-1118
Potvin, L., & Goldberg, C. (2012). Two roles of evaluation in transforming health promotion practice. In I. Rootman, S. Dupéré, A. Pederson & M. O'Neill (Eds.), Health promotion in Canada: Critical perspectives on practice (3rd ed., pp. 254–265). Toronto: Canadian Scholars Press.
Sidani, S., & Braden, C. (2011). Design, evaluation, and translation of nursing interventions. Chichester, UK: John Wiley & Sons.
Snowdon A., Schnarr, K., Hussein, A., & Alessi, C. (2012). Measuring what matters: The cost vs. the values of health care. London, ON: Ivey International Centre for Health Innovation. http://sites.ivey.ca/healthinnovation/files/2012/11/White-Paper-Measuring-What-Matters.pdf
Trauer, T. (1998). Issues in the assessment of outcome in mental health. Australian and New Zealand Journal of Psychiatry, 32, 337–343.
VandeVelde-Coke, S., Doran, D., Grinspun, D., Hayes, L., Sutherland Boal, A., Velji, K., … Hannah, K. (2012). Measuring outcomes of nursing care, improving the health of Canadians: NNQR(C), C-HOBIC and NQuiRE. Nursing Leadership, 25(2), 26–37.
Verhoef, M.J., Lewith, G., Ritenbaugh, C., Boon, H., Fleishman, S., & Leis, A. (2005). Complementary and alternative medicine whole systems research: Beyond identification of inadequacies of the RCT. Complementary Therapies in Medicine, 13(3), 206–212.
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