Translating research into practice

The Nursing and Midwifery Implementation Science Academy is committed to mentorship, capacity building and partnership to create a sustainable model for translating research into practice. Professor Sandy Middleton shares the steps they’ve taken towards achieving these goals.

The Nursing and Midwifery Implementation Science Academy (The Academy), a specialised subgroup of the SPHERE Science Implementation Platform. It is a collective of nurses and midwives with a wealth of clinical and research expertise and experience enabling them to exert a substantial influence on patient outcomes, healthcare delivery, and health policy.

Collaboration is key

Director of SPHERE’S Implementation Science Platform, Professor Sandy Middleton, explains the purpose of the Academy is to lead multidisciplinary implementation science research collaborations.

“By facilitating collaborative nurse/midwife-investigator initiated, multidisciplinary, multi-site implementation science research across the SPHERE network and within the Clinical Academic Groups (CAGs), we seek to conduct research projects that have a broad reach and impact. This collaborative approach enables the pooling of expertise from various disciplines, resulting in comprehensive and inclusive research outcomes that can inform both health practice and policy,” she said.

“The Academy also recognises the importance of capacity building and mentorship. So, by identifying and facilitating research training opportunities for early career nursing and midwifery implementation scientists, we aim to foster the continuity and growth of expertise in the field.

In addition to running webinar sessions on a variety of implementation science topics, the Academy is initiating an early-career researcher group for SPHERE nurses and midwives with the vision of promoting the conduct of further collaborative research projects across multiple sites. Led by Dr Nicola Straiton, a SPHERE early career nurse researcher, the Academy’s early-career researcher group seeks to strengthen connections between clinically-based doctoral-level nurses and midwives and their academic counterparts, fostering a culture of collaborative research.

Bold new initiatives

The scope of the Academy’s work encompasses high-priority topics and areas across SPHERE partners and CAGs. This comprehensive approach allows the Academy to build the evidence base, translate new evidence into practice, and support applications for large-scale external implementation science funding.

Development of the SPHERE Clinician Researcher Career Pathway

Clinical academic pathways for nurses and midwives have existed in the United Kingdom since 2012. However, similar formal research training pathways supported within the clinical setting are lacking in Australia. A strategy to build the critical mass of nurse and midwife clinician researchers (with direct clinical care and research roles) is therefore urgently needed to meet the challenge of providing evidence-based care in the context of increasing healthcare burden.

The SPHERE Clinician Researcher

Career Pathway is a newly proposed progressive training and career pathway from graduate to training at an Honours, Masters or Doctoral level to post-doctoral levels of research career development for nurses and midwives. Research led by Dr Maree Johnson and Academy members; ‘Exploring the SPHERE Nursing and Midwifery Clinician Researcher

Career Pathway: A qualitative study’ sought to describe the proposed Pathway in more detail. This research examined the viewpoints of nursing and midwifery service leaders and academics, yielding valuable insights into their assessment of the Pathway’s acceptability and utility.

The Pathway aims to transform the number of nurses and midwives within Local Health Districts with higher degrees in research (Masters by Research or PhD/Doctorate); and to contribute to an increase in the number of nurses and midwives at a population level (AHPRA registrations) with research as their principal role.

These two objectives directly address the vision of SPHERE, and potentially can deliver a workforce to generate new knowledge in nursing and midwifery and implement evidence already available into practice to improve the health of patients and communities.

Expanding on initial research efforts, the Academy is currently conducting an ongoing study, ‘Enablers and barriers to the Implementation and Sustainability of the SPHERE Nursing and Midwifery Clinician Researcher Career Pathway’ which aims to investigate the perspectives of qualified nurses and midwives across all professional levels, as well as student nurses and midwives, and health consumers regarding the proposed new career Pathway. The findings will help further shape the Pathway and provide an understanding on how best to embed it in practice.

Clinical registry data for quality improvement in Australian hospitals

Clinical registry participation is a measure of healthcare quality, yet limited knowledge exists on Australian hospitals’ participation in clinical registries and whether this registry data informs quality improvement initiatives. To examine this further a study led by Julie Gawthrone (Clinical Nurse Consultant, St Vincent’s Hospital Sydney and Clinical Fellow, Australian Catholic University) and Academy colleagues was conducted across seven hospitals in New South Wales. The study, ‘Are clinicians using routinely collected data to drive practice improvement? A crosssectional survey’ aimed to identify participation in clinical registries, determine if registry data inform quality improvement initiatives, and identify registry participation enablers and clinicians’ educational needs to improve use of registry data to drive practice change.

The study found that while registry data may be accessible to local specialty units, it is not consistently employed to inform quality improvement practices across these Australian hospitals. Suggestions to address these issues include centralised ongoing funding for registries, along with the development of accessible and transparent integrated information systems. Additionally, there is a pressing need for education and training programs that equip clinicians with the skills and knowledge necessary to effectively employ registry data in driving clinical improvement initiatives.

Enhancing opportunities and outcomes of collaborative, multi-site, investigator-initiated research

By leveraging the Academy’s extensive network connections and the wide-ranging expertise of its members throughout NSW, we continually seek to foster nurse and midwiferyled multi-site research. Be it through providing support and guidance on how to design and conduct highquality research, facilitating access to a larger pool of research sites for efficient recruitment or encouraging collaborations with experts from diverse disciplines and knowledge backgrounds. Collaborative, multisite research enables increased data diversity, enhanced generalisability of study findings, and the ability to tackle complex research questions more effectively.

The collaborative approach within the Academy has yielded numerous successful funding outcomes, as demonstrated by the current Assessment and Communication Excellence for Safe Patient Outcomes Plus Trial (ACCELERATE Plus). This multi-site trial, led by Professor Sandy Middleton and Adjunct Professor Anna Thornton, is being conducted across eight hospitals and 24 wards in New South Wales (NSW) and Victoria. This stepped-wedge cluster randomised trial includes a costbenefit analysis and process evaluation of an intervention encompassing nursing core physical assessment, patient-centered bedside handover, and improved multidisciplinary communication.

“The primary focus of the ACCELERATE Plus Trial is to assess the intervention’s impact on patient outcomes by reducing medical emergency team calls, unplanned intensive care unit admissions, falls, and pressure injuries,” explains Prof Middleton.

The ACCELERATE program of research builds on collaboration between numerous clinical and academic partners across the SPHERE Academy and broader NSW networks. This collaboration has provided invaluable data on factors influencing the intervention’s successful implementation and sustainability in real-world healthcare settings. Upon completion of the ACCELERATE Plus Trial, should the intervention prove beneficial, its rapid translation into practice and widespread adoption across NSW and beyond becomes an exciting opportunity. The fruitful collaboration within the Academy has undoubtedly paved the way for significant advancements in patient care and evidence-based practices and support for multi-site nursing trials.

Where to next?

The Nursing and Midwifery Implementation Science Academy aims to make a tangible difference in patient outcomes by fostering research collaboration, nurturing the next generation of nurses and midwives, and prioritising clinically relevant and impactful research to promote evidence-based practice. Together we can do better research.

Who are the Nursing and Midwifery Implementation Science Academy?

Professor Sandy Middleton, Director of the SPHERE’s Implementation Science Platform, and Professor Caleb Ferguson spearhead the Nursing and Midwifery Implementation Science Academy. Assisting them is an experienced Executive team comprising of, Executive Director of Nursing Anna Thornton, Professor Steve Frost, District Director of Nursing and Midwifery Kate Hackett, and Clinical Nurse Consultant Julie Gawthorne. Together, they bring together leading academic and clinical professionals in nursing and midwifery from across the 15 SPHERE clinical and research partners.

With a membership of more than 40 nurse and midwifery experts from academia, clinical practice and senior management, the Academy provides a unique platform for knowledge exchange. Through regular engagement, the Academy facilitates the productive exchange of ideas, best practices, and research findings to enable the integration of evidence-based approaches into healthcare settings. This has provided a very rare and special opportunity for nurse and midwife leaders from clinical and research areas across the greater Sydney basin to get together and help transform health by bridging the gap between research and clinical practice.

To find out more, contact: nicola.straiton@acu.edu.au