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Knowledge translation studies in paediatric emergency medicine: A systematic review of the literature
Catherine L Wilson1, David Johnson2, Ed Oakley1,3,4
1Departments of Emergency Research, Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia.
Insights
Translating knowledge into paediatric emergency care is challenging due to limited evidence. More effective interventions and study designs are needed to improve clinical practice for children in emergency departments.
Area of Science:
- Emergency Medicine
- Paediatric Care
- Knowledge Translation
- Health Services Research
Background:
- Knowledge translation aims to improve healthcare delivery by implementing evidence-based practices.
- Paediatric emergency care presents unique challenges in translating research findings into clinical practice.
- Effective interventions are crucial for optimizing the care of children in emergency settings.
Purpose of the Study:
- To systematically review and assess knowledge translation interventions in paediatric emergency care.
- To describe the types of interventions used in emergency departments for paediatric patients.
- To evaluate the effectiveness of implemented knowledge translation strategies.
Main Methods:
- Systematic review of knowledge translation studies in paediatric emergency care.
- Searched electronic databases for relevant studies conducted in emergency departments.
- Included 15 studies with varied designs, including cluster-controlled trials and randomized controlled trials.
Main Results:
- Interventions primarily targeted clinicians, with some aimed at organizational changes.
- Effectiveness was assessed over 6-28 months, with variable changes in clinical practice.
- Studies focusing on single diseases/treatments in single sites showed greater improvements.
Conclusions:
- Evidence for effective knowledge translation in paediatric emergency medicine is limited.
- There is a need for more optimal study designs with explicit intervention descriptions.
- Facilitating the application of effective procedures in diverse settings requires clearer guidance.
Aim:
Systematic review of knowledge translation studies focused on paediatric emergency care to describe and assess the interventions used in emergency department settings.
Methods:
Electronic databases were searched for knowledge translation studies conducted in the emergency department that included the care of children. Two researchers independently reviewed the studies.
Results:
From 1305 publications identified, 15 studies of varied design were included. Four were cluster-controlled trials, two patient-level randomised controlled trials, two interrupted time series, one descriptive study and six before and after intervention studies. Knowledge translation interventions were predominantly aimed at the treating clinician, with some targeting the organisation. Studies assessed effectiveness of interventions over 6-12 months in before and after studies, and 3-28 months in cluster or patient level controlled trials. Changes in clinical practice were variable, with studies on single disease and single treatments in a single site showing greater improvement.
Conclusions:
Evidence for effective methods to translate knowledge into practice in paediatric emergency medicine is fairly limited. More optimal study designs with more explicit descriptions of interventions are needed to facilitate other groups to effectively apply these procedures in their own setting.
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