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Bridging Diffusion of Innovation and CNS Practice Frameworks Using Digital Chest Drainage: A Clinical Exemplar
Christopher Picard1, Lyndon Rebello, Jaquelynne Demmy
1Clinical Nurse Specialist, Division of Trauma, Faculty of Nursing, University of Alberta, Island Health (Picard), Edmonton, AB; Resident Physician, Island Health, Division of Trauma (Rebello); Manager, Island Health, Division of Trauma (Demmy), Victoria, BC; Coordinator, Island Health, Renal Services (Picard), Nanaimo, BC; PhD Student, Faculty of Nursing, University of Alberta (Kruger); PhD Student, Faculty of Nursing, University of Alberta (Grewal); Clinical Nurse Specialist-Emergency, Alberta Health Services (O'Dochartiagh); Clinical Nurse Specialist-Critical Care, Alberta Health Services (Douma); Clinical Nurse Specialist-Trauma Services, Alberta Health Services (Middleton); Dean of Research, Faculty of Nursing, University of Alberta (Norris); Professor, Faculty of Nursing, University of Alberta (Montgomery), Edmonton, AB; Division Head, Island Health, Division of Trauma (Kim), Victoria, BC; Medical Director, Island Health, Division of Trauma (Culp), Nanaimo, BC, Canada.
Clinical Nurse Specialists can overcome barriers to adopting digital chest drainage systems by focusing on clinician engagement and social learning, not just technology. Effective knowledge translation is key for broader trauma care implementation.
Area of Science:
- Nursing Science
- Health Informatics
- Innovation Diffusion
Background:
- Clinical Nurse Specialists (CNS) play a vital role in knowledge translation.
- Barriers to adopting new medical technologies include technological, social, and educational factors.
- Digital chest drainage systems offer clinical and operational advantages over traditional analog systems.
Purpose of the Study:
- To reconcile the National Association of Clinical Nurse Specialists (NACNS) practice domains with the Integrative Model of innovation diffusion.
- To demonstrate how CNSs can overcome barriers to knowledge translation for digital chest systems.
- To examine the factors influencing the adoption of digital chest drainage in trauma care.
Main Methods:
- A narrative synthesis of evidence from surgical and nonsurgical literature.
- Comparison of NACNS competencies with the Integrative Model domains (technology, social structure, learning conditions).
- Examination of clinical benefit, stakeholder preferences, cost, and knowledge translation gaps.
Main Results:
- Digital chest drainage systems show clear clinical and operational advantages.
- Adoption is limited by resistance to analog systems, poor social influence, educational gaps, and insufficient marketing.
- Social factors like peer influence and local evidence are more critical than technology complexity.
Conclusions:
- Technology-centric implementation alone is inadequate for digital chest drainage adoption.
- Effective strategies require clinician engagement, social learning, and demonstrating system-level value.
- Targeted knowledge translation can facilitate the integration of advanced technologies like digital chest drainage into trauma care.
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