ONS Connect - December 2008 - (Page 25) AClOSERlOOk Translational Research: How What’s Learned at the Bench Gets to the Bedside [By Kristen L. Fessele, RN, MSN, APN-C, AOCN ®, Contributing Editor] ranslational research is the application of a discovery to practice (Mariani, 2003). It can be observed in many disciplines, including medicine and nursing science. For example, a scientist makes a new discovery in the laboratory about how a cancer cell adapts and thrives and identifies a novel survival pathway that the tumor depends on. She collaborates with a clinician to design a clinical trial using a therapy that should interrupt that pathway, and they conduct a pilot study. Examination of the initial findings shows that the new therapy does indeed impact the tumor’s survival in a new way, and larger-scale studies begin. William Hait (2003), past-president of the American Association for Cancer Research, used the familiar example of the cell cycle to explain the process: “T0, awaiting a bright idea; T1, discovery; S, synthesis with (existing) medical knowledge; T2, application to a medical problem; M, movement into the oncology clinic.” Key to the analogy is the idea that the process is circular and T evolving, where the results noted after the idea is applied in the clinic generate new questions, and the process begins again. The translation of nursing research discoveries to the clinic has a rich history, dating back to Florence Nightingale’s work in applying principles of hygiene to the care of hospitalized patients after observing the negative effects of unsanitary conditions (Nightingale & Skretkowicz, 1992). However, Suzanne Bakken and Dorothy A. Jones (2006) noted that despite decades of the generation of a large volume of nursing research, There remains a gap between the volume of work produced and its use by clinicians, administrators and planners, and policy makers. It is essential that this new knowledge is translated and incorporated into clinical practice and subsequent research initiatives to continue the evolution and growth of nursing science and knowledge to improve healthcare (p. S1). Translational research differs from the concept of evidence-based practice (EBP) in that translational research is focused on applying new, yet-unproven ideas. Some new discoveries will have direct application to the clinical area, and some might remain only interesting facts until another opportunity to apply them arises. EBP is the process by which experienced clinicians evaluate the strength of existing evidence on a topic and incorporate patients’ preferences for care. The intervention with the most credible evidence base for the problem is applied, and the outcomes are evaluated, likely generating new questions to be explored in the future (DePalma, 2000). Whether you are discussing a new idea or the highest level of existing evidence, a great deal of information is available for your use in the care of patients with cancer—look for new ways to apply knowledge in your practice! ✱ Bakken, S., & Jones, D.A. (2006). Translational research for quality health outcomes. Nursing Research, 55(Suppl. 2S), S1–S2. DePalma, J. (2000). Evidence-based clinical practice guidelines. Seminars in Perioperative Nursing, 9(3), 115–120. Hait, W.N. (2003, July). Barriers to translational research: The perils of Pauline. Presented at the 94th Annual Meeting of the American Association for Cancer Research, Washington, DC. Mariani, S.M. (2003). Highlights from the 2003 annual meeting of the American Association for Cancer Research; July 11–14, 2003; Washington, DC. Retrieved August 15, 2008, from http://www.medscape.com Nightingale, F., & Skretkowicz, V. (1992). Florence Nightingale’s notes on nursing (Rev., with additions ed.). London: Scutari Press. Contributing Editor Kristen L. Fessele, RN, MSN, APN-C, AOCN®, is the associate director for Human Research Services and an advanced practice nurse in the Breast Service at the Cancer Institute of New Jersey in New Brunswick. December 2008 ONS CONNECT 25 http://www.medscape.com
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