***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background There has been considerable interest recently in developing and evaluating interventions to increase research use by clinicians . However , most work has focused on medical practice s ; and nursing is not well represented in existing systematic review s. The purpose of this article is to report findings from a systematic review of interventions aim ed at increasing research use in nursing . Objective To assess the evidence on interventions aim ed at increasing research use in nursing . Methods A systematic review of research use in nursing was conducted using data bases ( Medline , CINAHL , Healthstar , ERIC , Cochrane Central Register of Controlled Trials , and Psychinfo ) , grey literature , ancestry search ing ( Cochrane Data base of Systematic Review s ) , key informants , and manual search ing of journals . R and omized controlled trials and controlled before- and after- studies were included if they included nurses , if the intervention was explicitly aim ed at increasing research use or evidence -based practice , and if there was an explicit outcome to research use . Method ological quality was assessed using pre-existing tools . Data on interventions and outcomes were extracted and categorized using a pre-established taxonomy . Results Over 8,000 titles were screened . Three r and omized controlled trials and one controlled before- and after- study met the inclusion criteria . The method ological quality of included studies was generally low . Three investigators evaluated single interventions . The most common intervention was education . Investigators measured research use using a combination of surveys ( three studies ) and compliance with guidelines ( one study ) . Research er-led educational meetings were ineffective in two studies . Educational meetings led by a local opinion leader ( one study ) and the formation of multidisciplinary committees ( one study ) were both effective at increasing research use . Conclusion Little is known about how to increase research use in nursing , and the evidence to support or refute specific interventions is inconclusive . To advance the field , we recommend that investigators : ( 1 ) use theoretically informed interventions to increase research use , ( 2 ) measure research use longitudinally using theoretically informed and psychometrically sound measures of research use , as well as , measuring patient outcomes relevant to the intervention , and ( 3 ) use more robust and method ologically sound study design s to evaluate interventions . If investigators aim to establish a link between using research and improved patient outcomes they must first identify those interventions that are effective at increasing research use Abstract Objectives : To evaluate the effectiveness of an asthma re source centre in improving treatment and quality of life for asthmatic patients Design : Community based r and omised controlled trial Setting : 41 general practice s in Greenwich with a practice nurse Subjects : All registered patients aged 15 - 50 years Intervention : Nurse specialists in asthma who educated and supported practice nurses , who in turn educated patients in the management of asthma according to the British Thoracic Society 's guidelines Main outcome measures : Quality of life of  asthmatic patients , attendance at accident and emergency departments , admissions to local hospitals , and steroid prescribing by general practitioners Results : Of 24 400 patients r and omly selected and surveyed in 1993 , 12 238 replied ; 1621 were asthmatic of whom 1291 were sent a repeat question naire in 1996 and 780 replied . Of 24 400 patients newly surveyed in 1996 , 10 783 ( 1616 asthmatic ) replied . No evidence was found for an improvement in asthma related quality of life among newly surveyed patients in intervention practice s compared with control practice s. Neither was there evidence of an improvement in other measures of the quality of asthma care . Weak evidence was found for an improvement in quality of life in intervention practice s among asthmatics registered with study practice s in 1993 and followed up in 1996 . Neither attendances at accident and emergency departments nor admissions for asthma showed any tendency to diverge in intervention and control practice s over the study period . Steroid prescribing rates rose steadily during the study period . The average annual increase in steroid prescribing was 3 % per year higher in intervention than control practice s ( 95 % confidence interval −1 % to 6 % , P=0.10 ) Conclusions : This model of service delivery is not effective in improving the outcome of asthma in the community . Further development is required if cost effective management of asthma is to be Background Research evidence underpins best practice , but is not always used in healthcare . The Promoting Action on Research Implementation in Health Services ( PARIHS ) framework suggests that the nature of evidence , the context in which it is used , and whether those trying to use evidence are helped ( or facilitated ) affect the use of evidence . Urinary incontinence has a major effect on quality of life of older people , has a high prevalence , and is a key priority within European health and social care policy . Improving continence care has the potential to improve the quality of life for older people and reduce the costs associated with providing incontinence aids . Objectives This study aims to advance underst and ing about the contribution facilitation can make to implementing research findings into practice via : extending current knowledge of facilitation as a process for translating research evidence into practice ; evaluating the feasibility , effectiveness , and cost-effectiveness of two different models of facilitation in promoting the uptake of research evidence on continence management ; assessing the impact of context ual factors on the processes and outcomes of implementation ; and implementing a pro-active knowledge transfer and dissemination strategy to diffuse study findings to a wide policy and practice community . Setting and sample Four European countries , each with six long-term nursing care sites ( total 24 sites ) for people aged 60 years and over with documented urinary incontinence Methods and design Pragmatic r and omised controlled trial with three arms ( st and ard dissemination and two different programmes of facilitation ) , with embedded process and economic evaluation . The primary outcome is compliance with the continence recommendations . Secondary outcomes include proportion of residents with incontinence , incidence of incontinence-related dermatitis , urinary tract infections , and quality of life . Outcomes are assessed at baseline , then at 6 , 12 , 18 , and 24 months after the start of the facilitation interventions . Detailed context ual and process data are collected throughout , using interviews with staff , residents and next of kin , observations , assessment of context using the Alberta Context Tool , and documentary evidence . A realistic evaluation framework is used to develop explanatory theory about what works for whom in what circumstances . Trial registration Current Controlled Trials IS RCT N11598502 Studies at area hospitals revealed many gaps between research evidence and intrapartum nursing practice s. A r and omized controlled trial involving 20 hospitals was used to evaluate the effectiveness of a marketing strategy to promote research -based nursing care . It was hypothesized that the strategy would result in lower rates of epidural analgesia , through increasing the amount of support nurses provided to their patients . Other outcomes included rates of narcotic analgesia , episiotomy , and operative delivery . The marketing strategy was unsuccessful in improving intrapartum nursing care . Much more research is needed about the factors that facilitate improvements in nursing practice The purpose of this r and omized controlled community trial is to evaluate the effects of a community intervention utilizing opinion leaders and educational strategies on the cancer pain management knowledge , attitudes , and the practice s of physicians and nurses , and cancer pain reported by patients . Six Minnesota communities participated in the study . The three communities r and omized to the intervention received educational programs over 15 months . The clinical community opinion leaders participated in a minifellowship , developed community task forces , and interacted with their peers . This strategy was reinforced with community outreach programs , clinical practice guidelines , educational material s , and media events . The primary study end point was patients ' pain intensity score . Comparing intervention to control communities , pain prevalence declined slightly , pain management index improved slightly , pain intensity scores increased slightly , patient and family attitude scores did not change , and physicians ' and nurses ' knowledge and attitude scores improved slightly . None of these changes , however , reached statistical significance . Participation in at least one intervention program improved physicians ' and nurses ' knowledge and attitude scores that approached statistical significance . Our results suggest that community opinion leaders combined with other educational programs may improve cancer pain management , but this strategy requires further study . The results suggest that more intense intervention application may be effective . Effective strategies to improve cancer pain management remain elusive PURPOSE / OBJECTIVES To demonstrate the effects of a program , directed at homecare nurses , of structured educational interventions on the management of pain and opioid-related side effects in homecare patients with cancer . DESIGN A longitudinal multilevel , r and omized , controlled clinical trial . SETTING Midwestern region in the United States . SAMPLE 202 nurses caring for patients with cancer recruited from homecare agencies . METHODS The two-tiered educational program focused on basic and advanced pain management strategies , particularly in the area of pharmacologic options and assertive communication skills . Instruments used were the Nurses ' Knowledge and Attitudes Survey Regarding Pain , the barriers question naire , perception of control over pain , and a demographic question naire . MAIN RESEARCH VARIABLES Knowledge and attitudes about pain management , barriers to pain management , and perception of control over pain . FINDINGS Nurses in the intervention group had a significant increase in their knowledge , a more positive attitude about pain management , fewer perceived barriers to pain management , and an increase in perceived control over pain compared to the nurses who did not receive the intervention . CONCLUSIONS The educational program Power Over Pain has beneficial effects for homecare nurses caring for patients with cancer pain . IMPLICATION S FOR NURSING A need exists for homecare nurses to gain more insight into pain management strategies and enhance their advocacy skills to improve pain management for patients with cancer treated in the home OBJECTIVES : To assess the effects of outreach visits by trained nurse facilitators  on the organisation of services used to prevent cardiovascular disease . To identify the characteristics of general practice s that determined success . DESIGN : A non-r and omised controlled trial of two methods of implementing guidelines to organise prevention of cardiovascular disease : an innovative outreach visit method compared with a feedback method . The results in both groups were compared with data from a control group . SETTING AND SUBJECTS : 95 general practice s in two regions in The Netherl and s. INTERVENTIONS : Trained nurse facilitators visited practice s , focusing on solving problems in the organisation of prevention . They applied a four step model in each practice . The number of visits depended on the needs of the practice team . The feedback method consisted of the provision of a feedback report with advice specific to each practice and st and ardised instructions . MAIN OUTCOME MEASURES : The proportion of practice s adhering to 10 different guidelines . Guidelines were on the detection of patients at risk , their follow up , the registration of preventive activities , and teamwork within the practice . RESULTS : Outreach visits were more effective than feedback in implementing guidelines to organise prevention . Within the group with outreach visits , the increase in the number of practice s adhering to the guidelines was significant for six out of 10 guidelines . Within the feedback group , a comparison of data before and after intervention showed no significant differences . Partnerships and practice s with a computer changed more . CONCLUSION : Outreach visits by trained nurse facilitators proved to be effective in implementing guidelines within general practice s , probably because their help was practical and design ed for the individual practice , guided by the wishes and capabilities of the practice team BACKGROUND Out reach facilitation is design ed to promote uptake of evidence -based guidelines . There is evidence indicating that outreach facilitation can be effective in improving implementation of preventive care in GPs ' offices . In this trial , we test a modified version of an outreach facilitation intervention . OBJECTIVE To evaluate whether a comprehensive preventive intervention program using outreach facilitators improves preventive care delivery . DESIGN Match-paired , cluster-r and omized controlled trial . SETTING Fee-for-service primary care practice s in Eastern Ontario , Canada , at a time of physician shortage . PARTICIPANTS Volunteer sample of 54 primary care practice s. MAIN OUTCOME MEASURES Mean difference between trial arms in practice s ' delivery of preventive manoeuvres , measured by preventive performance indices estimated from chart review s and patient survey data . RESULTS No difference was detected between the trial 's arms for the primary outcome 's overall prevention index [ 2.0 % ; 95 % confidence interval ( CI ) -3.2 to 7.3 ; P = 0.44 ] . A small significant difference between the arms was detected for the secondary outcome 's overall prevention index ( 2.8 % ; 95 % CI 0.7 - 4.8 ; P = 0.01 ) . CONCLUSION In contrast to similar facilitation trials , this outreach facilitation program did not produce improvements in the delivery of preventive care . This lack of effect may be due to differences in the intervention and context , or the practice 's limited capacity to change . Our intervention simultaneously facilitated a high number of manoeuvres , blinded facilitators and physicians to the targeted tests and had a relatively short intervention period and large number of practice s assigned per facilitator . Changes in the primary care service model in Ontario at the time of the trial could have also washed out the intervention effect BACKGROUND Although there is much room for improvement in the performance of recommended preventive manoeuvres , many inappropriate preventive interventions are being done . We evaluated a multifaceted intervention , delivered by nurses trained in prevention facilitation , to improve prevention in primary care . METHODS Forty-six health service organizations ( HSOs ) were recruited from 100 sites in Ontario . After baseline data were collected , we r and omly assigned the practice s to either an 18-month ( July 1997 to December 1998 ) multifaceted intervention delivered by 1 of 3 nurse facilitators ( 23 practice s ) or no intervention ( 23 practice s ) . The unit of intervention and analysis was the medical practice . The outcome measure was an overall index of preventive performance , which was calculated as the proportion of eligible patients who received 8 recommended preventive manoeuvres less 
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' As such , facilitation may be a broader intervention that includes organizing and delivering other interventions .