CONCEPTUAL FRAME WORK Modified Ottawa Model of Research Use Conceptual frameworks assist researchers to evaluate information and

organize phenomena in relation to their relevance to a common theme (Polit & Beck, 2008). Conceptual models can be made up by concepts, which describe the mental images of phenomenon and integrate them into meaningful configuration. Conceptual frameworks are often compared to a travel guide or map; they guide the researcher throughout a study to arrive at an outcome or conclusion (Sinclair, 2007). A conceptual model is often developed as a visual representation to demonstrate the conceptual framework utilized to guide the inquiry (Polit & Beck, 2008). The conceptual framework gives an idea to the researchers main view and core theme of the research study i.e., it is a visual diagram by which the researcher explains the specific area of interest. The present study is based on The Ottawa Model of Research Use. The Ottawa Model of
Research Use (OMRU) is an interactive model developed by Logan and Graham (1998). The feasibility and effectiveness of using the OMRU in actual practice contexts was supported by findings from a number of studies (Hogan & Logan, 2004; Logan, Harrison, Graham, Dunn, & Bissonnette, 1999; Stacey, Pomey, O'Conner, & Graham, 2006). The OMRU views research use as a dynamic process of interconnected decisions and actions by different individuals relating to each of the model elements (Logan & Graham, 1998). This model addresses the implementation of existing research knowledge. The model has gone through some revisions since its inception. The most recent version of the OMRU (Graham & Logan, 2004) includes six key elements: 1. Evidence-based innovation 2. Potential adopters 3. The practice environment 4. Implementation of interventions 5. Adoption of the innovation 6. Outcomes resulting from implementation of the innovation

According to Graham and Logan (2004), the OMRU relies on the process of assessing, monitoring, and evaluating each element before, during, and after the decision to implement an innovation. In this study the innovation made by many researchers is delayed cord clamping improves the hemoglobin level in newborns. This innovation is not implemented in many hospitals of the researchers locality. So the researcher tried to prove the innovation and implement it in her locality for the benefit of newborns. The Barrier assessments must be conducted on the innovation, the potential adopters, and the practice environment to identify factors that could hinder or support the uptake of the innovation. The potential adopters are hospital administrators and health professionals. The practice environment includes the patients, socio cultural, economic, structural and uncontrolled events occurring in the care of the mothers undergoing labour and delivery. The implementation plan is then selected and tailored to overcome the barriers and enhance the supports identified. In this study though the previous research reports supports delaying cord clamping even in high risk newborns, the researcher would like to do it only on the normal term newborns as a first step. Introduction of the implementation plan is monitored to ensure that the potential adopters learn about the innovation and what is expected of them. The monitoring is ongoing to help determine whether any change in the current implementation or a new implementation plan is required. Finally, the implementation outcomes are evaluated to determine whether the innovation is producing the intended effect or any unintended consequences. In this study all the newborns were safe and free of complications. Newborns in delayed cord clamping group had higher hemoglobin levels when compared to the newborns in early cord clamping group.

The Ottawa Model of Research Use by Logan and Graham

Assess barriers and supports

Monitor intervention and degree of use

Evaluate outcomes

Evidence-based innovation

- Development process - Delayed cord clamping improves hemoglobin level in newborns - Helps in prevention infancy anemiaWHO recommendation

Implementation intervention strategies

Adoption

Outcomes

Potential adopters

- Awareness of research findings - Attitudes towards utilization of research findings - Knowledge/ skill - Concerns - Current practice followed in the concerned organization

Practice environment

- Transfer of knowledge to practice. - Two study groups assigned. - Early cord clamping and Delayed cord clamping done and cord blood hemoglobin was estimated. - Follow up hemoglobin levels checked after 24 hours of birth to rule out any chance for anemia.

- Intension of the researcher to adopt delayed cord clamping practice. - Spreading the knowledge of effects of delayed cord claming

- Patient - Practitioner - system

Patients Culture/social Structural Economic uncontrolled events