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The visible librarian: evidence based practice training for occupational therapists in rehabilitation and aged care settings. Veronica Delafosse Librarian, Caulfield General Medical Centre Melbourne, Victoria, Australia
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The visible librarian:evidence based practice training for occupational therapists in rehabilitation and aged care settings Veronica Delafosse Librarian, Caulfield General Medical Centre Melbourne, Victoria, Australia What Now, Where Next? Current practice & future developments in Clinical Librarianship. 3rd Clinical Librarian Conference. 11th & 12th June 2007, St William's College, York, UK.
CGMC 1,000 EFT Part of Bayside Health Subacute services including rehabilitation, aged care, community health
Assumptions • Evidence based practice • PICO - clinical questions • Levels of evidence • CATs • Search strategies • Subject headings • Truncating, exploding, combining terms • Document delivery
Inpatient and ambulatory rehab • Amputee • Orthopaedic • General • Neurological • Spinal • Cardiac • Chronic pain
OT streams and sessions Aged Care (1) Musculoskeletal (3) Heart and Body (1) Neurological (2) Community (2)
EBP focus • Senior OT staff planned KLAs • Combination of group and streams • Encourage, support, gentle pace • Identify, learn, practise skills • PICO format • Searching - library sessions • Critical appraisal • Applying evidence
Scenario Setting: Rehabilitation and aged care Perspective: Occupational therapists Intervention: 1-3 library sessions Comparison: Community health Evaluation: 12 month survey
Databases • OTseeker (Uni Qld EB OT Group) • OTcats • PEDro • Joanna Briggs • Centre for Evidence-Based Rehab • CINAHL • Medline • Cochrane • Web
Accessing resources • Ejournals, ebooks and databases • Passwords • Access from work or home • Extra IDs/PWs for some journals • eTOCs • HTML vs PDF formats • Catalogue and print resources
Literature review • Measuring impact • User education • EBP • Searching skills • OT studies
Method • 9 sessions over 7 months • 34 attendees • 12 month evaluation • online survey • 100% response rate
Survey structure • Introduction • Invitation to participate • 13 questions • Thank-you
Which stream? Aged Care (12.5%) Musculoskeletal (25%) Heart and Body (25%) Neurological (25%) Community (12.5%)
First session How did you feel about approaching it? Nervous 25% Uninterested 12.5% Thought it would be a waste of time 0% Curious 7.5% Well-prepared 12.5% Eager to learn more 50% Other (please specify) 0%
Aged care Are egg-shell foam mattresses effective in reducing the development of pressure ulcers in a population of over 65yr old patients in a sub-acute setting?
Musculoskeletal What are the skills/information relating to wheelchair use that should be addressed within a hospital setting? What is the most effective way to teach these? Amputee and spinal rehab patients
Community – session 1 Does community based group work reduce the symptoms of depression for people over the age of 65 living in SRSs compared to individualised therapy?
Community – session 2 What is the effect of servicing long term, chronically ill clients on community based OT waiting lists? What methods are used to manage community based OT waiting lists?
Heart and Body What is the best way to produce a graded return to work program (cardiac rehab)? What are the benefits of a strength training program for elderly people? What are the factors affecting compliance to a home program for strength training following a rehab program?
Neurological In patients with a hemiplegic upper limb post stroke, does a prolonged low load stretch reduce the development of contractures in comparison to passive ranging?
Importance of stream Having the clinical question prepared within my stream helped me to approach the session with more confidence
Professional support I relaxed and learnt more quickly because I participated with colleagues on a common topic (compared to training with attendees from a variety of disciplines)
Conclusions • More aware of resources and services • Hands on sessions within streams best • Valued clear presentation style • Less daunted by e-resources • Community OTs coped • Eager to adopt EBP • Realise time constraints
What Now, Where Next - OTs • Journal club 2006 • Qualitative/quantitative review forms • Practise searching skills • Increasingly use library services • Seek further training when ready • Annual library orientation session
What Now, Where Next - Lib (1) • Act as a catalyst to support a culture of EBP • Keep up-to-date with EBP resources • Speak to managers re needs • Promote training sessions • Seek opportunities to increase visibility
What Now, Where Next - Lib (2) Share with colleagues via REBLs…with a cause ALIA Health Libraries Australia Special Interest Group for Rehab Evidence Based Librarians