Veronica Delafosse

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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.

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CGMC

• 1,000 EFT
• Part of Bayside Health
• Subacute services including rehabilitation, aged
  care, community health

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Assumptions

• Evidence based practice
• PICO - clinical questions
• Levels of evidence
• CATs
• Search strategies
• Subject headings
• Truncating, exploding, combining terms
• Document delivery

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Inpatient and ambulatory rehab

• Amputee
• Orthopaedic
• General
• Neurological
• Spinal
• Cardiac
• Chronic pain

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OT streams and sessions

• Aged Care (1)
• Musculoskeletal (3)
• Heart and Body (1)
• Neurological (2)
• Community (2)

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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

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Scenario

• Setting Rehabilitation and aged care
• Perspective Occupational therapists
• Intervention 1-3 library sessions
• Comparison Community health
• Evaluation 12 month survey

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Databases

• OTseeker (Uni Qld EB OT Group)
• OTcats
• PEDro
• Joanna Briggs
• Centre for Evidence-Based Rehab
• CINAHL
• Medline
• Cochrane
• Web

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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

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Literature review

• Measuring impact
• User education
• EBP
• Searching skills
• OT studies

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Method

• 9 sessions over 7 months
• 34 attendees
• 12 month evaluation
• online survey
• 100 response rate

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Survey structure

• Introduction
• Invitation to participate
• 13 questions
• Thank-you

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Which stream?

• Aged Care (12.5)
• Musculoskeletal (25)
• Heart and Body (25)
• Neurological (25)
• Community (12.5)

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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

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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?

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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

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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?

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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?

19
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?

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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?

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Importance of stream

• Having the clinical question prepared within my
  stream helped me to approach the session with
  more confidence

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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)

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Results (1)
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Results (2)
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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

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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

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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

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Increased use 2005-2006
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What Now, Where Next - Lib (2)

• Share with colleagues via
• REBLswith a cause
• ALIA Health Libraries Australia Special
  Interest Group
• for Rehab Evidence Based Librarians

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and stay visible at work or play