Veronica Delafosse

1
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

15
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?

16
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?

18
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?

20
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?

21
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)
QUESTION AGREE STRONGLY AGREE
Session relevant 75 25
Hands-on 38 50
Steps explained clearly 75 12
Training level suitable 62 12
Sufficient length 88 -
More comfortable using electronic resources 38 12
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Results (2)
QUESTION AGREE STRONGLY AGREE
Increased confidence 25 12
Changed handling of situation 38 12
Finding evidence is important 50 38
Would like to further searching skills 38 62
Library resources are indispensable to my work 12 62
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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