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
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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
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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
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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
6
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
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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
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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
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Measuring impact
User education
EBP
Searching skills
OT studies
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Method
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9 sessions over 7 months
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34 attendees
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12 month evaluation
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online survey
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100% response rate
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Survey structure
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Introduction
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Invitation to participate
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13 questions
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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
Uninterested
Thought it would be a waste of time
Curious
Well-prepared
Eager to learn more
Other (please specify)
25%
12.5%
0%
7.5%
12.5%
50%
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?
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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?
20
Importance of stream
Having the clinical question prepared within
my stream helped me to approach the
session with more confidence
75
80
70
60
50
40
30
20
10
12
0
0
SDIS
DIS
12
0
NA ND
AG
ST AG
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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)
70
62
60
50
40
30
25
20
12
10
0
0
0
SDIS
DIS
NA ND
AG
ST AG
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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
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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
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Journal club 2006
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Qualitative/quantitative review forms
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Practise searching skills
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Increasingly use library services
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Seek further training when ready
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Annual library orientation session
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What Now, Where Next - Lib (1)
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Act as a catalyst to support a culture of EBP
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Keep up-to-date with EBP resources
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Speak to managers re needs
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Promote training sessions
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Seek opportunities to increase visibility
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Increased use 2005-2006
Training Sessions 2005
Other
6%
Training Sessions 2006
Other
2%
Nursing
31%
Nursing
20%
Medical
8%
Allied Health
36%
Allied Health
70%
Medical
27%
Number Trained by Type 2005
Other
2%
Number Trained by Type 2006
Other Nursing
11%
1%
Nursing
20%
Medical
8%
Allied Health
55%
Medical
23%
Allied Health
80%
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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
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…and stay visible at work or play
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