What is evidence-based practice anyway? A rural survey
- Authors: Murphy, Angela
- Date: 2003
- Type: Text , Conference paper
- Relation: Paper presented at the 7th National Rural Health Conference, Canberra : 1st - 4th March, 2003
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- Description: Health service system developments in recent decades have, both nationally and internationally, been increasingly focused on quality service delivery and the attainment of improved health outcomes. Evidence-based practice (EBP) has been promoted as a central mechanism through which to achieve improved quality and safety in health service delivery (World Health Organisation, 1999; Australian Health Ministers Advisory Council,1996).
- Description: E1
- Description: 2003000515
Recruiting and retaining rural general practitioners : A mismatch between research evidence and current initiatives?
- Authors: McDonald, John , Bibby, Louise , Carroll, Steve
- Date: 2003
- Type: Text , Conference paper
- Relation: Paper presented at Seventh National Rural Health Conference, Hobart : 1st - 4th March , 2003
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- Description: This paper investigates the possible mismatch between current initiatives to attract and retain general practitioners (GPs) to rural areas, and Australian research evidence about the most significant factors affecting recruitment and retention. The results reported here are part of a broader project that aims to use evidence-based research to enhance rural GP workforce planning and management. This phase of the project analysed research reports evaluating the outcome of programs and services aimed at improving rural recruitment and retention. The search strategies for this review included: key word searches of electronic database publications over the last 15 years; hand searching of relevant journals; trawling websites of relevant organisations; and direct contact with relevant organisations to request copies of “grey” literature such as unpublished reports. A total of 22 Australian studies were identified that met these criteria. (It is acknowledged that many other initiatives have been tried, but evaluation reports for these do not exist or were not obtainable. Similarly, many other studies have examined recruitment or retention without evaluating workforce initiatives.) The 22 studies evaluated nine major recruitment and retention initiatives including: medical course admission criteria (2 studies); rural placements (7); student scholarships (1); financial incentives (2); continuing medical education (5); universitylinked rural practices (1); case management (1); and overseas-trained doctors (2); an community capacity-building (1). Demonstrating “causation” requires strong internal and external validity. Overall, however, there is not yet strong empirical evidence for the efficacy of the any of these initiatives. The methodological problems consistently identified in our analysis were: no use of comparison or control groups; an overreliance on surveys of GPs’ attitudes or intentions rather than actual behaviours; inconsistent definitions of key variables including “rural” and “retention”; inadequate sample sizes or unrepresentative samples and selection biases; inconsistent use of definitions of key variables including “rural” and “retention”; cross-sectional and retrospective designs; insufficient information on statistical analyses; and qualitative studies that did not formally and systematically apply techniques for strengthening credibility and transferability. Moreover, many of these initiatives do not appear to be closely aligned with the factors usually thought to influence recruitment or retention. The learnings from this project support the strategic and accessible use of evidencebased health care for rural workforce issues. Government departments and agencies should invest in rigorous evaluations that are then made publicly available. Policy and program development can benefit by drawing upon sound research knowledge. Rural communities can also become more informed and discerning consumers of this information.
- Description: E1
- Description: 2003000516
Striving for best practice: standardising New Zealand nursing procedures, 1930-1960
- Authors: Wood, Pamela , Nelson, Katherine
- Date: 2013
- Type: Text , Journal article
- Relation: Journal of Clinical Nursing Vol. 22 (21-22), no. 3217-3224 (2013 2013), p.
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- Description: Aims and objectives To identify how nurses in the past determined best practice, using the context of New Zealand, 1930–1960. Background In the current context of evidence-based practice, nurses strive to provide the best care, based on clinical research. We cannot assume that nurses in the past, prior to the evidence-based practice movement, did not also have a deliberate process for pursuing best practice. Discovering historical approaches to determining best practice will enrich our understanding of how nurses' current efforts are part of a continuing commitment to ensuring quality care. Design Historical research. Methods The records of the Nursing Education Committee of the New Zealand Registered Nurses' Association, 1940–1959, and the 309 issues of New Zealand's nursing journal, Kai Tiaki, 1930–1960, were analysed to identify the profession's approach to ensuring best practice. This approach was then interpreted within the international context, particularly Canada and the USA. Results For nearly 30 years, nurse leaders collaborated in undertaking national surveys of training hospitals requesting information on different nursing practices. They subsequently distributed instructions for a range of procedures and other aspects of nursing care to standardise practice. Standardising nursing care was an effective way to ensure quality nursing at a time when hospital care was delivered mostly by nurses in training. The reasons for and timing of standardisation of nursing care in New Zealand differed from the international move towards standardisation, particularly in the USA. Conclusions Historically, nurses also pursued best practice, based on standardising nursing procedures. Relevance to clinical practice Examining the antecedents of the present evidence-based approach to care reminds us that the process and reasons for determining best practice change through time. As knowledge and practice continually change, current confident assertions of best practice should and will continue to be challenged in future.
Awareness and use of the 11+ injury prevention program among coaches of adolescent female football teams
- Authors: Donaldson, Alex , Callaghan, Aisling , Bizzini, Mario , Jowett, Andrew , Keyzer, Patrick , Nicholson, Matthew
- Date: 2018
- Type: Text , Journal article
- Relation: International Journal of Sports Science and Coaching Vol. 13, no. 6 (2018), p. 929-938
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- Description: Coaches are essential to participant safety, particularly by implementing injury prevention programs. The evidence-based injury prevention programs developed by sports scientists will not prevent injuries in real-world sports settings if they are not properly implemented. This study investigated the knowledge and use of the highly efficacious 11+ injury prevention program among coaches of adolescent, female football teams, in Victoria, Australia. A cross-sectional online survey based on the RE-AIM framework identified that nearly half (42%) of the 64 respondents (response rate = 36%) were not aware of the 11+, and only one-third (31%) reported using it. Three-quarters (74%) of the 19 respondents who reported on the 11+ components they used, did not use the entire program. Nearly half (44%) of the 18 respondents who reported the frequency with which they used the 11+, used it less than the recommended twice a week. Barriers to implementing the 11+ included: limited awareness of the 11+; lack of knowledge about how to implement it; not having time to implement it; and believing that the 11+ does not incorporate appropriate progression. This study suggests that it is unlikely that the 11+ prevents a significant number of injuries in real-world football settings due to the lack of awareness and use among coaches. Football-governing bodies should use evidence-based strategies to raise awareness of the 11+, build coach competency to implement it, and address time-related implementation barriers that coaches experience. Coaches should keep up-to-date with injury prevention research evidence and prioritize injury prevention at training, including allocating time to implement injury prevention programs properly.
Facilitators and barriers to evidence-based practice : Perceptions of nurse educators, clinical coaches and nurse specialists from a descriptive study
- Authors: Malik, Gulzar , McKenna, Lisa , Plummer, Virginia
- Date: 2016
- Type: Text , Journal article
- Relation: Contemporary Nurse Vol. 52, no. 5 (2016), p. 544-554
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- Description: Background: Implementation of evidence-based practice (EBP) is a major initiative within health care settings to ensure clinical and policy decisions incorporate best available evidence. Aims: This paper reports findings from a descriptive study exploring nurse educators’, clinical coaches’ and nurse specialists’ perceptions of factors associated with using EBP. Methods: Data was collected from a senior group of nurses working in a tertiary health care network in Victoria, Australia by employing a questionnaire that was distributed to a total of 435 people, of whom 135 responded. Data Analysis:Descriptive statistics for each questionnaire item were determined using SPSS (Statistical Package for Social Sciences version 17). Thematic analysis was performed for the qualitative part of the questionnaire. Results Findings revealed that organisational support, sufficient resources, and access to continuing education were perceived as factors promoting acceptance of EBP. Barriers to such acceptance in health care settings were identified as lack of knowledge and skills, poor time allowance, limited support, and insufficient resources. Conclusion: The reported findings create evidence-based information for organisational strategic planning. Organisations need to develop educational programs to promote EBP and employ strategies to overcome barriers to implementation. © 2016 Informa UK Limited, trading as Taylor & Francis Group.
Assessment of the impact of a workplace intervention to reduce prolonged occupational sitting time
- Authors: Cooley, Dean , Pedersen, Scott , Mainsbridge, Casey
- Date: 2014
- Type: Text , Journal article
- Relation: Qualitative Health Research Vol. 24, no. 1 (2014), p. 90-101
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- Description: We aim to provide a better picture of the outcomes associated with implementing a nonpurposeful, physical activity, e-health intervention in a professional workplace. There is a need for health professionals to evaluate physical-activity-based workplace health interventions with a full range of measures. Using a social ecological model as a basis, we identify a range of subjective outcomes from 15 interviews of a cross section of participants. We document that not only did participants report a range of positive outcomes across multiple systems of influence, but they experienced some negative outcomes because of disruption to work flow and a changing of work habit. We conclude that using subjective evaluations provides a comprehensive picture of the factors that influence judgments of the efficacy of a workplace health intervention. © The Author(s) 2013.
Effectiveness of online tailored advice to prevent running-related injuries and promote preventive behaviour in Dutch trail runners : A pragmatic randomised controlled trial
- Authors: Hespanhol, Luiz , van Mechelen, Willem , Verhagen, Evert
- Date: 2018
- Type: Text , Journal article
- Relation: British journal of sports medicine Vol. 52, no. 13 (2018), p. 851-858
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- Description: BACKGROUND: Trail running is popular worldwide, but there is no preventive intervention for running-related injury (RRI). AIM: To evaluate the effectiveness of adding online tailored advice (TrailS6 ) to general advice on (1) the prevention of RRIs and (2) the determinants and actual preventive behaviour in Dutch trail runners. METHODS: Two-arm randomised controlled trial over 6 months. 232 trail runners were randomly assigned to an intervention or control group. All participants received online general advice on RRI prevention 1 week after baseline. Every 2 weeks, participants in the intervention group received specific advice tailored to their RRI status. The control group received no further intervention. Bayesian mixed models were used to analyse the data. RESULTS: Trail runners in the intervention group sustained 13% fewer RRIs compared with those in the control group after 6 months of follow-up (absolute risk difference -13.1%, 95% Bayesian highest posterior credible interval (95% BCI) -23.3 to -3.1). A preventive benefit was observed in one out of eight trail runners who had received the online tailored advice for 6 months (number needed to treat 8, 95% BCI 3 to 22). No significant between-group difference was observed on the determinants and actual preventive behaviours. CONCLUSIONS: Online tailored advice prevented RRIs among Dutch trail runners. Therefore, online tailored advice may be used as a preventive component in multicomponent RRI prevention programmes. No effect was observed on determinants and actual preventive behaviours. TRIAL REGISTRATION NUMBER: The Netherlands National Trial Register (NTR5431).
Sources of practice knowledge among Australian fitness trainers
- Authors: Bennie, Jason , Wiesner, Glen , van Uffelen, Jannique , Harvey, Jack , Biddle, Stuart
- Date: 2017
- Type: Text , Journal article
- Relation: Translational Behavioral Medicine Vol. , no. (2017), p. 1-10
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- Description: Few studies have examined the sources of practice knowledge fitness trainers use to inform their training methods and update knowledge. This study aims to describe sources of practice knowledge among Australian fitness trainers. In July 2014, 9100 Australian fitness trainers were invited to complete an online survey. Respondents reported the frequency of use of eight sources of practice knowledge (e.g. fitness magazines, academic texts). In a separate survey, exercise science experts (n = 27) ranked each source as either (1) 'high-quality' or (2) 'low-quality'. Proportions of users of 'high-quality' sources were calculated across demographic (age, sex) and fitness industry-related characteristics (qualification, setting, role). A multivariate logistic regression analysis assessed the odds of being classified as a user of high-quality sources, adjusting for demographic and fitness industry-related factors. Out of 1185 fitness trainers (response rate = 13.0%), aged 17-72 years, 47.6% (95% CI, 44.7-50.4%) were classified as frequent users of high-quality sources of practice knowledge. In the adjusted analysis, compared to trainers aged 17-26 years, those aged >/=61 years (OR, 2.15; 95% CI, 1.05-4.38) and 40-50 years (OR, 1.54; 95% CI, 1.02-2.31) were more likely to be classified as a user of high-quality sources. When compared to trainers working in large centres, those working in outdoor settings (OR, 1.81; 95% CI, 1.23-2.65) and medium centres (OR, 1.59; 95% CI, 1.12-2.29) were more likely to be classified as users of high-quality sources. Our findings suggest that efforts should be made to improve the quality of knowledge acquisition among Australian fitness trainers.
Analysing and interpreting outcomes data to support evidence-based practice using the example of AusTOMs-OT
- Authors: Unsworth, Carolyn
- Date: 2017
- Type: Text , Journal article
- Relation: British Journal of Occupational Therapy Vol. 80, no. 10 (2017), p. 631-637
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- Description: Statement of context: Occupational therapists working with clients who have neurological impairments routinely collect outcomes data. However, data cannot inform practice unless it is routinely reviewed. The aim of this paper was to show how outcomes data collected on the Australian Therapy Outcome Measures – Occupational Therapy scale were analysed and interpreted. Although the example pertains to clients with neurological problems, the approach can be applied to all areas of practice. Critical reflection on practice: When outcomes data are routinely analysed and findings reviewed, occupational therapists have an increased understanding of practice strengths and limitations. Implications for practice: Incorporating analysis and interpretation of outcomes data for clients with neurological problems into practice contributes evidence to support therapy and ensures clinicians retain control of their data. © 2017, © The Author(s) 2017.
Use of the AusTOMs-OT to record outcomes in an occupational therapy homeless service
- Authors: Alderdice, Elaine , Wolfe, Debra , Timmer, Amanda , Unsworth, Carolyn
- Date: 2022
- Type: Text , Journal article
- Relation: British Journal of Occupational Therapy Vol. 85, no. 9 (2022), p. 669-676
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- Description: Introduction: Occupational therapists provide services to homeless people internationally, yet relatively little research evidence underpins this practice. This study aimed to describe the process of selecting an outcome measure for use in a homeless occupational therapy service and demonstrate the changes experienced in the occupational performance of individuals participating in this service. Method: The Glasgow homeless occupational therapy service staff reviewed eight outcome measures against six pre-determined criteria. The selected tool was then used to collect data pre and post an occupational therapy intervention with 58 participants. Data were analysed using descriptive statistics and Wilcoxon Signed Ranks Test to determine statistically significant change from admission to discharge in the different domains of the selected outcome measure. Results: The AusTOMs-OT was implemented in daily practice and 70% of participants were discharged following achievement of therapy goals. Clients made clinically and statistically significant improvements over their admission as measured on AusTOMs-OT in areas such as Transfers, Self-Care and Domestic Life-Home, across the health domains of activity, participation and wellbeing. Conclusion: AusTOMs-OT was successfully implemented and demonstrated that participants improved over their time with the service. This evidence can be used to support the effectiveness of occupational therapy services with people experiencing homelessness. © The Author(s) 2022.