Evidence-based practice for young people who self harm: can it be sustained and does it improve outcomes?

In 1998-1999, two Area Health Services in NSW conducted a project to implement evidence-based service enhancements for the clinical management of young people who present with Deliberate Self Harm (DSH) behaviour. The present study examined what structures and procedures were required to implement and sustain evidence-based practice in different health care settings for patients with DSH behaviour. Service provision was assessed at three points during the initial project to assess the degree of change that occurred, and 9 months after the completion of the project to allow an assessment of sustainability of the service provision. We examined staff perceptions of the importance of education, management directives, policy and procedure changes, and cultural/ attitudinal changes, in implementing clinical best practice. Results indicated that support from both service management and clinical staff is necessary for successful implementation of service enhancements. High levels of staff education and policy development were also associated with high levels of service performance. The best sustained enhancements were those that were developed by the services themselves.

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Establishing and Sustaining a Culture of Evidence-Based Practice: An Evaluation of Barriers and Facilitators to Implementing the Best Practice Spotlight Organization Program in the Australian Healthcare Context

Healthcare ◽

10.3390/healthcare7040142 ◽

2019 ◽

Vol 7 (4) ◽

pp. 142 ◽

Cited By ~ 1

Author(s):

Greg Sharplin ◽

Pam Adelson ◽

Kate Kennedy ◽

Nicola Williams ◽

Roslyn Hewlett ◽

...

Keyword(s):

Focus Groups ◽

Best Practice ◽

Evidence Based Practice ◽

South Australia ◽

Governance Structure ◽

Evaluation Framework ◽

Successful Implementation ◽

Evidence Based ◽

Implementation Evaluation ◽

Healthcare Settings

Background: Nurses and midwives are central to the implementation and delivery of quality care through evidence-based practice (EBP). However, implementation of EBP in nursing and midwifery is under-researched with few examples of systematic and sustained change. The Registered Nurses Association of Ontario’s Best-Practice Spotlight Organization (BPSO) Program was adopted in South Australia as a framework to systematically implement EBP in two diverse and complex healthcare settings. Methods: The study was a post-implementation, mixed-method evaluation conducted at two healthcare settings in Adelaide, South Australia utilizing qualitative and quantitative data. Proctor’s implementation evaluation framework guided the evaluation design. Information sources included; interviews, focus groups, questionnaires, and document review. Results: Clinical and executive staff (n = 109 participants) from a broad range of stakeholder groups participated in the interviews, focus groups, and returned questionnaires. A number of facilitators directly affecting program implementation were identified; these pertained to embedding continuity into the program’s implementation and delivery, a robust governance structure, and executive sponsorship. Barriers to implementation were also identified. These barriers pertained to organizational or workforce challenges; staff turnover and movement (e.g., secondment), insufficient staff to allow people to attend training, and a lack of organizational commitment to the program, especially at an executive level. As a result of successful implementation, it was observed that over three years, the BPSO program positively influenced the uptake and implementation of EBP by clinicians and the organizations into which they were introduced. Conclusions: The BPSO model can be translocated to new healthcare systems and has the potential to act as a mechanism for establishing and sustaining EBP change. This study was the first to apply an implementation evaluation framework to the BPSO program, which allowed for structured analysis of facilitating or impeding factors that affected implementation success. The findings have important implications for other health systems looking to translocate the same or similar EBP programs, as well as contributing to the growing body of implementation evaluation literature.

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Evidence-Based Practice: The Cochrane Collaboration, and Occupational Therapy

Canadian Journal of Occupational Therapy ◽

10.1177/000841749806500304 ◽

1998 ◽

Vol 65 (3) ◽

pp. 144-151 ◽

Cited By ~ 14

Author(s):

Robyn L. Hayes ◽

John J. McGrath

Keyword(s):

Systematic Reviews ◽

Randomised Controlled Trials ◽

Best Practice ◽

Evidence Based Practice ◽

Occupational Therapists ◽

Cochrane Collaboration ◽

Controlled Trials ◽

Evidence Based ◽

Randomised Controlled ◽

The Cochrane Collaboration

This paper describes how occupational therapists can become involved in the Cochrane Collaboration — a well-developed tool for facilitating the involvement of health professionals and lay people in evidence-based practice. The Cochrane Collaboration is a growing international project intended to systematically locate, conduct systematic reviews (including metaanalyses) of, and disseminate information on all available randomised controlled trials of interventions in any area of health. In particular, occupational therapists can use the Cochrane Collaboration to become better informed about best practice and evaluate research in their areas of interest, and learn skills related to conducting randomised controlled trials, systematic reviews, and meta-analyses.

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Evidence-based practice and health policy development: the link between knowledge and action

Physiotherapy ◽

10.1016/j.physio.2004.07.009 ◽

2005 ◽

Vol 91 (1) ◽

pp. 14-21 ◽

Cited By ~ 9

Author(s):

Ruth J.E. Jones ◽

Pasqualina Santaguida

Keyword(s):

Health Policy ◽

Policy Development ◽

Evidence Based Practice ◽

Evidence Based

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An Evidence-Based Approach to the Use of Social Media to Promote Political Literacy among Youth in the Sultanate of Oman

International Journal of E-Politics ◽

10.4018/ijep.2017040103 ◽

2017 ◽

Vol 8 (2) ◽

pp. 30-39

Author(s):

Mohammed Nasser Al-Suqri ◽

Salim Said AlKindi ◽

Abdullah Khamis Al-Kindi

Keyword(s):

Social Media ◽

Young People ◽

Best Practice ◽

Political Conflict ◽

Evidence Based ◽

Citizen Engagement ◽

Sultanate Of Oman ◽

Political Literacy ◽

The Government ◽

Use Of Social Media

This paper presents the findings of a review of literature to understand the issues facing the Sultanate of Oman in this area, and to identify international examples of best practice in the use of social media to promote political literacy among young people. Evidence-based recommendations for the Government of the Sultanate of Oman are developed, which include the provision of social media literacy training at school and university level, as well as the establishment of an online citizen engagement portal. By adopting international best practice in the use of social media to promote political literacy and citizen engagement among young people, it is believed that the Sultanate of Oman can provide a model for other Middle Eastern Arab states, helping to reduce the potential for political conflict in these countries and promoting participatory approaches to policy-making which reflect the growing demands of young citizens.

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Tele-ICU Partners Enhance Evidence-Based Practice

AACN Advanced Critical Care ◽

10.4037/nci.0b013e31825dfec5 ◽

2012 ◽

Vol 23 (3) ◽

pp. 312-322 ◽

Cited By ~ 3

Author(s):

Carol Olff ◽

Cynthia Clark-Wadkins

Keyword(s):

Health Care ◽

Length Of Stay ◽

Best Practice ◽

Evidence Based Practice ◽

Care Delivery ◽

Health Care Team ◽

Evidence Based ◽

New Members ◽

Management Protocol ◽

Information Research

Evidence-based practice (EBP) has become more than just a trendy buzzword in health care; EBP validates care delivery methods and grants satisfaction to nurses in knowing the care they provide is based on valid, current information. Research-based enhancements are paramount to the advancement of nursing practice and prompt the implementation of creative methods to improve care. The advent of the tele–intensive care unit (ICU) introduces new members of the health care team to assist with implementation of EBP initiatives. This new partnership results in improved length of stay, mortality rates, and ventilator times for critical care patients. Current literature suggests that a clinician-driven, standardized ventilator management protocol is of significant benefit. Tele-ICU clinicians provide an interactive element to coordinate interdisciplinary team efforts. Enhanced communication, data evaluation, and timely intervention expedite the weaning process and reduce ventilator length of stay. Consistent collaboration between tele-ICU and bedside clinicians successfully improves patient outcomes through standardized adherence to best-practice initiatives.

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Assessing young people who deliberately harm themselves

The British Journal of Psychiatry ◽

10.1192/bjp.176.2.126 ◽

2000 ◽

Vol 176 (2) ◽

pp. 126-131 ◽

Cited By ~ 30

Author(s):

Jane Hurry ◽

Pamela Storey

Keyword(s):

At Risk ◽

Young People ◽

Service Management ◽

Postal Questionnaire ◽

Psychosocial Assessment ◽

Old Patients ◽

Admission Rates ◽

Accident And Emergency ◽

Patients At Risk ◽

Self Harm

BackgroundMany young people who harm themselves have chronic mental health or social problems or are at risk of future self-harm or even suicide. The accident and emergency (A&E) clinic is an important gateway to treatment.AimsTo describe the psychosocial assessment of 12- to 24-year-old patients attending A&E clinics following deliberate self-harm (DSH) and to identify features of service management and provision which maximise specialist assessment.MethodA postal questionnaire was sent to a sample of one in three A&E departments in England. In a representative sample of 18 of these hospitals, staff were interviewed and 50 case notes per hospital were examined.ResultsPsychosocial assessment by non-specialist doctors in A&E departments tended to be of variable quality, focused on short-term risk. Around 43% of patients aged 12–24 were assessed by a specialist; specialist assessment was associated with high admission rates and the presence of on-site psychiatric departments and DSH teams.ConclusionsYoung DSH patients at risk often go unidentified; as a result their psychological problems may not be treated. Hospitals are frequently unaware of the proportion of patients discharged without adequate assessment.

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Identifying Best Practice for Communication of Evidence‐Based Practice Changes to Frontline Nurses at a Large Complex Health Organization

Worldviews on Evidence-Based Nursing ◽

10.1111/wvn.12421 ◽

2020 ◽

Vol 17 (3) ◽

pp. 246-248

Author(s):

Ashley Hole ◽

Natalie Bell ◽

Kathleen Burt ◽

Abigail Cohen ◽

Megan Dunne

Keyword(s):

Best Practice ◽

Evidence Based Practice ◽

Evidence Based ◽

Large Complex ◽

Health Organization

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The barriers perceived to prevent the successful implementation of evidence‐based practice by speech and language therapists

International Journal of Language & Communication Disorders ◽

10.1080/13682820802585967 ◽

2009 ◽

Vol 44 (6) ◽

pp. 1018-1035 ◽

Cited By ~ 11

Author(s):

Siobhan O'Connor ◽

Catharine M. Pettigrew

Keyword(s):

Evidence Based Practice ◽

Successful Implementation ◽

Evidence Based ◽

Speech And Language

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Use of Evidence-Based Practice Among Athletic Training Educators, Clinicians, and Students, Part 2: Attitudes, Beliefs, Accessibility, and Barriers

Journal of Athletic Training ◽

10.4085/1062-6050-48.2.19 ◽

2013 ◽

Vol 48 (3) ◽

pp. 405-415 ◽

Cited By ~ 21

Author(s):

Cailee W. McCarty ◽

Dorice A. Hankemeier ◽

Jessica M. Walter ◽

Eric J. Newton ◽

Bonnie L. Van Lunen

Keyword(s):

Clinical Practice ◽

Athletic Training ◽

Evidence Based Practice ◽

Athletic Trainers ◽

Perceived Barriers ◽

Successful Implementation ◽

Evidence Based ◽

Attitudes And Beliefs ◽

Athletic Training Educators ◽

Personal Skills

Context: Successful implementation of evidence-based practice (EBP) within athletic training is contingent upon understanding the attitudes and beliefs and perceived barriers toward EBP as well as the accessibility to EBP resources of athletic training educators, clinicians, and students. Objective: To assess the attitudes, beliefs, and perceived barriers toward EBP and accessibility to EBP resources among athletic training educators, clinicians, and students. Design: Cross-sectional study. Setting: Online survey instrument. Patients or Other Participants: A total of 1209 athletic trainers participated: professional athletic training education program directors (n = 132), clinical preceptors (n = 266), clinicians (n = 716), postprofessional athletic training educators (n = 24) and postprofessional students (n = 71). Main Outcome Measure(s): Likert-scale items (1 = strongly disagree, 4 = strongly agree) assessed attitudes and beliefs and perceived barriers, whereas multipart questions assessed accessibility to resources. Kruskal-Wallis H tests (P ≤ .05) and Mann-Whitney U tests with a Bonferroni adjustment (P ≤ .01) were used to determine differences among groups. Results: Athletic trainers agreed (3.27 ± 0.39 out of 4.0) that EBP has various benefits to clinical practice and disagreed (2.23 ± 0.42 out of 4.0) that negative perceptions are associated with EBP. Benefits to practice scores (P = .002) and negative perception scores (P < .001) differed among groups. With respect to perceived barriers, athletic trainers disagreed that personal skills and attributes (2.29 ± 0.52 out of 4.0) as well as support and accessibility to resources (2.40 ± 0.40 out of 4.0) were barriers to EBP implementation. Differences were found among groups for personal skills and attributes scores (P < .001) and support and accessibility to resources scores (P < .001). Time (76.6%) and availability of EBP mentors (69.6%) were the 2 most prevalent barriers reported. Of the resources assessed, participants were most unfamiliar with clinical prediction rules (37.6%) and Cochrane databases (52.5%); direct access to these 2 resources varied among participants. Conclusions: Athletic trainers had positive attitudes toward the implementation of EBP within didactic education and clinical practice. However, accessibility and resource use remained low for some EBP-related resources. Although the perceived barriers to implementation are minimal, effective integration of EBP within athletic training will present challenges until these barriers dissolve.

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