1. 1 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. 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. The visible librarian: evidence based practice training for occupational therapists in rehabilitation and aged care settings

2. 2 CGMC 1,000 EFT Part of Bayside Health Subacute services including rehabilitation, aged care, community health

3. 3 Assumptions  Evidence based practice  PICO - clinical questions  Levels of evidence  CATs  Search strategies  Subject headings  Truncating, exploding, combining terms  Document delivery

4. 4 Inpatient and ambulatory rehab  Amputee  Orthopaedic  General  Neurological  Spinal  Cardiac  Chronic pain

5. 5 OT streams and sessions Aged Care (1) Musculoskeletal (3) Heart and Body (1) Neurological (2) Community(2)

6. 6 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

7. 7 Scenario Setting: Rehabilitation and aged care Perspective: Occupational therapists Intervention: 1-3 library sessions Comparison: Community health Evaluation: 12 month survey

8. 8 Databases  OTseeker (Uni Qld EB OT Group)  OTcats  PEDro  Joanna Briggs  Centre for Evidence-Based Rehab  CINAHL  Medline  Cochrane  Web

9. 9 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

10. 10 Literature review  Measuring impact  User education  EBP  Searching skills  OT studies

11. 11 Method  9 sessions over 7 months  34 attendees  12 month evaluation  online survey  100% response rate

12. 12 Survey structure  Introduction  Invitation to participate  13 questions  Thank-you

13. 13 Which stream? Aged Care (12.5%) Musculoskeletal (25%) Heart and Body (25%) Neurological (25%) Community(12.5%)

14. 14 First session How did you feel about approaching it? Nervous 25% Uninterested 12.5% Thought it would be a waste of time0% Curious7.5% Well-prepared12.5% Eager to learn more 50% Other (please specify) 0%

15. 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. 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

17. 17 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. 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. 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. 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. 21 Importance of stream Having the clinical question prepared within my stream helped me to approach the session with more confidence

22. 22 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)

23. 23 Results (1) QUESTIONAGREESTRONGLY AGREE Session relevant75%25% Hands-on38%50% Steps explained clearly75%12% Training level suitable62%12% Sufficient length88%- More comfortable using electronic resources 38%12%

24. 24 Results (2) QUESTIONAGREESTRONGLY AGREE Increased confidence25%12% Changed handling of situation38%12% Finding evidence is important50%38% Would like to further searching skills 38%62% Library resources are indispensable to my work 12%62%

25. 25 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

26. 26 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

27. 27 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

28. 28 Increased use 2005-2006

29. 29 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

30. 30 …and stay visible at work or play