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Lincolnshire Knowledge and Resource Service This search summary contains the results of a literature search undertaken by the Lincolnshire Knowledge and Resource Service librarians in April 2012. All of the literature searches we complete are tailored to the specific needs of the individual requester. If you would like this search re-run with a different focus, or updated to accommodate papers published since the search was completed, please let us know. We hope that you find the information useful. If you would like the full text of any of the abstracts listed, please let us know. Alison Price Janet Badcock alison.price@lpct.nhs.uk janet.badcock@lpct.nhs.uk Librarians, Lincolnshire Knowledge and Resource Service NHS Lincolnshire Beech House, Waterside South Lincoln LN5 7JH

Lincolnshire Knowledge and Resource Service Please find below the results of your literature search request. If you would like the full text of any of the abstracts included, or would like a further search completed on this topic, please let us know. A feedback form is included with these search results. We would be very grateful if you had the time to complete it for us, so that we can monitor satisfaction with the service we provide. Thank you! Disclaimer Every effort has been made to ensure that this information is accurate, up-to-date, and complete. However it is possible that it is not representative of the whole body of evidence available. No responsibility can be accepted for any action taken on the basis of this information. It is the responsibility of the requester to determine the accuracy, validity and interpretation of the search results. All links from this resource are provided for information only. A link does not imply endorsement of that site and the Lincolnshire Knowledge and Resource Service does not accept responsibility for the information displayed there, or for the wording, content and accuracy of the information supplied which has been extracted in good faith from reputable sources. Lincolnshire Knowledge & Resource Service Beech House, Witham Park, Waterside South, Lincoln LN5 7JH Search completion date: 17 th April 2012 Search completed by: Jan Badcock Literature Search Results Enquiry Details Evidence Based Practice Resources Searched CINHAL MEDLINE EMBASE Google/google scholar

Opening Internet Links The links to internet sites in this document are live and can be opened by holding down the CTRL key on your keyboard while clicking on the web address with your mouse Full Text Papers Links are given to full text resources where available. For some of the papers, you will need a free NHS Athens Account. If you do not have an account you can register by following the steps at: https://register.athensams.net/nhs/nhseng/ You can then access the papers by simply entering your username and password. If you do not have easy access to the internet to gain access, please let us know and we can download the papers for you. Guidance on Searching within Online Documents Links are provided to the full text of each of these documents. Relevant extracts have been copied and pasted into these Search Results. Rather than browse through often lengthy documents, you can search for specific words and phrases as follows: Portable Document Format / pdf. / Adobe Click on the Search button (illustrated with binoculars). This will open up a search window. Type in the term you need to find and links to all of the references to that term within the document will be displayed in the window. You can jump to each reference by clicking it. You can search for more terms by pressing search again. Word documents Select Edit from the menu, the Find and type in your term in the search box which is presented. The search function will locate the first use of the term in the document. By pressing next you will jump to further references.

Books E book Evidence-Based Practice In Primary Care http://www.fk.unair.ac.id/pdfiles/ebook/evidence%20based%20practice%20in%20prima ry%20care%20[illustrated].pdf Books available from United Lincoln Hospital - you will need to join them to borrow the bookstel: 01522 573952 http://ulht.nhslibraries.com/scripts/hapi.dll/search2?searchterm0=evidence%20based%20practic e Research 2006 current Competency, confidence and conflicting evidence: key issues affecting health visitors' use of research evidence in practice Shona Hilton, Helen Bedford, Michael Calnan and Kate Hunt BMC Nursing 2009, 8:4 Health visitors play a pivotal position in providing parents with up-to-date evidencebased care on child health. The recent controversy over the safety of the MMR vaccine has drawn attention to the difficulties they face when new research which raises doubts about current guidelines and practices is published. In the aftermath of the MMR controversy, this paper investigates the sources health visitors use to find out about new research evidence on immunisation and examines barriers and facilitators to using evidence in practice. It also assesses health visitors' confidence in using research evidence. Methods Health visitors were recruited from the 2007 UK Community Practitioners' and Health Visitors' Association conference. All delegates were eligible to complete the questionnaire if in their current professional role they advise parents about childhood immunisation or administer vaccines to children. Of 228 who were eligible, 185 completed the survey (81.1%). Results These health visitors used a wide range of resources to find out about new research evidence on childhood immunisation. Popular sources included information leaflets and publications, training days, nursing journals and networking with colleagues. A lack of time was cited as the main barrier to searching for new evidence. The most common reason given for not using research in practice was a perception of conflicting research evidence. Understanding the evidence was a key facilitator. Health visitors expressed less confidence about searching and explaining research on childhood immunisation than evidence on weaning and a baby's sleep position. Conclusion Even motivated health visitors feel they lack the time and, in some cases, the skills to locate and appraise research evidence. This research suggests that of the provision of already-appraised research would help to keep busy health professionals informed, up-

to-date and confident in responding to public concerns, particularly when there is apparently conflicting evidence. Health visitors' relative lack of confidence about research on immunisation suggests there is still a job to be done in rebuilding confidence in evidence on childhood immunisation. Further research on what makes evidence more comprehensible, convincing and useable would contribute to understanding how to bridge the gulf between evidence and practice. http://www.biomedcentral.com/1472-6955/8/4/ Factors influencing the development of evidence-based practice: a research tool Journal of Advanced Nursing Volume 57, Issue 3, pages 328 338, February 2007NURSING AND HEALTH CARE MANAGEMENT AND POLICYAim. The paper reports a study to develop and test a tool for assessing a range of factors influencing the development of evidence-based practice among clinical nurses. Background. Achieving evidence-based practice is a goal in nursing frequently cited by the profession and in government health policy directives. Assessing factors influencing the achievement of this goal, however, is complex. Consideration needs to be given to a range of factors, including different types of evidence used to inform practice, barriers to achieving evidence-based practice, and the skills required by nurses to implement evidence-based care. Methods. Measurement scales currently available to investigate the use of evidence in nursing practice focus on nurses sources of knowledge and on barriers to the use of research evidence. A new, wider ranging Developing Evidence-Based Practice questionnaire was developed and tested for its measurement properties in two studies. In study 1, a sample of 598 nurses working at two hospitals in one strategic health authority in northern England was surveyed. In study 2, a slightly expanded version of the questionnaire was employed in a survey of 689 community nurses in 12 primary care organizations in two strategic health authorities, one in northern England and the other in southern England. Findings. The measurement characteristics of the new questionnaire were shown to be acceptable. Ten significant, and readily interpretable, factors were seen to underlie nurses relation to evidence-based practice. Conclusion. Strategies to promote evidence-based practice need to take account of the differing needs of nurses and focus on a range of sources of evidence. The Developing Evidence-Based Practice questionnaire can assist in assessing the specific evidencing tendencies of any given group of nurses. http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2648.2006.04112.x/full

Examining the knowledge, attitude and use of research by nurses. Bonner A, Sando J. J Nurs Manag. 2008 Apr;16(3):334-43. AIM: This study sought to determine the knowledge, attitudes and use of research by nurses. BACKGROUND: There is little evidence about whether nurses are aware of using research and how much research they use in their clinical practice. METHOD: Using a descriptive design, 347 registered and Enrolled Nurses completed the Edmonton Research Orientation Survey. RESULTS: Senior Nurse Managers were more likely to have a positive attitude towards research, and completion of university subjects on nursing research was significant in determining attitude and knowledge of research. All nurses, regardless of position identified barriers to performing research. CONCLUSION: Nurses require specific research education, clinical nursing leadership and work environments conducive to ensure practice is evidenced-based. IMPLICATIONS FOR NURSING MANAGEMENT: A positive attitude towards research by Senior Nurse Managers has the potential to influence other nurses in establishing an active nursing research culture and promote evidence-based practice in the workplace. http://journals.ohiolink.edu/ejc/pdf.cgi/thompson_carl.pdf?issn=03092402&issue=v52i0 004&article=432_btepipvdacih Barriers to evidence-based practice in primary care nursing why viewing decision-making as context is helpful This paper reports a study examining the barriers associated with research knowledge transfer amongst primary care nurses in the context of clinical decisionmaking. Background. The research literature on barriers to nurses use of research knowledge is characterized by studies that rely primarily on self-report data, making them prone to reporting biases. Studies of the barriers to evidence-based practice often fail to examine information use and behaviour in the context of clinical decisionmaking. Methods. A multi-site, mixed method, case study was carried out in 2001. Data were collected in three primary care organizations by means of interviews with 82 primary care nurses, 270 hours of non-participant observation and 122 Q-sorts. Nurses were selected using a published theoretical sampling frame. Betweenmethods triangulation was employed and data analysed according to the principles of constant comparison. Multiple linear regression was used to explore relationships between a number of independent demographic variables (such as length of clinical experience) and the dependent variable of nurses perspectives on the barriers to their use of research knowledge. Results. Three perspectives on barriers to research information use emerged: the need to bridge the skills and knowledge gap for successful knowledge transfer; information formats need to maximize limited opportunities for consumption; and limited access in the context of limited time for decision-making and information consumption. Demographic variables largely failed to predict allegiance to any of the perspectives identified http://journals.ohiolink.edu/ejc/pdf.cgi/thompson_carl.pdf?issn=03092402&issue =v52i0004&article=432_btepipvdacih

Evaluating the successful implementation of evidence into practice using the PARiHS framework: theoretical and practical challenges Alison L Kitson, Jo Rycroft-Malone, Gill Harvey, Brendan McCormack, Kate Seers and Angie Titchen Implementation Science 2008, 3:1 The PARiHS framework (Promoting Action on Research Implementation in Health Services) has proved to be a useful practical and conceptual heuristic for many researchers and practitioners in framing their research or knowledge translation endeavours. However, as a conceptual framework it still remains untested and therefore its contribution to the overall development and testing of theory in the field of implementation science is largely unquantified. Discussion This being the case, the paper provides an integrated summary of our conceptual and theoretical thinking so far and introduces a typology (derived from social policy analysis) used to distinguish between the terms conceptual framework, theory and model important definitional and conceptual issues in trying to refine theoretical and methodological approaches to knowledge translation. Secondly, the paper describes the next phase of our work, in particular concentrating on the conceptual thinking and mapping that has led to the generation of the hypothesis that the PARiHS framework is best utilised as a two-stage process: as a preliminary (diagnostic and evaluative) measure of the elements and sub-elements of evidence (E) and context (C), and then using the aggregated data from these measures to determine the most appropriate facilitation method. The exact nature of the intervention is thus determined by the specific actors in the specific context at a specific time and place. In the process of refining this next phase of our work, we have had to consider the wider issues around the use of theories to inform and shape our research activity; the ongoing challenges of developing robust and sensitive measures; facilitation as an intervention for getting research into practice; and finally to note how the current debates around evidence into practice are adopting wider notions that fit innovations more generally. Summary The paper concludes by suggesting that the future direction of the work on the PARiHS framework is to develop a two-stage diagnostic and evaluative approach, where the intervention is shaped and moulded by the information gathered about the specific situation and from participating stakeholders. In order to expedite the generation of new evidence and testing of emerging theories, we suggest the formation of an international research implementation science collaborative that can systematically collect and analyse experiences of using and testing the PARiHS framework and similar conceptual and theoretical approaches. We also recommend further refinement of the definitions around conceptual framework, theory, and model, suggesting a wider discussion that embraces multiple epistemological and ontological perspectives. http://www.implementationscience.com/content/3/1/1/?mkt=162298/abstract/prep UB/ABSTRACT

ANALYSIS OF THE IMPACT OF A NATIONAL INITIATIVE TO PROMOTE EVIDENCE-BASED NURSING PRACTICE (Evidence-based practice initiative) Nicola Ring https://dspace.stir.ac.uk/bitstream/1893/1368/1/ring%20- %20BPS%20IJNP%20submission%20version%20260705.pdf 2000-2005 TOWARDS A MORE REFLEXIVE RESEARCH AWARE PRACTICE Social Work & Social Sciences Review 11(1) 2004 John Lawler and Andy Bilson This article reflects on the debates about Evidence Based Practice and suggests a new approach to implementing a more reflexive and research aware social work practice in professional teams. We show that there has been a substantial focus on the responsibility of the individual professional for using best evidence to guide their practice and on the organisation to provide an environment and policies suited to EBP. We argue that there is a need balance this by an increased focus on the professional and team culture in which social work takes place. We draw on the literature on organisational change and social work research to suggest a new direction for encouraging greater reflexivity and developing a more open participative approach to the use of evidence to shape new practices in social work at the local level. http://www.iresearch4birth.eu/iresearch4birth/resources/cms/documents/1297696110- swssr111lawler.pdf The PARIHS Framework A Framework for Guiding the Implementation of Evidence-based Practice Jo Rycrojt-Malone, Journal Of Nursing Care Quauty/October-December 2004 http://basale-stimulation.be/pflege/pflege-ol/parihs.pdf An exploration of the factors that influence the implementation of evidence into practice The challenges of implementing evidence-based practice are complex and varied. Against this background a framework has been developed to represent the multiple factors that may influence the implementation of evidence into practice. It is proposed that successful implementation is dependent upon the nature of the evidence being used, the quality of context, and, the type of facilitation required to enable the change process. This study sets out to scrutinize the elements of the framework through empirical enquiry. Aims and objectives. The aim of the study was to address the following questions: What factors do practitioners identify as the most important in enabling implementation of evidence into practice? What are the factors practitioners identify that mediate the implementation of evidence into practice? Do the concepts of evidence, context and facilitation constitute the key elements of a framework for getting evidence into practice? Design and methods. The study was conducted in two phases. Phase 1: Exploratory focus groups (n = 2) were conducted to inform the development of an interview guide. This was used with individual key informants in case study sites. Phase 2: Two sites with on-going or recent implementation projects were studied. Within sites semi-structured interviews were conducted (n = 17).

Results. A number of key issues in relation to the implementation of evidence into practice emerged including: the nature and role of evidence, relevance and fit with organizational and practice issues, multi-professional relationships and collaboration, role of the project lead and resources. Conclusions. The results are discussed with reference to the wider literature and in relation to the on-going development of the framework. Crucially the growing body of evidence reveals that a focus on individual approaches to implementing evidence-based practice, such as skilling-up practitioners to appraise research evidence, will be ineffective by themselves. Relevance to clinical practice. Key elements that require attention in implementing evidence into practice are presented and may provide a useful checklist for future implementation and evaluation projects. http://bmhlibrary.info/sep-14.pdf The Challenge of Using Evidence-Based Practice Sams, Lisa MSN, RNC; Penn, Barbara K. PhD, RN; Facteau, Lorna DNSc, RN Establishing evidence-based practice is a difficult process. The authors describe an innovative collaborative project for establishing evidence-based practice in managing pain in pediatric oncology patients. Using the project as an example, they address the theoretical foundation to support evidence-based practice, barriers to adopting evidence, and strategies for overcoming barriers. http://ovidsp.uk.ovid.com/sp- 3.5.1a/ovidweb.cgi?WebLinkFrameset=1&S=KGKGPDOMKFHFCHGIFNALCEAGGCODAA00&returnUrl=ovidweb.c gi%3f%26full%2btext%3dl%257cs.sh.15.16%257c0%257c00005110-200409000- 00006%26S%3dKGKGPDOMKFHFCHGIFNALCEAGGCODAA00&directlink=http%3a%2f%2fgraphics.uk.ovid.com %2fovftpdfs%2fPDHFFNAGCEGIKF00%2ffs047%2fovft%2flive%2fgv024%2f00005110%2f00005110-200409000- 00006.pdf&filename=The+Challenge+of+Using+Evidence- Based+Practice.&pdf_key=PDHFFNAGCEGIKF00&pdf_index=/fs047/ovft/live/gv024/00005110/00005110-200409000-00006 Barriers to evidence-based practice in primary care. McKenna HP, Ashton S, Keeney S. J Adv Nurs. 2004 Jan;45(2):178-89. BACKGROUND: Evidence-based practice is one of the most important underlying principles in modern health care. In the United Kingdom, successive governments have highlighted the fact that a quality health service is built upon the use of best evidence. Health professionals are becoming more accountable within clinical governance structures for the care they provide. The need to use robust research findings effectively is a critical component of their role. However, studies show that a number of barriers prevent the effective use of best available evidence. AIM: This study aimed to identify barriers to evidence-based practice in primary care. METHOD: A specially designed questionnaire was used to gather respondents' perceptions of the barriers to evidence-based practice. Data were collected in 2000/2001. FINDINGS: Findings show that general practitioners (GPs) ranked barriers differently to community nurses. GPs believed that the most significant barriers to using evidence in practice were: the limited relevance of research to practice, keeping up with all the current changes in primary care, and the ability to search for evidence-based information. In contrast, the most significant barriers to the identified by community nurses were poor computer facilities, poor patient compliance and difficulties in influencing changes within primary care. This suggests that these two groups may require different strategies for barrier removal.

CONCLUSIONS: Identifying barriers is just the first step to addressing issues surrounding the use of evidence-based practice. Extra resources will be needed if these barriers are to be tackled. However, if the resultant change improves the health and wellbeing of people and communities, then the extra costs would be offset by more efficient use of services. http://journals.ohiolink.edu/ejc/pdf.cgi/mckenna_hugh_p.pdf?issn=03092402&issue=v4 5i0002&article=178_btepipc Enabling the implementation of evidence based practice: a conceptual framework Alison Kitson, Gill Harvey, Brendan McCormack Quality in Health Care 1998;7:149 158 The argument put forward in this paper is that successful implementation of research into practice is a function of the interplay of three core elements the level and nature of the evidence, the context or environment into which the research is to be placed, and the method or way in which the process is facilitated. It also proposes that because current research is inconclusive as to which of these elements is most important in successful implementation they all should have equal standing. This is contrary to the often implicit assumptions currently being generated within the clinical effectiveness agenda where the level and rigour of the evidence seems to be the most important factor for consideration. The paper offers a conceptual framework that considers this imbalance, showing how it might work in clarifying some of the theoretical positions and as a checklist for staff to assess what they need to do to successfully implement research into practice. http://www.ncbi.nlm.nih.gov/pmc/articles/pmc2483604/pdf/v007p00149.pdf

NHS Evidence library.nhs.uk Table of Contents Search Results Search History... page 2 1. Evidence based medicine: what it is and what it isn't.... page 3 2. Down with odds ratios!.... page 3 3. Transferring evidence from research into practice: 2. Getting the evidence straight.... page 3 4. Transferring evidence from research into practice: 3. Developing evidence-based clinical policy.... page 3 5....so little time, and...... page 3 6. Transferring evidence from research into practice: 4. Overcoming barriers to application.... page 3 7. Applying the results of trials and systematic reviews to individual patients.... page 3 8. Guidelines for evaluating tools for clinical decision making.... page 4 9. How to keep up with the medical literature: why try to keep up and how to get started.... page 4 10. How to keep up with the medical literature: deciding which journals to read regularly... part 2.... page 4 11. How to keep up with the medical literature: expanding the number of journals you read regularly... part 3.... page 4 Page 1

NHS Evidence library.nhs.uk Search History 1. EMBASE; (evidence AND based AND practice).ti,ab; 27255 results. 2. EMBASE; sackett.au; 0 results. 3. MEDLINE; sackett.au; 0 results. 4. MEDLINE; EVIDENCE-BASED PRACTICE/; 2557 results. 5. MEDLINE; COMPREHENSION/; 5973 results. 6. MEDLINE; 4 AND 5; 10 results. 7. MEDLINE; *EVIDENCE-BASED PRACTICE/; 1099 results. 8. MEDLINE; NURSES/; 26921 results. 9. MEDLINE; 7 AND 8; 3 results. 10. AMED, BNI, EMBASE, HMIC, MEDLINE, PsycINFO,, HEALTH BUSINESS ELITE; sackett.au; 151 results. Page 2

NHS Evidence library.nhs.uk 1. Evidence based medicine: what it is and what it isn't. Citation: Clinical Orthopaedics & Related Research, 01 February 2007, vol./is. 455/(3-5), 0009921X 2. Down with odds ratios!. Sackett DL; Rosenberg WM; Gray JA; Haynes RB; Richardson WS Citation: Evidence Based Medicine, 01 September 1996, vol./is. 1/6(164-166), 13565524 Sackett DL; Deeks JJ; Altman DG 3. Transferring evidence from research into practice: 2. Getting the evidence straight. Citation: Evidence Based Medicine, 01 January 1997, vol./is. 2/1(4-6), 13565524 Haynes RB; Sackett DL; Gray JAM; Cook DL; Guyatt GH 4. Transferring evidence from research into practice: 3. Developing evidence-based clinical policy. Citation: Evidence Based Medicine, 01 March 1997, vol./is. 2/2(36-38), 13565524 5....so little time, and... Gray JAM; Haynes RB; Sackett DL; Cook DJ; Guyatt GH Citation: Evidence Based Medicine, 01 March 1997, vol./is. 2/2(39-40), 13565524 Sackett DL 6. Transferring evidence from research into practice: 4. Overcoming barriers to application. Citation: Evidence Based Medicine, 01 May 1997, vol./is. 2/3(68-69), 13565524 Haynes RB; Sackett DL; Guyatt GH; Cook DJ; Gray JAM 7. Applying the results of trials and systematic reviews to individual patients. Page 3

NHS Evidence library.nhs.uk Citation: Evidence Based Medicine, 01 November 1998, vol./is. 3/6(165-166), 13565524 Full Text: Glasziou P; Guyatt GH; Dans AL; Dans LF; Straus S; Sackett DL Available in print at Lincolnshire Knowledge & Resource Service Available in print at Lincolnshire Knowledge & Resource Service Available in print at Lincolnshire Knowledge & Resource Service 8. Guidelines for evaluating tools for clinical decision making. Citation: Nurse Educator, 01 September 2001, vol./is. 26/5(215-220), 03633624 Abstract: Dickerson SS; Sackett K; Jones JM; Brewer C Managed care is designed to reduce healthcare costs by controlling use of services and by improving quality outcomes. Preparation of nurses to practice in a health management environment mandates clear understanding of this new environment. Nursing educators should focus on the spectrum of health services and enhance the nurses' ability to assess patients independently, implement health plans, and be responsible for outcomes. Nurses must understand how clinical decision-making tools facilitate planning care to maximize use of resources. The authors describe the construction and evaluation of a learning strategy that involves the use of guidelines to evaluate clinical decision-making tools. Two examples are presented: evaluating clinical pathways in a case management project and evaluating algorithm (practice guideline) outcome data from a prenatal population case study from a local health maintenance organization. 9. How to keep up with the medical literature: why try to keep up and how to get started. Citation: Annals of Internal Medicine, 01 July 1986, vol./is. 105/1(149-153), 00034819 Haynes RB; McKibbon KA; Fitzgerald D; Guyatt GH; Walker CJ; Sackett DL 10. How to keep up with the medical literature: deciding which journals to read regularly... part 2. Citation: Annals of Internal Medicine, 01 August 1986, vol./is. 105/2(309-312), 00034819 Haynes RB; McKibbon KA; Fitzgerald D; Guyatt GH; Walker CJ; Sackett DL 11. How to keep up with the medical literature: expanding the number of journals you read regularly... part 3. Citation: Annals of Internal Medicine, 01 September 1986, vol./is. 105/3(474-478), 00034819 Haynes RB; McKibbon KA; Fitzgerald D; Guyatt GH; Walker CJ; Sackett DL Page 4