Evidence based healthcare: current work and proposal for rapid research collaboration

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Evidence based healthcare current work and
proposal for rapid research collaboration
Angus Forbes Peter Griffiths Ian Norman
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Angus

• Research areas
• Diabetes
• MS
• Role evaluation
• Literature synthesis

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Current research projects

• - Contribution of nurses to chronic disease
  (synthesis empirical)
• - Modelling diabetes outcome data in primary care
  (empirical)
• - Specialist nurse evaluation (empirical)
• - Learning needs analysis - psychometric tool
  development (empirical)
• - Contribution of nurses, midwives and health
  visitors to child health (synthesis)
• - Assessment of older frail people with diabetes
  (empirical)
• - Transition form child to adult health care
  (synthesis)
• - Measuring social capital- psychometric
  questionnaire development (synthesis empirical)
• - Educational evaluation of e-learning approaches
  (empirical)

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Research Students

• - Tele-health intervention for weight reduction
  in Type 2 diabetes
• - Transition to insulin therapy in Type 2
  diabetes
• - Patient participation in health care planning
• - Diabetes knowledge and metabolic outcomes
• - Effect of different management cut-off
  thresholds in gestational diabetes

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PeterNursing-led care

• Intermediate care in inpatient units
• 3 trials Cochrane Review
• Nurse specialists (Bronchiechtasis, MS)
• trial, quasi experiment
• presumed benefits not always realised
• ask how to achieve goals, not whether nurses can
  do it

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self-assessment by and for older people

• Self-assessment
• Self-report
• Self-completion / direction
• Self as beneficiary
• /-
• Self-initiated
• Self-interpretation
• Self-care
• strong rhetoric, questionable reality
• presumed benefit, little evidence

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Ians Research Programme

• Study of workforce and education initiatives for
  improving delivery of health care and the outcome
  of these initiatives for staff, patients and
  services.
• Previous studies include
• - evaluations of quality assessment instruments
  in nursing, Nursing Development Units, clinical
  competence assessment measures, NHS Cadet Schemes
  
• - development of clinical audit in the therapy
  professions
• - education needs of mental health and learning
  disability nurses
• - investigation of social organisation of care
  for people suffering from dementia living at home
• - family interventions for people suffering from
  schizophrenia in Hong Kong

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Ians Current Studies include

• 1. National evaluation of supplementary
  prescribing by MHNs
• - survey case studies incorporating
  posttest-only design with equivalent groups (with
  While, Whittlesea)
• 2. Computer-aided vs. tutor-delivered teaching of
  exposure therapy for phobia/panic
• - RCT with pre-registration nursing students
  (with Gega, Marks)
• 3. Evaluation of impact of professional education
  on professional identity, RIPL,
  inter-professional stereotypes
• - longitudinal panel survey from 2002 of
  pre-registration students, (n2,232) 7 health
  care disciplines, 3 HEI interviews

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Emerging findings from comparison of medical with
other students data on entry

• Weaker PI than other students, although all
  groups high
• Positive views towards IPE But 36 of medical
  students were neutral or endorsed The function
  of nurses is mainly to provide support for
  doctors (RIPLS) NB 35 of nursing students
  endorsed this too!!
• Positive high correlation between in-group and
  out-group ratings But midwifery students
  substantially more positive view of their
  profession than others

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Our shared interests Use of evidence

• Experience of teaching EBP, systematic reviews
• Typically nurses do not have the knowledge and
  skills to
• seek evidence for practice
• evaluate evidence for practice
• This applies to senior and junior staff

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Proposed rapid research project across EANS
departments

• Objectives are to
• Compare post-registration syllabi in
  evidence-based practice (EBP)
• Evaluate change in students knowledge before and
  after taking EBP course
• Identify aspects of EBP courses associated with
  positive change in students knowledge

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Method

• Design Multiple group pre-test, post-test
• Sample All students taking EBH course across all
  EANS departments
• Two elements
• a) Collection of information on format and
  content of EBH course Berlin Course data
  collected from teachers, 9 items,
• b) Berlin EBM Knowledge Questionnaire (2
  versions), before and after (random allocation),
  15 items, 45 mins

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Next steps?