Evidence-based Practice Model Research Articles

A multi-dimensional EBP educational program to improve evidence-based practice and critical thinking of hospital-based nurses: Development, implementation, and preliminary outcomes

Improving outcomes and quality of care through evidence-based practice (EBP) is a priority globally. But most nurses have insufficient competence in EBP. How to conduct Educational interventions to enhance clinical nurses' EBP competencies and critical thinking disposition (CTD) requires more evidence. One hundred eleven clinical nurses from a Chinese four-campus hospital were enrolled in our EBP education program. The Johns Hopkins Nursing Evidence-Based Practice Model was used to develop and guide the educational and practical sessions. Multi-dimensional learning strategies —including online self-learning, on-site lectures, workshops, and social media-facilitated group discussions—were used to facilitate the implementation of the education sessions. After education, nurses embedded evidence into practice. The Chinese versions of the EBP Believe scale (EBPB), EBP Implementation scale (EBPI), and the Simplified Chinese Version of the Critical Thinking Disposition Inventory (CTDI-SCV) were applied to assess the relevant competencies among clinical nurses before and after the education program. Clinical nurses' EBPB, EBPI, and CTDI-SCV scores improved. But only EBPB and EBP skills and attitudes were enhanced with a statistical difference (t = −2.980, −4.141, and −2.695, with all p < 0.01). There was a small positive association between EBPB and CTDI-SCV (r = 0.396, p < 0.01). Fifteen EBP programs were successfully accomplished.

Introducing evidence based practice in nursing care delivery, utilizing the Iowa model in intensive care unit at Kamuzu Central Hospital, Malawi

BackgroundNowadays, having knowledge of Evidence Based Practice (EBP) and its implementation strategies are critical skills for nurses to promote delivery of safe, effective and quality care. Nursing care delivery is faced with a challenge of delivering EBP. The purpose of this study was to build the capacity of and support nurses to implement an EBP change using Iowa Model of EBP. MethodsAction research using quantitative approaches was conducted in intensive care unit at Kamuzu Central Hospital (KCH). A descriptive, pretest-posttest design using repeated measures was employed. Iowa model was used to implement change. Convenient sampling of six-co researchers and 26 patients was done, the inclusion criteria was all patients with fever. STATA 12.0 software was used to analyze data and paired t-test was used to determine the mean difference of the paired temperature observations. ResultsIowa model effectively supported and guided nurses to: identify fever as a clinical problem; select fever control interventions; implement and evaluate the evidence-based interventions; refine and integrate the evidence-based interventions in routine practice. After Paired t-tests were run; there was an insignificant mean difference for exposure 0.07 °C, t (85) = 1.4123 and the P = 0.1615. This suggest that exposure has minimal effect on temperature reduction. The mean difference for paired temperature observation for: tepid sponge bath was 0.6 °C/hour, (t (85) = 9.8427, P = <0.001.); Ice packs 0.5 °C/hour, (t (56) = 6.7854, P = <0.001); antipyretics-paracetamol 0.3 °C/hour, t (23) = 3.4371, P = <0.002) and intravascular cooling 2.4 °C/hour (t (21) = 19.8080, P = <0.001). These methods had a significant mean difference of temperature reduction. This shows that the methods are effective in reducing temperature. Then a fever guideline was developed to guide nurses in smooth integration of the evidence-based fever control intervention into routine nursing care delivery to ensure sustainability. ConclusionUsing Iowa model improves nurses' EBP capability and capacity. Increasing knowledge of key staff members, team work, availability of local resources are crucial to increase nurse’s capacity of taking their EBP role. For effective EBP initiative it is recommended to: utilize of EBP models, ensure active participation of all nurses at the unit level, have supportive leadership, communicate available EBP policies, guidelines and job description to providers, and integrate the pilot EBP innovation in routine nursing care operations.

Physical and Behavioral Health Characteristics of Aging Homeless Women in the United States: An Integrative Review.

Background: The average age of the homeless population is and will continue to rise. Although women comprise a significant and growing percentage of this vulnerable population, their age- and sex-specific health characteristics are poorly understood. Materials and Methods: This integrative review appraises published research addressing the physical and behavioral health characteristics of aging homeless women (≥50 years) in the United States (2000-2019). The authors searched six electronic databases to identify eligible studies. Studies were screened for methodological quality by using the Johns Hopkins Nursing Evidence-Based Practice model. The review is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Results: Ten primary studies met the review eligibility criteria. All were level III (non-experimental); nine appraised as "good" quality (level B), and one as "lower" quality (level C). Aging homeless women demonstrate elevated rates of physical health conditions, related to suboptimal nutrition, lower than expected preventive health screening uptake, and geriatric concerns. Disproportionate rates of mental health conditions are compounded by substance use and interpersonal trauma. Familial and social dynamics and socioeconomic disadvantage contribute to social health concerns. Spiritual health is a critically important yet underexplored protective factor. Conclusions: Studies are limited, though collective findings suggest that aging homeless women endure a disproportionate physical, behavioral, and social health burden compared with aging non-homeless women and aging homeless men. Implications for research on early aging, preventative health strategies, and homelessness among women, and clinical practice in the context of geriatric and women's health are described.

Effect of applying a vascular Nursing Staff Development Competency Program on Nurses Practices and Knowledge

Background: The specialist nurses in vascular surgery department have a great role in the application of all the core generic knowledge and competencies and special skills required for caring of vascular surgical patients through improves patient outcomes by empowering nurses to implement an evidence-based practice model of care. This model encourages nurses to learn comprehensive vascular care through education and training regarding best practice care for patients with complex vascular needs. Aims of the study: This study aimed to determine the effect of applying a nursing staff development program on vascular surgery nursing practices practices and knowledge Design: The present study follows a quasi experimental research design .Setting: This study was conducted at the vascular surgery department, Main University hospital, Alexandria. Subjects: The study Subjects were30 nurses. Tool: Vascular Staff Nurse Portfolio of Competency assessment check list. Results: Good knowledge was detected among 40% of nurses immediately after implementing the nursing staff development program, and then decreased to 26.7%, after two months post program implementation, after being zero percent before applying the program. Recommendations: Performing annual in-service training programs, concerning for all nurses working with patients with a vascular disorders, is mandatory, and Continuing nursing supervision, education and evaluation is advocated to identify areas of knowledge lack or malpractice.

질적 메타합성에 대한 문헌고찰

Purpose: Recently, with the increasing demand for a evidence-based practice model in the health care area, qualitative meta-synthesis studies that provide a comprehensive understanding of phenomena of interest has increased. This study was conducted to understand the concept of qualitative meta-synthesis and guide the application of appropriate methods. Methods: This study is a literature review to address and analyze concepts and methods used in qualitative meta-synthesis studies. Results: The definition and purpose of qualitative meta-synthesis, philosophical background, procedures and outcomes are described. And the meta-ethnography, which is widely applied, was described. In addition, grounded theory, critical interactive synthesis, and meta-study were briefly introduced. It is also desirable to evaluate the quality of the primary research paper by utilizing evaluation criteria and evaluation tools to select the primary research paper, which also affects the quality of qualitative meta-synthetic studies. It is necessary for the researcher to recognize the epistemological difference in qualitative meta-synthesis, to consider saturation of the primary research paper, and to minimize the decontextualization of the primary research paper. Above all, the creative interpretation of researchers should provide expanded knowledge and insights into the research area. Conclusion: By clarifying the purpose of qualitative meta-synthesis, the researcher should ensure justification for performing qualitative meta-synthesis. Researchers also need to make efforts to ensure methodological transparency in order to overcoming the limitations of qualitative meta-synthesis.

An evidence-based approach to clinical supervision

ABSTRACT Derek Milne has developed and disseminated an evidence-based model for clinical supervision (EBCS) that is unique and differs from other approaches. Based on an integrative model of evidence-based clinical practice, Derek’s research program has included a series of literature reviews, an empirical definition, a basic model of clinical supervision, and an instrument for observing and evaluating clinical supervision (Supervision: Adherence and Guidance Evaluation: SAGE). Dissemination of this work led to a manualized account of EBCS, including practical guidelines and video-demonstrations. EBCS has been particularly influential in the UK, where it has been incorporated within the IAPT initiative.

Effect of Music Therapy on Relaxation and Breastfeeding Anxiety

Clinical nurses on a postpartum unit noted an opportunity to improve patient care during the breastfeeding process. Although breastfeeding is perceived to be a natural physiological process, many postpartum women experience breastfeeding anxiety. Maternal anxiety decreases the milk production by inhibiting the milk ejection reflex. The 8A’s evidence-based practice model was used to answer the PICO (P—patient, problem or population; I–intervention; C–comparison, control, or comparator; O—outcome(s)) question. To determine whether, among postpartum breastfeeding women, music therapy increased relaxation and reduced breastfeeding anxiety. Scientific literature demonstrates that music therapy is an effective evidenced-based intervention to improve the following outcomes: milk volume, cortisol level, anxiety-related behaviors, and self-reported relaxation and anxiety. The health care system’s Institutional Review Board approved the project with exempt status on July 26, 2019 (IRB#:1908801). All breastfeeding women who were admitted to the postpartum unit were offered the opportunity to participate. Implementation occurred for those who agreed to participate (n = 30) during one of the feedings between 24 and 96 hours postpartum. Using disposable earphones, women were asked to listen to music of their choice (lullaby, instrumental, or piano with nature sounds) for at least 5 minutes before the breastfeeding session. They then began breastfeeding while the same music played through a speaker. After breastfeeding sessions were completed, the participants filled out self-reported surveys. Using Likert-scale surveys, breastfeeding women reported feeling significantly more relaxed after breastfeeding, as evidenced by a mean score of 6.07 (0 = not relaxed to 7 = very relaxed). The change in breastfeeding anxiety level through survey questions, “I have previously been anxious about breastfeeding,” and “I am anxious about breastfeeding in the future,” was statistically significant (p < .001). Music therapy increases relaxation, decreases breastfeeding anxiety, and, therefore, enhances the milk ejection reflex. Furthermore, past research has found that maternal anxiety decreases the chance of breastfeeding success and increases the risk for postpartum depression. Future projects could examine the effect of music therapy on exclusive breastfeeding rate, postpartum depression, and pumped-milk volume produced by mothers of premature newborns.

AQUEDUCT Intervention for Crisis Team Quality and Effectiveness in Dementia: Protocol for a Feasibility Study.

BackgroundSpecialist community teams often support people with dementia who experience crisis. These teams may vary in composition and models of practice, which presents challenges when evaluating their effectiveness. A best practice model for dementia crisis services could be used by teams to improve the quality and effectiveness of the care they deliver.ObjectiveThe aim of this study is to examine the feasibility of conducting a large-scale randomized controlled trial comparing the AQUEDUCT (Achieving Quality and Effectiveness in Dementia Using Crisis Teams) Resource Kit intervention to treatment as usual.MethodsThis is a multisite feasibility study in preparation for a future randomized controlled trial. Up to 54 people with dementia (and their carers) and 40 practitioners will be recruited from 4 geographically widespread teams managing crisis in dementia. Quantitative outcomes will be recorded at baseline and at discharge. This study will also involve a nested health economic substudy and qualitative research to examine participant experiences of the intervention and acceptability of research procedures.ResultsEthical approval for this study was granted in July 2019. Participant recruitment began in September 2019, and as of September 2020, all data collection has been completed. Results of this study will establish the acceptability of the intervention, recruitment rates, and will assess the feasibility and appropriateness of the outcome measures in preparation for a large-scale randomized controlled trial.ConclusionsThere is a need to evaluate the effectiveness of crisis intervention teams for older people with dementia. This is the first study to test the feasibility of an evidence-based best practice model for teams managing crisis in dementia. The results of this study will assist in the planning and delivery of a large-scale randomized controlled trial.International Registered Report Identifier (IRRID)DERR1-10.2196/18971

Determinants of an evidence-based practice environment: an interpretive description

BackgroundDespite the available research to inform nursing practice, many patients still fail to receive evidence-based care. Several evidence-based practice (EBP) models have been developed to guide nurses through the steps in the process, yet these models have not been uniformly adopted or consistently used. The original purpose of this research was to gather perspectives and experiences of nurses using the Iowa Model of EBP to help inform its introduction into other practice settings. As a more in-depth understanding was gained, the emphasis of the study shifted towards understanding the determinants of the EBP environment.MethodThe study was conducted in an 800-bed comprehensive academic medical centre in the USA with a 25-year history of using the Iowa Model of EBP. Semi-structured in-depth interviews were conducted with twelve nurses from various roles to ascertain their perspectives and experiences using the model. The interview transcripts were reviewed alongside relevant published literature and internal documents in a process of synthesising, theorising, and conceptualising. Data were collected during the first half of 2019.ResultsFour determinants of the local EBP environment were identified from the perspectives and experiences of participants: (1) the importance of a shared model to guide staff through the EBP process; (2) support for EBP in the form of education, hands-on training, and knowledge infrastructure; (3) active team facilitation by direct care nurses, nurse managers, nurse specialists, and nurse scientists; and (4) a culture and leadership that encourages EBP.ConclusionIntroducing an EBP model is an essential first step for an organisation to improve consistent and reliable evidence-based care; to be most effective, this should be done in conjunction with efforts to optimise the EBP environment.

Microbiome-gut-brain axis in cancer treatment-related psychoneurological toxicities and symptoms: a systematic review.

The microbiome-gut-brain (MGB) axis provides a dynamic model to understand associations between the gut microbiota and psychoneurological comorbidities. The role of the MGB axis in cancer treatment-related psychoneurological symptoms (PNS) remains unknown. The purpose of this study was to conduct a systematic review of the existing literature to identify the influence of the gut microbiota on cancer and cancer treatment-related PNS and toxicities mediated by the MGB axis. We searched the databases of PubMed, Embase, and Web of Science from their earliest records to October 2019. All studies identified in the database searches were screened by title and abstract, followed by a review of the full texts. The Johns Hopkins Nursing Evidence-Based Practice Model was adopted to assess the evidence levels and qualities; the Joanna Briggs Institute critical appraisal tools were used to assess the methodological quality and the possibility of bias for each included study. All the study findings were combined, synthesized, and presented through narrative format. Six studies were included in this systematic review. These studies primarily focused on cancer survivorship while receiving chemotherapy, and they were conducted between 2016 and 2019. The gut microbiome was assessed via fecal samples, which were analyzed using 16S rRNA sequencing approaches. With small-scale studies, the gut microbiota was associated with cancer treatment-related PNS, including fatigue, anxiety, depression, sleep disturbance, cognitive impairment, and chemotherapy-induced peripheral neuropathy. A higher relative abundance of Bacteroides was associated with a higher level of fear of cancer recurrence but a higher relative abundance of Lachnospiraceae.g and Ruminococcus was associated with a lower level in fear of cancer recurrence. Changes in fatigue interference were associated with the frequency of genera Faecalibacterium and Prevotella, and changes in anxiety were associated with the frequency of genera Coprococcus and Bacteroides. The gut microbiota showed significant associations with cancer treatment-related PNS. Recent work regarding the MGB axis in cancer psychoneurological toxicities focused primarily on individual toxicity and symptoms in cancer survivors with chemotherapy exposure. Associations between the gut microbiota and PNS should be further studied in cancer populations across different ages, cancer types, and treatment modalities.

Development, implementation and evaluation of an evidence-based practice model in a new hospital in Chile.

To describe an implementation programme for an evidence-based practice (EBP) model in a new Chilean hospital and to analyse the programme evaluation results. Evidence-based practice is key to professional nursing for improving health care safety and quality. First, a literature review was performed to develop an institutional EBP model. Second, internal and external analyses contributed to assessing facilitators for and barriers to implementation. Third, a multi-stage implementation plan was conducted. Fourth, process and outcome indicators were evaluated. The model considered the basic elements of EBP and outlined different decision-making levels in clinical practice. Several facilitators for implementation were identified. Each implementation stage included activities addressing EBP knowledge, attitude and skills. Outcome indicators showed significant improvement regarding knowledge (p=.038). Providers with formal EBP training, compared with providers without training, showed a significant difference of 8.6% (0.6 points) in the average CPBE-19 score in knowledge, attitude and application in the last evaluation (p<.01). Having an EBP programme with ongoing implementation strategies improves knowledge over time, and formal training enhances positive results. Nurse managers can build an institutional research culture to improve the quality of care using an EBP programme that fits organisational needs.

Neuron Model of Interprofessional Education and Evidence-Based Practice.

Interprofessional education (IPE) and evidence-based practice (EBP) are relatively new concepts in health professions education in many parts of the world. These critical reforms are implemented with great effort. As clinical practice has become more collaborative and evidence-based, teamwork and research need to be well integrated in the curriculum. However, many stakeholders struggle to visualize the work of IPE and EBP in the context of health professions education and practice. The Neuron Model, using parts of the neuron, is designed to detail how IPE and EBP integrate in health professions curriculum design or reveal a hidden curriculum. Evidence-based interprofessional care has been implemented with limitations in academic health systems. Lack of a common understanding of how it works is a limitation. The neuron model thus aims to visualize IPE and EBP in health professions education and practice.

Evidence-informed practice: simplifying and applying the concept for nursing students and academics.

Nurses' ability to apply evidence effectively in practice is a critical factor in delivering high-quality patient care. Evidence-based practice (EBP) is recognised as the gold standard for the delivery of safe and effective person-centred care. However, decades following its inception, nurses continue to encounter difficulties in implementing EBP and, although models for its implementation offer stepwise approaches, factors, such as the context of care and its mechanistic nature, act as barriers to effective and consistent implementation. It is, therefore, imperative to find a solution to the way evidence is applied in practice. Evidence-informed practice (EIP) has been mooted as an alternative to EBP, prompting debate as to which approach better enables the transfer of evidence into practice. Although there are several EBP models and educational interventions, research on the concept of EIP is limited. This article seeks to clarify the concept of EIP and provide an integrated systems-based model of EIP for the application of evidence in clinical nursing practice, by presenting the systems and processes of the EIP model. Two scenarios are used to demonstrate the factors and elements of the EIP model and define how it facilitates the application of evidence to practice. The EIP model provides a framework to deliver clinically effective care, and the ability to justify the processes used and the service provided by referring to reliable evidence.

When Psychotherapy Is Not Working: Ethical Considerations

Evidence-based practice (EBP) models have been developed, in part, to enhance the likelihood that the outcome of health care treatment, including psychotherapy, leads to positive improvement. However, two additional outcomes can occur: no change and poor outcome (e.g., harm, worsening of symptoms). What does the clinician do when psychotherapy is not working? When faced with various treatment decisions, such as this, the EBP model posits that therapists should apply their clinical expertise in considering the “best available research” within the context of various patient characteristics. In part because of various limitations of this approach, I suggest that another important set of principles are important to consider in tandem when faced with this clinical dilemma—that is, ethical concerns. Borrowing from the American Psychological Association’s (2017a) Ethics Code, I discuss how the following issues exist when clinicians wrestle with this question: avoidance of harm, competence, conflicts of interest, and informed consent. I conclude this paper with a list of suggestions that can potentially foster the application of ethical principles when making treatment decisions.

Developing an evidence-based reading intervention for early brain injury rehabilitation

AbstractIntroduction:Providing evidence-based services in areas with emerging or low-level evidence is a challenge for many clinicians. The aim of the current study was to apply a newly designed novel methodology to develop and describe a new intervention for cognitive-communication reading comprehension deficits in early acquired brain injury rehabilitation.Methods:An emergent multi-phase mixed methods design allowed phases of different research activity to build an evidence base of quantitative and qualitative data. A pragmatic clinical framework was developed to combine these traditional research findings with principles from knowledge translation and implementation science, evidence-based practice and intervention development models, clinical contextual practice guidelines and the Medical Research Council’s guidelines for developing and evaluating complex interventions, to create an evidence-based contextually driven clinical intervention.Results:The resulting reading comprehension intervention and service delivery model is presented and involves a multiple-strategy intervention across increasing level of reading comprehension complexity. In areas where traditional methodologies provide low-level evidence, this method provides an alternate way to conduct evidence-based clinical research.

Association of Community Health Nursing Educators', 2020 evidence-based project priorities: A national blueprint for unifying research and evidence-based practice priorities.

The Association of Community Health Nursing Educators (ACHNE) Research Committee Subcommittee on Evidence-Based Practice (EBP) presents a paper on the state of translation of science into public health nursing education practice. The paper builds from the integrative research review completed by the ACHNE Research Priorities Subcommittee (McElroy et al., Public Health Nursing, 2020) offering updated research priorities and a Research in Action model. Four EBP Project Priorities were established using the Johns Hopkins EBP Model guided by Dang and Dearholt's (Johns Hopkins nursing evidence-based practice: Model and guidelines, 2018) 19-step process. The EBP Project Priorities emphasize the need for EBP projects to align ACHNE strategic plans and research priorities. The authors recommend that the Research in Action model guide deliberate unification of both the Research and EBP Project Priorities. Standards and criteria for essential effort unifying collaborative effort between PhD and Doctorate in Nursing Practice scholars, coordination of research efforts, and innovative practice partnerships is provided.

Twenty-five years after the introduction of Evidence-based Medicine: knowledge, use, attitudes and barriers among physiotherapists in Italy - a cross-sectional study.

ObjectivesTo explore the knowledge, use, attitudes towards Evidence-based Medicine, also known as Evidence-based Practice (EBP), and perceived barriers to its dissemination among physiotherapists.DesignCross-sectional study.Setting and participantsMembers of the Italian Association of Physiotherapists (n=2000) were invited to participate in an online survey about EBP knowledge and use.Primary outcome measuresThe survey questionnaire comprised four sections: (1) respondent characteristics; (2) knowledge of EBP principles; (3) attitude, use and perceived effectiveness of EBP; (4) perceived barriers to implementing EBP in clinical practice.ResultsOut of 2000 physiotherapists, 1289 participated in the survey (64.5% response rate). Overall, 90% perceived EBP as useful and necessary for their clinical practice. More than 85% stated that they were familiar with the principles of EBP, 75% reported that they were able to search online databases for relevant information and 60% reported that they were able to understand statistical analyses. However, 56% believed that patient preferences and 39% that clinical expertise are not part of the EBP model. Half stated that they understood and could explain the term ‘meta-analysis’ but only 17% knew what a forest plot is and just 20% correctly judged the finding of a given meta-analysis. Lack of time was reported as the main barrier to EBP.ConclusionThe majority of Italian physiotherapists overrated their knowledge about EBP, demonstrating a gap between perceived and actual knowledge of EBP in this population.

The Trach Trail: A Systems-Based Pathway to Improve Quality of Tracheostomy Care and Interdisciplinary Collaboration.

To implement a standardized tracheostomy pathway that reduces length of stay through tracheostomy education, coordinated care protocols, and tracking patient outcomes. The project design involved retrospective analysis of a baseline state, followed by a multimodal intervention (Trach Trail) and prospective comparison against synchronous controls. Patients undergoing tracheostomy from 2015 to 2016 (n = 60) were analyzed for demographics and outcomes. Trach Trail, a standardized care pathway, was developed with the Iowa Model of Evidence-Based Practice. Trach Trail implementation entailed monthly tracheostomy champion training at 8-hour duration and staff nurse didactics, written materials, and experiential learning. Trach Trail enrollment occurred from 2018 to 2019. Data on demographics, length of stay, and care outcomes were collected from patients in the Trach Trail group (n = 21) and a synchronous tracheostomy control group (n = 117). Fifty-five nurses completed Trach Trail training, providing care for 21 patients placed on the Trach Trail and for synchronous control patients with tracheostomy who received routine tracheostomy care. Patients on the Trach Trail and controls had similar demographic characteristics, diagnoses, and indications for tracheostomy. In the Trach Trail group, intensive care unit length of stay was significantly reduced as compared with the control group, decreasing from a mean 21 days to 10 (P < .05). The incidence of adverse events was unchanged. Introduction of the Trach Trail was associated with a reduction in length of stay in the intensive care unit. Realizing broader patient-centered improvement likely requires engaging respiratory therapists, speech language pathologists, and social workers to maximize patient/caregiver engagement. Standardized tracheostomy care with interdisciplinary collaboration may reduce length of stay and improve patient outcomes.

Applied and conceptual approaches to evidence-based practice in research and academic libraries

Evidence-based practice is an approach to professional practice that involves a structured process of collecting, interpreting and applying valid and reliable research and evidence to support decision-making and continuous service improvement in professional practice. This paper reports on emerging initiatives in evidence-based practice at the University of Southern Queensland (USQ) Library, a regional multi-campus university in Australia. It demonstrates how evidence-based practice forms part of our organisational strategy to engage with our community and society. The case study describes a new model of embedding evidence-based practice through a role explicitly dedicated to developing the library’s evidence base. While other libraries may have a person responsible for assessment, performance metrics or data analysis, the Coordinator (Evidence-Based Practice) has a broader mandate – to work with library staff to develop tools, skills and expertise in evidence-based practice. The paper will describe why this role was created and how the Coordinator is working to engage with library staff to understand their business and the evidence needed to support service improvement for the Library. By doing this, USQ Library is building the capacity to demonstrate value to stakeholders, gain a deeper understanding of clients’ needs and experiences, promote robust decision-making and improve service delivery. The paper also outlines an initiative led by the Coordinator (Evidence-Based Practice) to develop a conceptual model of evidence-based practice within academic libraries at the organisational, rather than individual level. Current models of evidence-based library and information practice apply predominantly to individuals. Informed by relevant literature and 16 semi-structured interviews with library professionals from Australian and New Zealand university libraries, three themes emerged to describe how evidence-based practice might be experienced at the organisational level. The lived experience at USQ Library and our research investigations suggest that being evidence-based provides benefits to an academic library’s culture, practice and impact.

The Manage Care Model - Developing an Evidence-Based and Expert-Driven Chronic Care Management Model for Patients with Diabetes.

Background:Most current care models are disease- or symptom-focused and mostly do not account for the individual needs of patients with chronic diseases. The aim of this study was to develop an innovative, evidence-based and expert-based practice model for the management of patients with type 2 diabetes mellitus.Method:An iterative approach was used combining systematic literature search with qualitative methods, including a standardised survey of experts in chronic care (n = 92), an expert workshop of professionals (n = 22) and a multilingual online survey (n = 659). Using three consensus meetings involving researchers, policy makers and experts in chronic care, a limited number of core components and care recommendations was set up to develop a new chronic care model.Results:The developed ‘MANAGE CARE MODEL’ includes aspects of the health and social care system, resources derived from the living environment, aspects of health promotion and prevention, as well as an expanded understanding of improved outcomes as an integral part of chronic care.Conclusion:The MANAGE CARE MODEL provides guidance for the development and implementation of chronic care programs, regional networks and national strategies. Future research is needed to validate the model as an instrument of regional chronic care management.