Deshpande Neelima, Publicover Mary, Gee Harry, Khan Khalid S
Birmingham Women's Health Care NHS Trust, Birmingham, UK.
Health Info Libr J. 2003 Jun;20(2):86-94. doi: 10.1046/j.1471-1842.2003.00422.x.
To implement evidence-supported delivery suite ward rounds using strategies to overcome barriers.
Qualitative case study to identify barriers and a quantitative assessment of outcomes on ward rounds.
After an introduction to the proposed evidence-supported delivery suite ward round reactions were elicited from 15 clinicians. Responses were categorized into barriers related to knowledge, skills, attitudes and behaviour. Using strategies to overcome these barriers, a weekly evidence-supported ward round was established. During patient-centred discussions, clinical questions were formulated. Following literature searches, evidence was acquired and appraised.
Clinicians had limited awareness about the potential benefits of a clinical librarian's support during ward rounds. They were unsure of their skills in evidence-based practice. There was scepticism, fear of loss of autonomy, poor motivation and resistance to change. Clinicians identified several factors that could impinge on their practice. Using appropriate strategies when evidence-supported ward rounds were conducted, 67 questions were raised. However only seven articles were appraised in time to affect decisions on that ward round.
Knowledge of barriers was helpful in developing plans for implementation of evidence-supported ward rounds. The pilot study indicates the feasibility of this approach.
运用策略克服障碍，实施有循证支持的产房查房。
定性案例研究以识别障碍，并对查房结果进行定量评估。
在介绍拟议的有循证支持的产房查房后，征集了15名临床医生的反应。回答被归类为与知识、技能、态度和行为相关的障碍。运用克服这些障碍的策略，建立了每周一次的有循证支持的查房。在以患者为中心的讨论中，提出了临床问题。在进行文献检索后，获取并评估了证据。
临床医生对查房期间临床图书馆员支持的潜在益处认识有限。他们不确定自己在循证实践方面的技能。存在怀疑态度、担心自主权丧失、积极性不高以及抵制变革的情况。临床医生确定了几个可能影响其实践的因素。在进行有循证支持的查房时运用适当策略，共提出了67个问题。然而，只有7篇文章及时得到评估，从而影响了该查房的决策。
了解障碍有助于制定实施有循证支持的查房的计划。该试点研究表明了这种方法的可行性。
