Training, resources and current awareness were provided by the Trust Outreach Librarian to support the effective implementation of NICE guidelines and evidence-based practice. Barriers to access were reduced by having a flexible approach to delivery i.e. on site, and at times to suit individual teams and wards. As a result, staff feel more informed, valued and able to access a range of resources to support their clinical practice.
Lancashire Care NHS Foundation Trust
Guidance the shared learning relates to:
Does the example relate to a general implementation of all NICE guidance?
Does the example relate to a specific implementation of a specific piece of NICE guidance?
The aim was to initially provide quick, simple and flexible training to Nursing staff to raise awareness about the importance of NICE guidelines and enable them to better provide evidence-based practice and improve patient care. An individualised approach was adopted, sessions were structured around the persons / groups chosen subject area, then awareness was raised about the various resources available i.e. a dedicated website, current awareness bulletins, patient information, literature searches, book stock and the services of the library. - To remove the barriers to accessing training and awareness in mental health information and resources, to all staff working within the trust. - To raise awareness of NICE guidelines and how they apply to clinical practice by providing a timetable of training, delivered on-site with the support of managers. - To produce a Toolkit and a range of resources to promote NICE guidelines and evidence-based practice to all staff and show staff how easy it was to access this after the training via the library blog.
Lancashire Care NHS Foundation Trust Library & Information Service aim and objective is to support the clinical activities, education and research activities and to improve quality of patient care. Providing timely and relevant information and knowledge resources 24 hours a day, via a dedicated, dynamic library website and current awareness service the library aims easy access to all staff. By promoting the importance of Information literacy, we seek to support individual and organisational learning, creativity and innovation and contribute to improved healthcare delivery through a continuously evolving, reliable information base. As Outreach Librarian for the trust my role is to take the service to all sites and bridge the physical gap by providing flexible training, a website which is available at work and home and access to a range of online resources. Partnership working with the Trusts, Patient & Carer Co-ordinator for Older Adult Network resulted in an idea to pilot NICE guidelines e-alerts to all nursing staff in the older adult network. The service was piloted and proved a success. August 2010 saw the start of a timetable of dates not just in the older adults but across the trust. The appointment of a NICE Implementation Lead in the Trust in 2010, saw the start of another partnership, working to develop new resources in relation to NICE guidelines. The initiative, was driven by a simple request for a list of books for the Child and Adolescent Mental Health Service (CAMHs) on eating disorders. This was to prove the start of Bibliotherapy, self-help as recommended in NICE guidelines. The service is working to help staff to gain greater confidence and awareness of how evidence-based practice can improve patient care and to realise that the outreach librarian service is an approachable supportive resource they can use as an individual, or team to answer their clinical questions and provide access to resources.
The main barriers to staff being able to access clinical guidelines and information about evidence based practice were: - time and convenience - not part of my role - lack of confidence and motivation - accessibility of resources - awareness or resources - dedicated time - searching/IT skills - lack of guides/resources to NICE. After the initial pilot a Toolkit was produced to facilitate the training. An easy step-by-step guide was produced on how to set up email alerts via the NICE site. Taking into consideration some of the barriers, ie. 'lack of confidence', IT skills, all staff who attended were guided through the process step-by-step to ensure everyone who attended went away with the NICE e-alert service in place and an Athens username and password. In addition everyone received an overview of evidence-based practice, how they could search and access quality resources via NHS Evidence, and an explanation of how NICE guidance impacts on their clinical practice. A range of clinical papers were available for staff to take away, examples of the range of literature available via searching NHS Evidence. The training took an average of 5 minutes per person and approximately 10 minutes was spent giving an overview of how the outreach and library service could help them in practice. The training was conducted on-site, in-between shift handovers, making sure the training was flexible and easy to attend. Every member of staff who took part in the training filled out an evaluation form and the results of these were used to help development of the training, resources and the outreach library service. All staff who attended the training received a certificate of attendance and have been entered on to the trust database as part of their CPD. By the end of the training and awareness session staff felt valued and were surprised how quick, easy, informative and useful the session had been. There was no additional costs incurred.
At each site that the training was conducted I evaluated the existing use of the outreach library service, use of the website and library prior to the training. Each time training was undertaken, use and awareness of the services increased by at least 50%. A number of new initiatives arose at their request. For example after the training at Royal Blackburn Hospital, Hillview, I produced a Current Awareness Bulletin on Person-Centred Care and the elderly. After the training at Guild Lodge, medium-secure unit, a number of staff highlighted that the need to access articles, resources around psychosocial interventions at the recommendation of NICE guidelines. I conducted an extensive search of the literature and disseminated the results to staff at Guild and posted the most current literature on the trust library site for all to access. I produced a second Current awareness bulletin on Physical Health after it was highlighted that 80% of patients at Guild were obese. Liaison with staff from the Occupational Therapy produced an extensive literature search to support the development of a Clinical Care Pathway for overweight & obese adults. The bulletin featured links to NICE guidance and resources obtained using NHS Evidence. The impact at Guild Lodge in particular far exceeded my expectations for up-take of the training and evidence-based practice after the initial introduction. The requests for literature directly related to improving patient care more than tripled and as one member of staff commented you could be permanently based here at Guild Lodge. The outreach librarian service is going some way to saving costs, as training is delivered in the workplace, so one member of staff (myself) is travelling as opposed to potentially 50 staff travelling to the library. A dual saving, reducing both travelling costs and the amount of time staff have to take away from the ward.
1. Communicate in every way possible and listen to others to ensure that the training and information you deliver is needed and wanted. 2. Don't work in isolation, partner with other people in your organisation and outside if appropriate, our shared aim: to provide excellence in patient care. 3. Set yourself a question: 'How do you make contact with nursing staff on the wards and show them that they too can you evidence-based practice to improve patient care?' It became the catalyst for new initiatives that has answered and far exceeded the first question. 4. I have learned that your own personal passion and enthusiasm helps staff engage with training. 5. Don't be put off by initial negative thoughts regarding training, it is your job to sell the idea, use your enthusiasm and personality to make sure that staff leave wanting to know more. 6. Confidence in your own ability to effectively demonstrate your expertise in information literacy. 7. As a preliminary step, taking the time to identify barriers to staff being able to access library services pays dividends in increased uptake and in reducing financial costs. 8. Take time to get to know who you are training before you plan your training session, find out individuals abilities and experience before you put together a training package. 9. Provide a range of resources around their clinical area, guidelines, papers, for staff to takeaway. 10. Listen to barriers, needs and wants and let others know. The training highlighted that staff would welcome protected time to look at guidelines and current literature to support practice. 11. If you don't hear back from an initial meeting, or there wasn't an initial uptake, don't give up, contact the team again. 12. Share your good experiences whilst training staff on-site. Let the ward manager know the compliments department, build relations.
Lancashire Care NHS Foundation Trust
Is the example industry-sponsored in any way?