Is it only 'what works' that 'counts' in new knowledge economies? Evidence-based practice, educational research and teacher education in Australia

Recent texts on globalisation and education policy refer to the rapid flow of education policy texts producing or responding to common trends across nation states with the emergence of new knowledge economies. These educational policies are shaping what counts as research and the dynamics between research, policy, and practice in schools, creating new types of relationships between universities, the public, the professions, government, and industry. The trend to evidence-based policy and practice in Australian schools is used to identify key issues within wider debates about the ‘usefulness’ of educational research and the role of universities and university-based research in education in new knowledge economies.

Evidence-based practice and the borders of data in the global information era

This article explores the range of boundaries to negotiate the demands of evidence-based practice. Increasing demands that social work be a profession committed to evidence-based practice have coincided with innovations in information technology, which potentially give social workers unprecedented access to a plethora of sources and types of evidence. Because these innovations can enable access to evidence beyond traditional boundaries, the question of how the author establish the borders of acceptability warrants consideration. Recommendations for a critical approach to selective evidence based for social work interventions are also provided.

Evidence based practice: are critical care nurses ready for it?

In the emergence of the evidence based practice movement, critical care nurses have struggled to identify scientific evidence on which to base their clinical practice. While the lack of critical care nursing research is a major concern, other important issues have significantly stalled the implementation of evidence even when it is available. A descriptive study of 274 critical care nurses was undertaken to examine nursing research activity in Victorian critical care units. The study aimed to identify critical care nurses' research skills, the barriers encountered in participation and implementation and the current availability of resources.

Results revealed that 42 per cent of the nurses who participated in the study believed that they were not prepared adequately to evaluate research, and less than a third believed they were sufficiently skilled to conduct valid scientific studies. An association was found between nurses' ability to confidently perform research activities and higher academic qualifications. The study found that there is a lack of organisational support and management commitment for the development of evidence based nursing.

In order to facilitate the implementation of evidence based practice, clinicians must be made aware of the available resources, be educated and mentored when carrying out and using clinical research, and be supported in professional initiatives that promote evidence based practice. It is argued that this will have positive implications for patient outcomes in the critical care environment.

Is it only 'what works' that 'counts' in new knowledge economies? Evidence-based practice, educational research and teacher education in Australia

Recent texts on globalisation and education policy refer to the rapid ¯ow of education policy texts producing or responding to common trends across nation states with the emergence of new knowledge economies. These educational policies are shaping what counts as research and the dynamics between research, policy, and practice in schools, creating new types of relationships between universities, the public, the professions, government, and industry. The trend to evidence-based policy and practice in Australian schools is used to identify key issues within wider debates about the `usefulness' of educational research and the role of universities and university-based research in education in new knowledge economies.

Using meta-synthesis to facilitate evidence-based practice

In a previous column, Fineout-Overholt et al. (2008) discussed the use of systematic reviews in decision making for clinical practice, focusing primarily on the quantitative studies, such as randomised controlled trials. Narrative reviews were included but in less detail; this was intentional because the synthesis of qualitative evidence is a complex process and has evoked significant discussion over the past 5 years. Consequently, this column addresses some of the process issues surrounding qualitative evidence synthesis, or meta-synthesis as it is more commonly known, and offers ideas for how evidence arising from these can be used to inform education, teaching, and practice.

Implementing a journal club in a palliative care setting : a link in the chain of evidence-based practice

This paper describes the implementation and evaluation of a journal club in a privately funded palliative care unit. Journal club meetings were initiated as part of a quality improvement process to foster the uptake of evidence-based practice. Nurses were presented with research articles each month and discussions were conducted focussing on methodological considerations of the research and implications of the research for patient care. The maximum number of attendees at any one meeting was nine and the minimum number was four. Overall, evaluations were positive about all aspects of the meetings. Attendees found that the selected articles were relevant, providing new information, stimulated discussion and reflection on clinical practice and encouraged further reading. One of the positive aspects of the meetings identified by participants was the facilitation style that enabled discussion in a safe and supportive environment. An important outcome of the meetings is the potential to explore evidence-based practices relevant to palliative care and to implement new practices or revise existing ones. As part of this process practice changes and clinical guidelines have been implemented. A dedicated facilitator with university links and a supportive organisational culture promoted club meetings as a practical way to provide clinical nurses with the opportunity to explore evidence-based research in the area of palliative care.

An evidence-based practice approach to improving nursing care of acute stroke in an Australian emergency department

Aims. The aim of this study was to improve the emergency nursing care of acute stroke by enhancing the use of evidence regarding prevention of early complications.
Background. Preventing complications in the first 24–48 hours decreases stroke-related mortality. Many patients spend considerable part of the first 24 hours following stroke in the Emergency Department therefore emergency nurses play a key role in patient outcomes following stroke.
Design. A pre-test/post-test design was used and the study intervention was a guideline for Emergency Department nursing management of acute stroke.
Methods. The following outcomes were measured before and after guideline implementation: triage category, waiting time, Emergency Department length of stay, time to specialist assessment, assessment and monitoring of vital signs, temperature and blood glucose and venous-thromboembolism and pressure injury risk assessment and interventions.
Results. There was significant improvement in triage decisions (21Æ4% increase in triage category 2, p = 0Æ009; 15Æ6% decrease in triage category 4, p = 0Æ048). Frequency of assessments of respiratory rate (p = 0Æ009), heart rate (p = 0Æ022), blood pressure (p = 0Æ032) and oxygen saturation (p = 0Æ001) increased. In terms of risk management, documentation of pressure area
interventions increased by 28Æ8% (p = 0Æ006), documentation of nil orally status increased by 13Æ8% (ns), swallow assessment prior to oral intake increased by 41Æ3% (p = 0Æ003), speech pathology assessment in Emergency Department increased by 6Æ1% (ns) and there was 93Æ5 minute decrease in time to speech pathology assessment for admitted patients (ns).
Relevance to clinical practice. An evidence-based guideline can improve emergency nursing care of acute stroke and optimise patient outcomes following stroke. As the continuum of stroke care begins in the Emergency Department, detailed recommendations for evidence-based emergency nursing care should be included in all multidisciplinary guidelines for the management of acute stroke.