′Clinical context for evidence–based practice′ provides insights into the key contextual issues to be considered in the implementation and assessment of evidence–based practice. It addresses professional, educational, and organizational obstacles to the implementation of practice change in a range of healthcare settings and explores practical strategies that have been used effectively to overcome them. Specific contextual issues in different care settings e.g. acute care, primary health care, peri–operative settings, paediatrics, aged care, mental health, midwifery are also addressed.
Each chapter is written by an internationally known and respected author, with experience of developing or reviewing contextual strategies/factors related to the impact of implementation. They reflect the international context, explore how gaining a better understanding of context made a difference to the implementation outcome or process and address the potential to transfer different approaches to a range of healthcare settings.
Notes on Contributors.
1 Introduction (Bridie Kent and Brendan McCormack).
2 Context: overview and application (Bridie Kent and Brendan McCormack ).
Defi ning context.
Models and frameworks.
Context Assessment Index.
The Ottawa Model of Research Use.
Mode 2 thinking and context for evidence–based practice.
3 Making context work in primary health care (John Rosenberg and Debbie Kralik).
What is primary health care?
PHC as a set of strategies.
Assessing community need.
4 Making context work in acute care (Alison Hutchinson and Tracey Bucknall).
The acute care context in relation to use of evidence in practice.
Characteristics of acute care contexts.
Evidence of the influence of acute care context on the use of research in practice.
Interventions and strategies to implement interventions.
Application of research evidence in the acute care context a case example.
5 Making context work in pediatrics (Valerie Wilson).
Evidence from practice.
Overcoming the barriers to implementing evidence into practice.
6 Making context work in the perioperative setting (Victoria M. Steelman).
Randomized clinical trials.
Other sources of evidence.
Clinical practice guidelines and perioperative standards.
7 Midwifery in the context of new and developing technologies (Marlene Sinclair).
Defi ning healthcare technology.
Defi ning birth technologies.
Understanding the complexity of technology and its relevance to midwifery.
Philosophical perspectives on birth technology.
Midwives and birth technology: major theoretical positions.
Birth technology competence.
Pregnant women s use of the Internet in pregnancy.
Current context of midwifery care.
The midwifery model of care.
International definition of the midwife.
Global health: The World Health Organization.
Global statistics on Internet usage.
Inappropriate use of technology.
Use of technology during pregnancy and childbirth.
Conclusion: the Instantaneous Age and the role of modern technology in childbirth.
8 Making context work in mental health (Dawn Freshwater and Jane Cahill).
Contextualizing mental health care.
The practice of reviewing: the evolution of scientific literature.
Interpreting the evidence.
Implications of context for practice: effect of peer review on practice.
Benchmarking practice: its place in the hierarchy of evidence.
Interpreting the evidence.
Implications of benchmarking practice for mental health practice.
Summary of how the different contexts of reviewing and benchmarking practices impact on mental health and practice environments.
9 Making context work in aged care (Nadine Janes).
Aged care settings and providers.
Best practice in aged care.
A program of research on evidence–based aged care.
Infl uences on evidence–based aged care.
Summary: maximize relationships, minimize stress.
10 Enabling context with policy (Gill Harvey).
Evidence and policy making.
The policy–making process.
The place of evidence in the policy process.
From policy to practice.
Taking account of policy in implementation strategies.
Bridging the gaps between practice, policy, and research.
11 Context in context (Bridie Kent and Brendan McCormack).
Considering these individual contexts context within contexts.
The impact of the changing world on contextual.
factors for evidence–based healthcare?