Putting Research into Practice in Peterborough

Katy Harrison

GP/DN Questionnaire

• An introduction to research - helped by Stephen, Natalie Miranda and Pete

• A steep learning curve • - deciding what we wanted to know• - how to phrase questions• - how to get it to the appropriate people• - difficulties in getting returns• And how to analyse the results

Positive Approach

• Helped me get to know nursing teams/GP practices and Carehomes

• Identified my role with End of Life Care across Peterborough

• Recognition of the usefulness of the research derived from the questionnaire enabled me to return to all the areas of practice to offer updates e.g. use of analgesia/laxatives

Change Management

• Initiation of new working practices

• helped by the sessions run by Angela and Connor on organisational culture and The Planning for Change work

• Enabled me to begin introducing monthly Gold Standard Meetings, use of End of Life Tools, integrating care between home/Carehome/hospital and hospice

Developing knowledge

• Listening to GP/DN/Carehome needs enabled me to encourage talking – communication – between groups

• This led to the start of joint meetings• The sharing of ideas• I began to introduce nurse specialists to the

meetings e.g. Heart Failure nurse• I also started to get the Carehomes involved

which highlighted their role to the Primary care Team

Action Learning Sets

• Helped develop ideas and how to transfer thought into practice.

• Particularly with dealing with difficult colleagues and practices

• Helped in the development of Communication Workshops

Systematic Review

• A second piece of research using a systematic approach

• Gemma and I have been looking at how and who makes decisions regarding artificial nutrition for those who lack the capacity to make the decision for them selves

Deciding the research question was hard!

• To get the question answered correctly led us to look at 693 abstracts!

• Some were discounted because a repeat of an original research, some were an interpretation, others were not new data but an interpretation of someone else’s work and some had no relevance at all

• How a title of an article can be misleading!• I stated to recognise which journals were a

better source for original data

PubMed database search

Titles: N = 3332

AMED database search

Titles:N = 147

CINAHL database search

Titles: N = 779

EMBASE database search

Titles: N = 5188

Total database search titles:

N = 9721Titles screened

Abstracts:

N = 990

Abstracts

N = 993Abstracts screened

Duplicates removed

Includedpapers

N =64

Papers screened

Abstracts (incl. duplicates):

N = 1926

Papers

N = 164

PsychINFO database search

Titles: N = 279

Open-Sigle search

Titles: N = 7

Hand search N = 3

Expert consult N = 0

Index search N = 0

Figure 1. Flowchart illustrating systematic search strategy for evidence on decision making regarding artificial nutrition for those at risk of lacking capacity

Lots of reading!

• After a number of weeks we were left with 164 full papers read

I found the reading very interesting and have now decided that, I will not choose to live in Japan and be forced to have a PEG feed or in Scandinavia incase they have too much discussion, or the UK where my thoughts are not necessarily counted, maybe I should go to the Netherlands………………….

Thank you Gemma!

• For helping me get to grips with the reading

• And putting forward the abstract for us to present at the 9th Palliative Care Conference in Newcastle in March

• Scary stuff but very exciting!!

• And what a good end to my CLAHRC year

Highlights of the year

• Meeting so many people from areas I have not realised existed and learning about their roles in research- the Judge Business School

• Developing my understanding of Dementia – thank you Jane and team!

• Having time out of my job to understand research better so that I can put it into use.

• Understanding better what journals do NOT hold good research and how much work each piece of research needs

• Ethics!! Still learning that one!

The down side

• Cramming 5 days work into 4

• The A14

• Not going to the pub because I am reading

• Realising how little I know

• Trying to explain what I am doing

• Did I mention the A14?

The Future

• Further GP/DN education • Developing and participating in local

conferences to promote researched based ideas

• Development of the recognition of the end of life in Dementia

• Continuation of Communication Workshops

• Trying not to drive on the A14