Hand therapy (HT) is a specialty area of occupational therapy (OT) practice that focuses on rehabilitation for individuals with hand and upper extremity related conditions with aim to return to performance of daily activities required for life. As with other health professionals, occupational therapy practitioners (OTPs) have a duty to the public to ensure that services rendered are safe and use evidence-based best practices to improve patient health-outcomes. In HT clinics, OTPs face numerous challenges implementing evidence-based practice (EBP) including a lack of time, skills, and misperceptions of EBP (Scurlock-Evans et al., 2014), as well as reimbursement and funding models which incentivize high productivity over time to evaluate the evidence and integrate into clinical practice. The cost of OTPs not implementing EBP into their clinical decisions negatively impacts health outcomes of the patients under their care. The Hand Therapy with Evidence Based Practice (HT-EBP) program aims to enhance patient care through enhancing private HT clinics adoption of up-to-date research evidence into clinical practice. The HT-EBP program is designed for use in community-based private HT clinics that typically have less than 10 OTPs employed. A commitment of two OTPs, preferably one seasoned and one entry level, coming together in a mentor-mentee relationship is needed to implement the program. This program requires the participating clinics and OTPs to actively engage in the development of clinical care plans through review of research evidence on selected clinical diagnoses. Resulting from the HT-EBP program, the HT clinic will be able to provide evidence-based quality care while the OTP participants will develop professionally in the field of HT, gaining firm knowledge in clinical topics and building clinical confidence at the same time. This program will be further enhanced through 1) access to high quality research databases from clinic affiliated universities, 2) professional organization’s focus on continuing education courses that develop research knowledge and analytic skills for OTPs, and 3) collaborating with clinic managers to facilitate more time for clinicians to engage in acquiring and creating knowledge in chosen clinical topics of interests. The HP-EBP will first be piloted at the author’s private HT clinic prior to recruiting other private HT clinics to adopt the program. The HT-EBP program will aim to address the challenges that OTPs face when implementing EBP by working with universities, professional organizations. With time, it is anticipated that a significant volume of evidence-based clinical care plans would be compiled and shared among OTPs in HT, thus enhancing care for patients with hand conditions. Successful implementation of the HT-EBP program may have the potential to serve as a template for other healthcare specialties to deploy EBP.

No description available.

Studiens syfte är att beskriva och analysera chefer och medarbetare syn på sina organisatoriska förutsättningar att etablera evidensbaserad praktik (EBP) i socialtjänsten. I uppsatsen läggs ett särskilt fokus på den organisatoriska förutsättningen strategiskt ledarskap och dess betydelse i en EBP-kontext. Frågeställningarna behandlar huruvida det finns en tydlig riktning kring hur verksamheten ska utvecklas, om konkreta förutsättningarna skapas för genomförandet, ifall kontinuerlig uppföljning och återkoppling ges på arbetet samt om det finns uthållighet i utvecklingsarbetet i organisationen. Skillnader i uppfattning mellan chefer och medarbetare undersöks. Empirin har hämtats från två barn- och ungdomsenheter i Stockholms stad i form av en enkätundersökning och fyra fokusgrupper. Materialet har analyserats utifrån tidigare forskning om ledarskap kopplat till implementering av EBP samt Scheins ramverk om organisationskultur och ledarskap. Resultaten från enkätundersökningen visar på statistiskt säkerställda skillnader i uppfattning mellan chefer och medarbetare: cheferna svarar genomgående i en mer positiv riktning än medarbetare. Resultaten från fokusgrupperna visar möjligheter att skapa tydlig riktning, flera likheter i uppfattning om konkreta förutsättningar samt möjligheter att utveckla arbetet med uppföljning och återkoppling. Faktorer som påverkar uthålligheten i organisationen lyfts fram. Sammanfattningsvis visar undersökningen att det strategiska ledarskapet ännu inte finns fullt ut i de undersökta organisationerna men viktiga steg har tagits för att skapa denna organisatoriska förutsättning. Resultat från undersökningen pekar också mot att man framöver bör arbeta mer systematiskt med att inkludera medarbetarna i arbetet med att etablera en evidensbaserad praktik. / The purpose of this study is to describe and analyze social work managers’ and employees’ views of the organizational prerequisites to establish evidence-based practice (EBP) in the social services. The thesis has a particular focus on the organizational preconditions of strategic leadership and its importance in an EBP context. The research questions reflect whether the strategy for development is clear, if conditions are established for implementation, if continuous evaluation is used and feedback given, and whether there is perseverance regarding the developmental work in the organization. Differences in the opinions between managers and employees are examined. The study has a mixed-methods approach. Empirical data were derived from two children and youth units in Stockholm city in the form of a survey and four focus groups. The material was analyzed based on previous research on leadership related to implementation of EBP and Schein's framework of organizational culture and leadership. The results from the survey show statistically significant differences in the opinions between managers and employees: managers consistently respond in a more positive direction compared to the employees. The results from the focus groups show opportunities to provide clear direction, several similarities in opinion about how to create concrete conditions for implementation, as well as possibilities to develop work on evaluation and feedback. These results further highlight factors related to sustainability for strategic leadership. To conclude, the investigations of present study find that the strategic leadership does not yet characterize these organizations, but important steps have been taken in developing this organizational condition. Moreover, the results indicate that future work would benefit from systematically involve employees in the developing efforts to establish an evidence-based practice.

The purpose of this study was to explore and describe the knowledge that a cohort of 40 intensive care unit nurses had of evidence-based practice. It was assumed that they lacked the knowledge to locate, evaluate understand and apply research findings. Quantitative, non-experimental descriptive research was conducted to explore their knowledge and to formulate recommendations for promoting it. Data collection involved administering a structured questionnaire administered to the cohort in an intensive care unit. The findings revealed that, although they were familiar with the basic concept of evidence-based practice, they were reluctant and lacked the skills to adopt it in their practice. It is recommended that they be trained and empowered to develop research expertise from within their own ranks. Finally it is recommended that nursing management should play a more proactive role in identifying cost-effective strategies in overcoming barriers to finding, promoting and integrating evidence-based practice / Health Studies / M.A. (Health Studies)

Against the backdrop of the transformations in the entire framing of professional work, social work has come under close scrutiny in many countries, including Sweden. Doubts have been raised about practitioners’ existing knowledge base, and the importance of practitioners engaging in learning and the renewal and extension of professional capacities has been emphasized. The present thesis concerns knowledge use and learning in the daily practices of child investigation work. The aim is to explore processes of knowledge use and learning in practice. The study is based on a mix of qualitative approaches, basically from ethnography, comprising methods such as participant observations, interviews, reflective dialogues and documentary analysis of case data. The main findings demonstrate that investigation work is characterized mainly by the use of practice-based knowledge. Research-based knowledge is predominantly used as a means of explaining a client’s situation or to underpin and legitimize one’s own beliefs and decisions made on other grounds. Professional learning is largely adaptive in character, as the social workers learn to handle tasks in a fairly routinized way on the basis of rules or procedures that draw on existing knowledge in the practice setting. Two conclusions are drawn: First, the use of knowledge in child investigation work bears little resemblance to principles of evidence-based practice. Second, the reproduction of professional knowledge is largely implicit and taken for granted. The study offers insight into the much-discussed topic of putting knowledge into practice, which is of importance to strategies for organizing profes sional learning and knowledgeable practice. / Ett i allt högre grad vetenskapsbaserat samhälle har lett till att kunskapsbasen i många verksamheter ifrågasatts, däribland socialt arbete. Avhandlingen behandlar kunskapsanvändning och lärande i utredningsarbetet inom den sociala barn- och ungdomsvården. Syfte är att öka kunskapen kring hur individer använder kunskap och lär sig i och genom sin dagliga praktik. Avhandlingen baseras på fyra delstudier som genomförts i tre svenska kommuners socialtjänst. Det empiriska materialet består av deltagande observationer, intervjuer, reflekterande dialoger och dokumentanalyser. Studien tar sin utgångspunkt i ett kognitivt perspektiv på lärande med teoretiska rötter i pragmatism. Ett grundläggande antagande bakom studien är att lärandet utgår från hur individen tolkar och förstår den situation som hen möter och därefter handlar. Resultaten visar att utredningsarbetet företrädesvis baseras på praktikbaserad kunskap som erhålls från tidigare erfarenheter och kollegor. Forskningsbaserad kunskap används huvudsakligen för att bekräfta och legitimera en uppfattning och inte för att ifrågasätta och utmana existerande åsikter och antaganden. Lärandet kan främst karaktäriseras som ett anpassningsinriktat lärande där praktikern med stöd i tidigare erfarenheter och utifrån befintlig kunskapsbas skapar rutiner för att hantera arbetet. Kunskapsanvändningen inom den sociala barn- och ungdomsvården ligger långt ifrån idealen för evidensbaserad praktik. Reproduktionen av professionell kunskap sker främst implicit och utan frågasättande. Förståelse för praktikers faktiska kunskapsanvändning och lärande har central betydelse för hur verksamheter kan organiseras för att stödja lärande i arbetet.

Introdução: As taxas de episiotomia e lacerações perineais espontâneas no parto normal apresentam grande variação entre os diferentes serviços. Esses traumas perineais e as morbidades relacionadas podem ser prevenidos ou reduzidos com a adoção de práticas baseadas em evidências científicas na assistência ao parto e no reparo perineal. Embora existam evidências científicas bem estabelecidas sobre prevenção e reparo do trauma perineal no parto, em nosso meio faltam estudos sobre a implementação destas evidências na prática. Objetivo geral: Promover as melhores práticas baseadas em evidências científicas para prevenção e reparo do trauma perineal no parto normal. Objetivos específicos: 1) Avaliar a prática corrente na prevenção e reparo do trauma perineal no parto normal; 2) Implementar as melhores práticas baseadas em evidências científicas para prevenção e reparo do trauma perineal no parto normal; 3) Avaliar o impacto da implementação dessas práticas nos desfechos maternos. Método: Estudo de intervenção quase experimental, tipo antes e depois, segundo a metodologia de implementação de evidências na prática clínica do Instituto Joanna Briggs. Foi conduzido no Hospital da Mulher Mãe Luzia, em Macapá, AP. Foram realizadas 74 entrevistas com enfermeiros e médicos obstetras e residentes de ambas as categorias e 70 entrevistas com mulheres que deram à luz nesse local. Foram também analisados dados de prontuários (n=555). Foi realizada uma intervenção educativa, por meio de um seminário para os profissionais, com a finalidade de apresentar e discutir as evidências científicas disponíveis e as melhores práticas em relação ao cuidado perineal no parto. O estudo foi realizado em três fases: pré-auditoria e auditoria de base (fase 1); implementação de boas práticas (fase 2, que corresponde à intervenção educativa); auditoria pósimplementação (fase 3). Os dados foram analisados mediante a comparação entre os resultados das fases 1 e 3, com nível de significância de 5%. O estudo foi aprovado pelo Comitê de Ética em Pesquisa da Escola de Enfermagem da Universidade de São Paulo. Resultados: Em relação aos profissionais, a comparação entre as fases 1 e 3 mostrou que houve aumento da proporção de profissionais que raramente ou nunca incentivam o puxo dirigido (55,0% versus 81,2%; p=0,009), restringem a realização da episiotomia (83,3% versus 96,9%; p=0,021) e deixam as lacerações de primeiro grau sem reparo (61,9% versus 81,2%; p=0,011). Em relação às puérperas entrevistadas, além da posição litotômica no parto ter sido apontada pela maioria das mulheres na fase 1 (77,1%), foi também a mais frequente na fase 3 (97,1%), com diferença estatística significante (p=0,028). Quanto à dor perineal após o parto (períodos de 1-2 dias, 10-12 dias e 30 dias), a frequência diminuiu no decorrer do pós-parto (94,0%, 66,7% e 63,6%, respectivamente, em cada período, na fase 1, e 79,0%, 57,1% e 38,5%, respectivamente, em cada período, na fase 3), com diferença estatisticamente para os diferentes períodos (p=0,019), mas sem diferença entre as fases 1 e 3. Os dados de prontuário das puérperas mostraram que menos mulheres tiveram a laceração perineal suturada (92,0%, na fase 1, e 82,1%, na fase 3; p=0,039) e mais profissionais utilizaram o fio ácido poliglicólico ou poliglactina 910 na mucosa (4,8%, na fase 1, e 28,1%, na fase 3; p=0,006) e na pele (10,2%, na fase 1, e 25,0%, na fase 3; p=0,033). Em relação às demais práticas e desfechos analisados, não houve diferença estatisticamente significante antes e após a intervenção educativa. Conclusão: A metodologia de implementação de práticas baseadas em evidências científicas melhorou os cuidados e os desfechos perineais, incluindo menos profissionais enfermeiros e médicos que realizam puxos dirigidos e episiotomia de rotina e mais registros nos prontuários do uso do fio de sutura ácido poliglicólico ou poliglactina 910 na mucosa e na pele. Por outro lado, a pesquisa identificou lacunas na implementação de evidências e algumas inadequações no manejo do cuidado perineal, tais como, relatos de puérperas submetidas à posição de litotomia e falta de registros nos prontuários em relação à sutura das lacerações perineais. A continuidade das auditorias e novas intervenções educativas sobre a prática baseada em evidências podem melhorar o cuidado e os resultados de saúde materna. / Introduction: Episiotomy rates and spontaneous perineal trauma in normal birth have considerable variation among different health care services. These perineal traumas and related morbidity may be prevented or restricted adopting evidence-based practices during childbirth and perineal repair. Although the well established evidence on perineal trauma prevention and repair, in Brazil there are few studies on the implementation of this evidence in practice. Objectives: Promote the best evidence-based practices for perineal trauma prevention and repair in normal birth; Assess the current practice in perineal trauma prevention and repair in normal birth; Implement the best evidence-based practices on perineal trauma prevention and repair in normal birth; Assess the impact of these implementation on maternal outcomes. Methods: Quasi-experimental intervention study before and after, according to Institute Joanna Briggs methodology implementation of evidence in clinical practice. It was conducted 74 interviews with nurses, obstetricians, residents of both categories and 70 with post-partum women who have had birth at Hospital da Mulher Mãe Luzia, in Macapá, AP, Brazil. It was also analyzed 555 patient data records. The educational intervention was a seminar for professionals, to present and discuss the best evidence-based practice available in relation to perineal care during labour and birth. The study was conducted in three stages: pre-audit and base audit (phase 1); implementation of best practices (phase 2: educational intervention); post-implementation audit (phase 3). Data were analysed comparing the results of phases 1 and 3, with significance level of 5%. The Research Ethics Committee of the School of Nursing of the University of São Paulo approved the study. Results: Concerning professionals, the comparison between phases 1 and 3 showed an increased proportion of professionals who rarely or never encourage direct pushing (55.0% versus 81.2%; p=0.009), perform episiotomy (83.3% versus 96.9%; p=0.021) and leave first-degree lacerations without repairing (61.9% versus 81.3%; p=0.011). Concerning post-partum women, besides the lithotomy position have been most frequent referred by women in the phase 1 (77.1%), it was also the most frequent position in phase 3 (97.1%), with statistical difference (p=0.028). Related to perineal pain 1-2 days, 10-12 days and 30 days after childbirth, the frequency decreased (94.0%, 66.7% and 63.6%, respectively, in each period, in phase 1, and 79.0%, 57.1% and 38.5%, respectively, in each period in phase 3), with statistical difference considering all periods (p=0.019), but no difference between phases 1 and 3. Concerning patient data records, less women had perineal lacerations sutured (92.0%, in phase 1, and 82.1%, in phase 3; p=0.039) and more women had perineal mucosa (4.8%, in phase 1, and 28.1%, in phase 3; p=0.006) and perineal skin (10.2%, in phase 1, and 25.0%, in phase 3; p=0.033) sutured by polyglycolic acid and polyglactin 910. Concerning other analyzed practices and outcomes, no one had statistical significant difference before and after the educational intervention. Conclusion: The evidence-based practice implementation methodology improved the childbirth care and perineal outcomes, such as less nurses and obstetricians performing directed pushes and routine episiotomies, and more records about the use of polyglycolic acid and polyglactin 910 to suture perineal mucosa and skin. On the other hand, it was identified gaps in evidence implementation and some inappropriate perineal care management, such as women submitted to lithotomy position during birth and lack of records in suturing perineal tears. On-going audits and educational interventions on evidence-based practice can improve the childbirth care and maternal outcomes.

O transplante de fígado é uma modalidade terapêutica utilizada em pacientes portadores de doença hepática terminal, quando não há mais nenhum outro tratamento capaz de reverter as alterações da doença no organismo. A complexidade desta modalidade terapêutica exige a formação de uma equipe multidisciplinar para o atendimento do paciente e familiares. O enfermeiro é responsável pelo planejamento da assistência de enfermagem, no período perioperatório; entretanto, observamos a escassez de produção científica nesta área, o que nos motivou para a realização deste estudo. A prática baseada em evidências consiste no referencial teórico-metodológico adotado, e a revisão integrativa da literatura é o método de pesquisa selecionado. O presente estudo teve como objetivo buscar e avaliar as evidências disponíveis na literatura sobre o conhecimento científico produzido, relacionado ao cuidado de enfermagem prestado ao paciente adulto submetido ao transplante de fígado, no período perioperatório. As bases de dados Lilacs, Medline e Cinahl foram utilizadas para a busca dos estudos, cuja amostra foi de 20 artigos científicos. Os resultados evidenciaram que o enfermeiro atua nas diferentes fases do período perioperatório, por meio da realização de cuidados de enfermagem direcionados para o preparo do paciente visando o procedimento anestésico-cirúrgico, a prevenção e a detecção precoce de complicações pós-operatórias, e para a orientação do paciente em relação a recuperação e reabilitação dos pacientes. Além disso, o enfermeiro atua no suporte nutricional e emocional do paciente, e desempenha, ainda, um importante papel no ensino da terapêutica imunossupressora, e na conscientização dos pacientes para a adesão ao regime terapêutico. Ao finalizarmos este estudo esperamos ter fornecido subsídios para a melhoria da prática perioperatória e estimulado os enfermeiros no desenvolvimento de pesquisas relacionadas ao transplante de fígado. / Liver transplantation is a therapeutic modality applicable to patients affected by end-stage hepatic diseases when there is no other available treatment capable of reversing the alterations in the organism caused by them. The complexity of this therapeutic modality requires the establishment of a multidisciplinary team for patient and family support. The nurse is responsible for planning the nursing assistance to be given during the perioperative period; nevertheless, we observed a lack of scientific production in this field, which stimulated the accomplishment of this study. Evidence based practice consists in the theoretical and methodological basis and the integrative literature review in the selected research method adopted for this work. The present study aimed at searching and evaluating the evidences available in literature concerning the scientific knowledge produced regarding nursing care delivered during the perioperative period to adult patient submitted to liver transplantation. Lilacs, Medline and Cinahl databases were searched for studies, which resulted in a sample composed of 20 scientific papers. The results evidenced that the nurse plays an important part in the different stages of the perioperative period, delivering nursing care addressed to preparing the patient to the anesthetic-surgical procedure, prevention and early detection of postoperative complications, and to the patient education regarding his recovery and rehabilitation. In addition, the nurse acts in the nutritional and emotional support of the patient and also fulfills an important role in instructing patients about the immunosuppressive therapeutics and making them aware of the need of adhering to the therapeutics regimen. Our expectation is that this study provides resources required for the improvement of perioperative practice and stimulates the nurses to conduct researches related to liver transplantation.

A complexidade do diagnóstico de enfermagem de Retenção Urinária (RU) requer do enfermeiro pensamento crítico bem-sucedido. Os protocolos assistenciais enfatizam o desenvolvimento de um diagnóstico de enfermagem assertivo. Este estudo teve como objetivo a luz das melhores evidências científicas, propor e validar protocolo de avaliação clínica para o diagnóstico de enfermagem de RU em pacientes adultos. Estudo realizado em duas fases. Na fase 1 foram realizadas duas revisões de literatura pelas normas do Instituto Joanna Briggs, uma Scoping Review baseada na pergunta \"Quais as práticas utilizadas para o diagnóstico de pacientes em retenção urinária?\" e uma Revisão Sistemática com base na pergunta \"Qual a eficácia do uso do ultrassom portátil de bexiga na avaliação da RU em pacientes adultos?\". Para as revisões foi utilizada a estratégia PICO, e as seguintes bases de dados Literatura Latino-Americana e do Caribe em Ciências da Saúde, Web of Science, National Library of Medicine, Cumulative Index to Nursing and Allied Health Literature, The Cochrane Library e SCOPUS. Na fase 2 foi realizado um estudo descritivo, do tipo metodológico, com abordagem quantitativa de desenvolvimento e validação de protocolo. Para a construção do protocolo, foi utilizada a revisão sistemática da literatura (fase 1) e para validação do protocolo utilizou-se a técnica Delphi em duas rodadas, em que profissionais especialistas na área avaliaram o protocolo proposto com auxílio de um instrumento de avaliação. Utilizou-se o Índice de Validade de Conteúdo (IVC) para validação. Os resultados da Scoping Review foram oriundos de 23 artigos, os quais foram agrupados de acordo com a clínica do paciente em clínica cirúrgica, clínica de reabilitação e clínica obstétrica. As práticas utilizadas para o diagnóstico da RU encontradas foram o cateterismo urinário de alívio, o uso do ultrassom portátil de bexiga, o uso do ultrassom portátil de bexiga associado ao cateterismo urinário e medidas não invasivas. A revisão sistemática incluiu dez estudos os quais demonstraram que o ultrassom portátil de bexiga é um instrumento eficaz e confiável para avaliação da RU em pacientes em processo de reabilitação e pós-operatório. O protocolo foi construído nos achados da revisão e validado por peritos brasileiros e portugueses em duas rodadas com alto índice de IVC. A prática baseada em evidências contribui para a reflexão e a qualificação das práticas de enfermagem. Nesse estudo embasaram a construção de um protocolo de diagnóstico de enfermagem RU em pacientes adultos / The complexity of the Urinary Retention (UR) nursing diagnosis requires successful critical thinking nurse. The care protocols emphasize the development of an assertive nursing diagnosis. This study had as objective the light of the best scientific evidence, to propose and to validate protocol of clinical evaluation for the diagnosis of UR nursing in adult patients. This study was carried out in two phases. In Phase 1, two literature reviews were conducted by the Joanna Briggs Institute, a Scoping Review based on the question \"What are the practices used for the diagnosis of patients in urinary retention?\" and a Systematic Review based on the question \"How effective is the Use of bladder portable ultrasound in the UR evaluation in adult patients? \". For the reviews, the PICO strategy was used, and the following databases Latin American and Caribbean Literature in Health Sciences, Web of Science, National Library of Medicine, Cumulative Index to Nursing and Allied Health Literature, The Cochrane Library and SCOPUS. Phase 2 shows a descriptive methodological study with a quantitative approach to protocol development and validation. For the construction of the protocol, a systematic review of the literature (Phase 1) was used, and for the validation of the protocol, the Delphi technique was used in two rounds, in which expert professionals in the area evaluated the proposed protocol with the aid of an evaluation instrument. The Content Validity Index (CVI) was used for validation. The results of the Scoping Review came from 23 articles, which were grouped according to the patient\'s clinic in the surgical clinic, rehabilitation clinic and obstetric clinic. The practices used for the diagnosis of UR were: urinary catheterization of relief, use of portable bladder ultrasound, use of portable ultrasound of the bladder associated with urinary catheterization and non- invasive measures. The systematic review included ten studies which demonstrated that portable bladder ultrasound is an efficient and reliable instrument for UR assessment in patients in the rehabilitation and postoperative process. The protocol was built on the findings of the review and validated by Brazilian and Portuguese experts in two rounds with a high CVI index. Evidence-based practice contributes to the reflection and qualification of nursing practices. In this study, we based the construction of an UR nursing diagnosis protocol in adult patients

This research was undertaken to study the impact of single and multicomponent knowledge translation interventions (KTIs) on barriers to the integration of Clinical Practice Guidelines (CPG) into Clinical Decision Making (CDM) in the context of physical therapists (PTs) and find out which of the two KTIs was more effective. A literature review showed that research knowledge (e.g. CPG) in the field of PT (Physical Therapy) is not being integrated in to clinical practice (e.g. CDM), thus leading to a research-practice (R-P) gap in other words CPG-CDM gap. It is suggested in the literature that the management and behavioural aspects of PTs might be acting as barriers hindering the integration of the research knowledge into clinical practice consequently affecting the delivery of optimum patientcare. Remedial measures, namely KTIs, are suggested to address those barriers and to bridge the R-P gap. However, the phenomenon of the R-P gap, the causes of it and the possible interventions are not well understood concepts in the literature, particularly in the context of PTs. CPG for Venous Thromboembolism (VTE) in PT was chosen as the example of research knowledge. It was argued that barriers have the potential to affect CDM which in turn can affect the CPG-CDM gap. Lack of knowledge about CPG-CDM gap is a major limitation in the literature that is affecting the integration of CPG into CDM. Other gaps found in the literature that have the potential to affect CPG-CDM gap include management and behavioural variables as probable causes of CPG-CDM gap (or barriers), use of KTIs to bridge the CPG-CDM gap and, KTIs. Furthermore, lack of knowledge about relationship between barriers and CPG-CDM gap, KTIs and barriers, KTIs and CPG-CDM gap and the impact of KTIs (effectiveness) in bridging CPG-CDM gap were the other gaps found in the literature that had potential implications to CPG-CDM gap. These gaps were addressed in this research to some extent. Relationships between the independent variables (lack of knowledge of PTs in CPG, lack of favourable attitude of PTs towards CPG and lack of self-efficacy and motivation of PTs to integrate CPG into CDM) and the dependent variables (CDM and CPG-CDM gap) were defined and models were proposed. Further, it was posited that KTIs could impact barriers based on theories and models found in the literature that provided some basis to create the linkage between KTIs and management and behavioural barriers. Education material (EM) and virtual communities of practice (VCoP) were chosen as of the KTIs in this study. The models of Cabana et al. (1999) and Fischer et al. (2016), primarily, were used to ground the conceptual models represented by figures and equations. Methodologically, a positivist approach with an objective ontological stance was employed and a deductive approach and quantitative research method were used to address the research gaps. The research design included a longitudinal element and survey questionnaire. The target population was licensed PTs in the USA. Random sampling was used. Two groups of PTs were identified namely EM-group and VCoP group. Data was collected from the groups before and after administering the KTIs. The results showed that single and multicomponent KTIs impacted barriers in different ways. EM impacted lack of favourable attitude of PTs towards CPG, and lack of self-efficacy and motivation of PTs to integrate CPG into CDM as barriers and narrow the CPG-CDM gap. VCoP was found to impact the combination of four barriers and narrow CPG-CDM gap. In addition, barriers in groups of two were also impacted by VCoP and narrowed the CPG-CDM gap. Furthermore, a CPG knowledge score card and a corresponding CDM score card developed by the researcher were used to test the change behaviour of PTs in integrating CPG into CDM. This experiment showed that barriers existed and caused CPG-CDM gap and KTIs could narrow the CPG-CDM gap. The findings indicate that this research has contributed to knowledge in many ways, including unearthing the relationship between CPG-CDM gap and barriers, better understanding of KTIs, their relationship with CPG-CDM gap and barriers, gaining knowledge about the impact of single and multicomponent KTIs on single and multiple barriers and identification of methods to bridge the CPG-CDM gap.

The number of Social StoriesTM studies and reviews has increased in recent years, yet concerns regarding quality and effect sizes continue to be expressed. With the emphasis on evidence-based practices (EBPs) for the education and treatment of people with autism spectrum disorders (ASD), this issue becomes of paramount importance as professionals and parents attempt to select interventions for the people with ASD in their care. The current study makes a unique contribution in its use of an extensive EBP evaluation model to examine 33 single-subject studies across 13 peer-reviewed journals, a 12-year period, and a wide range of grouping variables. Using the Mayton, Wheeler, Menendez and Zhang (2010) EBP evaluation protocol, studies were investigated in terms of eight quality indicators comprised 23 operationally defined standards. Studies included in this analysis met the following criteria: (1) they were intervention studies using single-subject research designs; (2) they included only participants with disorders on the autism spectrum; and (3) the primary intervention was the use of a Social Story. Findings included on- or above-standard acceptability in EBP indicators related to important aspects of dependent variables within studies and below-standard acceptability in indicators related to both internal and external validity of studies.