People and paper: information for evidence-based practice and the differing needs of doctors and nurses

The study aimed to establish the importance of different information sources in changing clinical practice and to ascertain awareness of and access to evidence-based literature. A random sample of 150 consultants and 105 general practitioners (GP) and a purposive sample of 44 nurses was interviewed using a telephone questionnaire. The overall response rate was 187/299 (62%). Respondents identified 167 changes to clinical practice and 294 sources for those changes. The literature accounted for a third of all sources used. The second most frequently used sources varied and were for nurses, education; for GPs, expert advisors; and for consultants, conferences and meetings. Less than half of all doctors reported they had access to effective Health Care Bulletins and less than one in five to the Cochrane Database but access to traditional forms of evidence-based literature, e.g. Drugs and Therapeutic Bulletins was high (> 97%). It is concluded that although the literature is an important source, practitioners may not always have access to the best 'evidence-based' literature. The multiplicity of information sources used suggests that dissemination of 'evidence' to influence practice changes will require an understanding of the way that infomation flows through practitioner networks.