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Activity Update - Thailand

January to December 2007

[click here for the 2006 Activity Update]

Workshops
Education and training sessions relevant to evidence-based practice (generating, appraising or using evidence) conducted under the guidance and preparation of the SEA-ORCHID team. Examples include: EBP/EBM workshops, preparing Cochrane systematic reviews, CPG appraisal and development, appraisal of RCTs and qualitative research, literature searching, using the Cochrane Library and RHL.
Date	Topic	Duration (hrs)	Who	No.	Participants
Khon Kaen University (Srinagarind) Hospital
7 Feb	Using corticosteroid in preterm labor to accelerate fetal lung maturity: the appropriate time and dose?	1	Caroline Crowther	50	Physicians, nurses, medical students, and residents
8 Feb	Clinical practice guideline development and adaptation	1.5	Tari Turner	20	Physicians, nurses, medical students, and residents
13 Feb	Psychology of learning and behavior change	3	Jacki Short	20	Physicians, nurses, medical students, and residents
19 Feb	EBP introduction and exclusive breastfeeding	3	Ruth Martis Jadsada Thinkhamrop	26	Medical students, interns, maternity nurses, obstetricians
21 Feb	EBP introduction and selective use of episiotomy and how to prevent perineal tearing	3	Ruth Martis Jadsada Thinkhamrop	12	Medical students, interns, obstetricians
23 Feb	EBP and continuous support in labour, mobility in labour and birth positions	3	Ruth Martis Jadsada Thinkhamrop	24	Medical students
4 May	EBP and exclusive breastfeeding	2	Ruth Martis Jadsada Thinkhamrop	20	Dept O&G physicians, nurses
4 May	EBP and selective use of episiotomy and prevention of perineal tears	2	Ruth Martis Jadsada Thinkhamrop	20	Dept O&G physicians, nurses
1 Jun	Electronic evidence searching and how to use the Cochrane Library	3	Songsri Deesrikaew Butsakorn Ussahgij	13	Physical therapists, physicians [Srinagarind Hospital ]
1-31 Aug	Library service and searching for EBM	84	Songsri Deesrikaew Butsakorn Ussahgij	3	Medical librarians [Khon Kaen Hospital, Kalasin Hospital, Subpasithiprasong Hospital]
8 Aug	Clinical practice guideline development	6	Jadsada Thinkhamrop Butsakorn Ussahgij	50	Physicians, nurses, medical students
6 Sep	Information searching for EBM	3	Songsri Deesrikaew Butsakorn Ussahgij	9	Health Personnel from WHO, India
19-20 Nov	Introduction to analysis	6	Pisake Lumbiganon Jadsada Thinkhamrop Malinee Laopaiboon	20	Physicians
Totals	Hours:	120.5	Participants:	287
Khon Kaen Hospital
2 Feb	EBP and searching for literature	3	KKU medical librarian	20	Physicians, nurses, joined in with the participants at KKU
20 Feb	Introduction to CPG using example of MgSO4	2	Ruth Martis Ussanee Swadpanich	35	Medical students, obstetricians, maternity nurses
20 Feb	How to use the WHO RHL	1	Ruth Martis Ussanee Swadpanich	35	Medical students, obstetricians, maternity nurses
22 Feb	EBP introduction and the use of corticosteroids	1	Ruth Martis Ussanee Swadpanich	35	Medical students, obstetricians, maternity nurses, paediatricians
22 Feb	EBP introduction, painrelief for neonates and the use of sucrose	2	Ruth Martis Ussanee Swadpanich	35	Medical students, obstetricians, maternity nurses, paediatricians
30 Apr	EBP introduction and mobility in labour, continuous support and birth positions	3	Ruth Martis Ussanee Swadpanich	22	Medical students, obstetricians, physicians, interns, nurses, Head of Nursing School
30 Apr	Exclusive Breastfeeding – does it really make a difference?	3	Ruth Martis Ussanee Swadpanich	24	Physicians, nurses
1 May	Normal Birth	3	Ruth Martis Ussanee Swadpanich	25	Physicians, nurses
7 Aug	Update topics for the protocol: Preterm labour, PPH, Severe PIH	3	Ussanee Swadpanich	8	O&G staff
Totals	Hours:	21	Participants:	239
Kalasin Hospital
14 Feb	Principle of adult learning & psychology of learning and behavior change	3	Jacki Short Bunpode Suwannachat Jadsada Thinkhamrop	30	Physicians and nurses
15 Feb	EBP introduction and selective use of episiotomy and how to prevent perineal tearing	3	Ruth Martis Jadsada Thinkhamrop	35	Maternity nurses and medical students
16 Feb	EBP introduction and exclusive breastfeeding	3	Ruth Martis Jadsada Thinkhamrop	35	Rural maternity nurses and midwives
2 May	EBP and exclusive breastfeeding	3	Ruth Martis Bunpode Suwannachat	50	Physicians, nurses, midwives
3 May	EBP and mobility, continuous labour support, birth positions, routine use of enemas and shaving	2.5	Ruth Martis Jadsada Thinkhamrop	42	At district hospital K’amalasai, one of 13 district hospitals that feed into Kalasin Hospital. Participants were mainly nurses from all district hospitals.
3 May	EBP and selective use of episiotomy and how to prevent perineal tears EBP prem labour and corticosteroids How to use the RHL	3.5	Ruth Martis Jadsada Thinkamrop Bunpode Suwannachat	22	At district hospital K’amalasai, one of 13 district hospitals that feed into Kalasin Hospital. Participants were mainly nurses from all district hospitals.
3 May	Corticosteroids	3	Ruth Martis Bunpode Suwannachat	40	Physicians, nurses, midwives
25 May	How to search the electronic literature and use the Cochrane Library	3.5	Butsakorn Ussahgij Bunpode Suwannachat	61	Physicians, nurses
17 Jul	Development of competency assessment tools for registered nurses in labour room: admission, assessments, comfort promotion and pain management, normal delivery, active management of the third stage of labour, care of the perineum suture, immediate care of the newborn, immediate care of the puerperium, care of pregnancy at risk, competency rating scale of using evidence-based medicine to practice.	8	Dr Apinya Bussarin Khianman	85	Nurses, midwives
27 Jul - 3 Aug	Neonatal Cardio Pulmonary Resuscitation [NCPR]	5	Dr. Skulrat Dr. Npaporn Dr. Paiboon Bussarin Khianman	85	Nurses, midwives, clinicians
11-12 Sep	Breastfeeding for personnel and community network in Kalasin Province	16	Bunpode Suwannachat Naputsorn Supipat	80	Physicians, nurses, breastfeeding mothers
Totals	Hours:	53.5	Participants:	565
National & Regional Workshops
16 Mar	Effective referral system in MCH care in upper Northeast Thailand	6	Pisake Lumbiganon Thitiporn Siriwachirachai Ussanee Swadpanich National Health Security Staff	75	Physicians, nurses, KKH staff National Heath Security Office Staff
18 Mar	Developing CPG: background, objectives, question formulation (PICO) and locating and selecting studies (web searching) [Yogyakarta: Indonesia]	7	Jadsada Thinkhamrop Detty Nurdiati	25	Physicians and nurses
14-15 Sep	Protocol development & RevMan	12	Pisake Lumbiganon Jadsada Thinkhamrop Malinee Laopaiboon Ussanee Swadpanich Bunpode Suwannachat	30	Physicians, nurses [various hospitals in Thailand and Department Medical Services, Ministry of Public Health] organised in Bangkok
Totals	Hours:	25	Participants:	130

Meetings
Meetings of SEA-ORCHID team members with local, regional or national leaders. The purpose of these meetings is varied and may include increasing awareness of the Project, promoting networking and increasing the potential to bring about practice change.
Date	Topic	Who
Khon Kaen University (Srinagarind) Hospital
23 Mar	Feedback on the project baseline data	O&G Head and Staff
10 Apr	Exclusive Breastfeeding in SE Asia	Dr. Jacky Knowles, UNICEF Consultant for Nutrition
Khon Kaen Hospital
23 May	Departmental meeting; identify the barriers for EBM changes in OB-Gyn and CPG implementation	Obstetricians, nurses
Kalasin Hospital
2, 3, 9, 10 Jul	The development in maternal and child health care meeting, CUP 1, Kalasin Province	Maternal and child health care committee, nurses

Additional activities
For example, regular departmental activities (e.g. journal club, case conferences, ward rounds, etc) that have been introduced or modified to include evidence-based practice, critical appraisal, etc. Please indicate the change that has taken place and who the change has affected.
Activity	Change	Who
Khon Kaen University (Srinagarind) Hospital
Produced and disseminated the educational posters at O&G Dept and the labour room	Changing practice: Routine episiotomy and evidence-based practice	Nurses, Phisicians, Medical Student, Residents
Video production of active management of third stage for WHO RHL CD		Users of the RHL
Produced educational brochures on common practices: corticosteroid dosage for high risk pregnancy of preterm delivery(pre-term labor, PPROM) antibiotic prophylaxis to prevent infectious morbidity during pregnancy and delivery amnionitis		Nurses, physicians, medical students, residents
Organised exhibition about PICO/Library & EBM	Searching, appraising and implementing evidence from the literature	Nurses, physicians, medical students, residents
Produced posters about evidence searching for improving the efficiency of evidence-based practice	Joined with the University activity via poster about EBM and PICO	KKU staff
Produced introduction to EBM and PICO brochures	Promotion to users about what is EBM and how to search for evidence	Nurses, physicians, medical students, residents
Produced obstetric evidence-based textbook in Thai	Promote access to evidence	SEA-ORCHID sites and affiliated hospitals and
Khon Kaen Hospital
Journal club (weekly)	Critical appraisal of RCT studies and systematic reviews: increase personal learning experiences on how to appraise papers develop more skills for reading journals use of CONSORT for RCT appraisal	Obstetricians, residents, medical students
Teaching of medical students (monthly)	Introduced EBP into medical teaching, incl. RHL & Cochrane systematic reviews: learn more about EBM increase competency to implement EBM into practices	Obstetricians, medical students
Perinatal conferences (1-2 monthly)	Introduce EBM with interesting topics	Obstetricians, Paediatricians, residents, medical students, nurses
Ward rounds & feedback system	Introduced EBP knowledge on common topics (e.g. preterm labour, PIH, PPH) to ward rounds Gave feedback to community hospitals in Khon Kaen province	Obstetricians, nurses
Kalasin Hospital
Weekly departmental meetings to follow up on the progress of CPG development	Regular follow up of CPG development (DM, preterm labour, PIH, caesarean section, breech presentation)	Each doctor in charge of writing a CPG
Introduction of EBP into the College of Nursing – curriculum development	Increase in the use of selective use of episiotomy	Bunpode Suwannachat with Head of School and other educators – nursing students
Introduction to EBP policy at Kalasin Hospital		Each time a new group of doctors starts at Kalasin Hospital
Mortality & morbidity conference	Care of preterm labour	Nurses, midwives
Weekly departmental meeting	Identifying barriers and gaps for improving evidence-based practice	O&G staff (physicians, nurses)
Weekly case conference	Peer review, identifying good evidence, developing guidelines, improving current practices	O&G staff (physicians, nurses)
Monthly departmental meeting	Monitoring and feedback of level of change in evidence-based care	O&G staff (physicians, nurses)

Conference Presentations
Local, national or international conferences at which SEA-ORHCID team members presented an aspect of the SEA-ORCHID Project either as conference speaker or poster presenter
Date	Conference title and location	Title of presentation/poster	Presenter
29 Apr	WHO RHL@10 Meeting Khon Kaen, Thailand	SEA-ORCHID project – capacity strengthening in SE Asia [plenary session]	Pisake Lambiganon Steve McDonald
29 Apr	WHO RHL@10 Meeting Khon Kaen, Thailand	SEA-ORCHID project experience - implementing best practice	Pisake Lumbiganon Steve McDonald Jadsada Thinkhamrop Bundpode Suwannacha Ussanee Swadpanich Ruth Martis Mario Festin Detty Nurdiati Jackie Ho Caroline Crowther
18 Oct	Annual Academic Conference, Faculty of Medicine, Khon Kaen University	SEA-ORCHID baseline data	Jadsada Thinkhamrop