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Getting Research into PracticeThe CARI Guideline Implementation projects are researching the best evidence-based methods of the implementation of evidence into action for patients at all stages of chronic kidney disease. Implementation of the Iron Guideline (Phase 1): Commenced 2004An audit of iron management processes was completed for 6 units from around Australia. The units were: Monash Medical Centre (Melbourne), Royal Melbourne Hospital (Melbourne), Western Sydney Area Health Service (Sydney), Central Coast Area Health Service (Sydney), Central Sydney Area Health Service (Sydney), and Canberra Hospital (Canberra). Data was also retrieved from ANZDATA on each unit's iron and haemoglobin levels. Iron levels varied quite markedly between the units and so did iron management practices. Links were made between high percentage in target iron range and positive iron management practices. One major finding indicated that nurse-managed iron protocols resulted in high levels of patients in target iron range. Barriers to improved iron levels have been documented for the units and these results have been released to the units and the resultant impact of this discussed with key stakeholders. A manuscript regarding the first stage of this project has been submitted for publication. Iron Management (Phase 2)We are now working with the 6 units and encouraging, following and documenting the change process in each unit as they act on the results of the audit for their unit. This phase of the project will enable CARI to map out further implementation strategies for other Guidelines. Systematic Review of Implementation of Evidence in Chronic Kidney DiseaseWe are currently underway with a systematic review of the implementation of evidence in the renal field. We will be looking at any project that gives details of the implementation methods used and provides before and after results. We will not limit the review to randomised controlled trials. We hope that this review will give us some insight as to the best methods of implementation in the renal field and how to move implementation of evidence in chronic kidney disease forward in Australia. 3jonathanc">Jonathan CraigStaff |