Learning Objective #1: 1. The learning will become aware of the importance of clinical leadership in the aged care sector

Learning Objective #2: 2. The learner will become familiar with the use of clinical audit as an effective strategy in implementing best evidence into practice

---

The notion of 'best-practice' is now central to the planning and implementation of health-care systems internationally, and recent reforms in Australian aged care promote a 'best-practice' approach. It is acknowledged that the concept of best practice is poorly understood in the sector, with few examples of systematic, easy-to-use approaches to clinical practice improvement and best practice. Providing clinicians with the skills necessary to become leaders in their field is essential to improving client/resident outcomes. The Clinical Fellowship program was an initiative of the Joanna Briggs Institute and the Commonwealth of Australia's Department of Health & Aging. The program provided clinicians in the aged care sector the opportunity to participate in an evidence based implementation and evaluation project. In 2005, two intakes of four registered nurses were successful in generating national awareness of the role of clinical leadership and at building capacity within the existing aged care nursing workforce, where they developed project plans of relevance to clinical practice improvement and/or resident outcomes for their organisations. Each project drew on existing international research evidence to develop the standards against which practice was measured in the clinical audits. Fellows used the JBI PACES program to design their clinical practice improvement projects, including collection of baseline data, implementation of practice change, and evaluation of the effectiveness of change with a follow up audit. Where the audit outcomes from baseline were not compliant with best practice, the Fellows implemented an action research orientated process to examine the types of barriers to effective practice change, identify appropriate resources to resolve the barriers, and developing an action plan to overcome identified barriers. This presentation will overview the audit methods undertaken by a cohort of Clinical Fellows, and highlight commonalities and variances in the barriers to practice change, and strategies to overcome these barriers.