Continuing Education 101: Evidence-Based Nursing

1. Presented by: Sharon Kambeitz, MLIS, AHIP Coordinator, Library Outreach Program Continuing Education 101:Evidence-Based Nursing Next

2. 1. To understand the concept of Evidence-Based Nursing. 2. To become familiar with two evidence-based databases of information that apply to your nursing practice at your institution. 3. To have a basic understanding of how to search MEDLINE and limit to evidence-based publication types. Objectives Next

3. This module is the first in a series of continuing education modules for which you will receive Allina CE credit as part of your affiliation with the Allina Library Outreach Program. To begin you will need approval from the library liaison at your hospital. Next send an email to me confirming that you are taking the web-based CE by permission. Contact information sharon.kambeitz@allina.com; or phone (612) 863-9060. Next you will have a one month period of time from the date you received the link to the module from your manager, in which this can be completed for CE. Upon completion of the learning module you must complete the post test and evaluation return it to Allina Library Outreach program coordinator. A CEU Certificate will be mailed to your manager upon completion. He or she will present it to you. You will receive 1 Contact Hour for completing this course. Introduction Next

4. This module is merely a demonstration • Simply go through the module by advancing the slides. • At several stopping points you can take time to practice during the module, or if you choose, practice on your own a later time. • If you have your browser open, toggle between the module (use the hypertext links provided) and the slides, to go directly to the database in the demonstration. After you’ve practiced, toggle back to the module, then advance to the next slide to continue from where you left off. Next

5. Registered Nurses’ Association of Ontario (RNAO). Locate the Library Outreach web page: Note the electronic links for Nursing. Definition of Evidence-Based Nursing. Virginia Henderson International Nursing Library (VHINL) National Library of Medicine’s PubMed/Medline. Summary of Contents Conclusion, Post-Test, Evaluation. Topic 1 Topic 2 Topic 3 Topic 4 Topic 5 Topic 6 Next

6. Explore for yourself You can read through the slides to understand the content, or you can click on the hypertext links provided and participate as you follow through the module. Next

7. Topic 1 Locating the Library Outreach page Locating the Library Outreach page http://www.allina.com/ahs/libmedia.nsf/ http://www.allina.com/ahs/libmedia.nsf/ [press the control key and then press the right mouse to open this link. On the menu click on Open Hyperlink ] Next

8. Go to the Allina Library web page. The URL ishttp://www.allina.com/ahs/libmedia.nsf/ Next double click on Library Outreach Services. Next

9. This screen-shot shows a section of the Outreach page. Click the Nextarrow for additional views N.B. From this page you can use the request forms for article or literature search requests. Or, an even easier way is to email us at library.services@allina.com or phone, (612) 863-4312. Next

10. Scroll down to view the Nursing section Next

11. Then scroll down a bit more to view the entire Nursing section on the Outreach web page Next

12. Topic 2Definitions of Evidence-Based NursingNow that you are oriented tothe Nursing section of the Library Outreach Page let’s move forward. Next

13. Definition of EBN: • “In essence, evidence-based nursing is a discipline in which nurses make clinical decisions using current ‘best’ research evidence, which is then blended with approved policies and clinical guidelines, clinical expertise and judgment, and patient preferences.” (Ciliska, Pinelli, DiCenso, & Cullum, 2001; Erickson-Owens & Kennedy, 2001; Ervin, 2002; Rycroft-Malone et al., 2004.) • “Evidence-based nursing practice recognizes the importance of intuition and sound judgment (Ervin, 2002), but also incorporates the components of current research evidence on which clinical practice guidelines are based.” (Rycroft-Malone et al., 2004) Next

14. An evidence-based nursing site The following slide explores the first EBN site we will study in this module. The database is freely available to you. It is of interest, too, for its emphasis on community nursing. Let’s begin! Next

15. Topic 3 Introduction to the Registered Nurses’ Association of Ontario (RNAO) web site http://www.rnao.org [press the control key and then press the right mouse to open this link. On the menu click on Open Hyperlink] Next

16. Double click on RNAO link in the nursing sectionof the Outreach web page First double click on the RNAO link. Next

17. Home page: Registered Nurses’ Association of Ontariohttp://www.rnao.org[press the control key and then press the right mouse to open this link. On the menu click on Open Hyperlink] Next

18. Register first: Access courses Create your own account. Next

19. Create account here After you’ve logged in select an e-learning course. The pointer shows a link to a free CE course. Next

20. Look for the tab Nursing Best Practice Guidelines 1. Click this tab to open Nursing Best Practice Guidelines. 2. Next, click on this link. Go to next slide to read an overview of Clinical Practice Guidelines Program. Next

21. Overview/Description of guidelines Read the Clinical PracticeGuideline Overview and description. Next

22. Go to the Links & Resources link From the previous slide scroll down to Links & Resources. Then, open the link.

23. More guidelines and fact sheets Click the Breastfeeding best practice link. This is a partial list of the Best Practice Guidelines. See next slide. Next

24. While everything is not free, related links freely display similar content. Some content is not free, but look, here is a freely accessible document on breastfeeding that we referred to in the previous slide. Next

25. Click on Guidelines and Fact Sheets, then click the Next arrow. You can view the guidelines listed at the following slide. Next

26. View the list of RNAO Best PracticeGuidelines of the College of Nurses Ontario (CNO) Documents As an example, double click on Infection Prevention and Control. Next

27. Access to Links & Resources from the Best Practice tab Or you can go Directly to the Hand Hygiene Panel Report. Next

28. Cover page of the Hand Hygiene report referred to in the previous slide Next

29. Here you can see page 3 (free full text) of 16 pagesof the Infection ControlPracticeStandard Next

30. From the Nursing Best Practice Guidelines Click on Guidelines and Fact Sheets to look deeper.

31. You have several options Look closer for Health Education Fact Sheets open this link to view the education sheets.

32. Under the tab Nursing Best Practice Guidelinesview the Health Education Fact Sheets Open this link to view The Deciding to Quite Smoking education fact sheet. See next slide for the fact sheet. Next

33. View of the health education link Deciding to Quit Smoking from the previous slide Next

34. Lastly, more books, monographs, and guidelines Next

35. Topic 4 The Virginia Henderson International Nursing Library (VHINL) http://www.nursinglibrary.org/portal/main.aspx [press the control key and then press the right mouse to open this link. On the menu click on Open Hyperlink] Next

36. A content placeholder. Use for text, graphics, tables and graphs. You can change this text or delete it. Next, from the Nursing page, choose the Virginia Henderson site Again, from the Nursing section of the Outreach page double click on The Virginia Henderson site. Next

37. A content placeholder. Use for text, graphics, tables and graphs. You can change this text or delete it. Virginia Henderson International Nursing Library. This is the VHINL home page. Free registration. Go to Sign In. Next

38. Instructions How to use this web site. Directions on how to search the database. Next

39. A content placeholder. Use for text, graphics, tables and graphs. You can change this text or delete it. Too many irrelevant titles. 623 results are too unwieldy. Let’s refine it down to something more manageable. The search topic is patient safety. Opportunity to refine search here. Patient safety At this point I recommend you practice on your own or come back to it later to practice. Next

40. Refine your search by doing an advanced search. Limited even more to Conference Abstracts. I chose to limit to ANCC Magnet Practice Innovations from the drop down menu. Advanced page is for refining a topic. Next

41. By limiting, 3 search results were retrieved, a relevant and pertinent set Three citations display your limited results. Next

42. View the Find Resources tab for additional EBN links. Use the “Find Resources” tab on VHINL, another way to find EBN information. The tab scrolls down to other categories. But here the focus is on the EBN section where other EBN sites are also offered. Next

43. The scientific medical literature where we can find more scientific technical Evidence-Based Medicine (EBM). Set your browser to http://www.pubmed.gov After looking at the nursing literature, let’s move on tothe medical literature (PubMed/Medline) [Press the control key and then press the right mouse to open this link. On the menu click on Open Hyperlink] Next

44. Topic 6 PubMed/Medline PubMed/Medline is the gold-standard database of medical literature. Let’s begin exploring the home page http://www.pubmed.gov Next

45. Some interesting facts about PubMed. PubMed comprises over 20 million citations for the biomedical literature from MEDLINE, life science journals, and online books. The citations cover the fields of medicine, nursing, dentistry, veterinary medicine, and the health care system. PubMed is a free resource developed and maintained by the National Center for Biotechnology (NCBI) at the U.S. National Library of Medicine (NLM) which is located at the National Institutes of Health (NIH). Time coverage: generally 1946 to the present, with some older material. Source: Currently, citations from approximately 5,516 worldwide journals in 39 languages; 60 languages for older journals. Updates: Since 2005, between 2,000-4,000 completed references are added each day Tuesday through Saturday; nearly 700,000 total added in 2010. Next

46. Nursing journals indexed in PubMed Of the nearly 5,000 journals indexed in PubMed (Index Medicus): 618 additional, non-Index Medicus journals in the following allied health areas are:90 Dentistry  22 AIDS/HIV   18 Consumer Health   188 Nursing 109 Health care administration and delivery   86 Health care technology   105 History of medicine core journals Next

47. PubMed/Medline is sponsored by the National Library of Medicine (NLM) and the National Institutes of Health (NIH) Notice some of the interesting features. Next

48. PubMed/Medline is sponsored by the National Library of Medicine (NLM) and the National Institutes of Health (NIH) Start by clicking on the PubMed/Medline link. Next

49. Tutorials are great for learning the fine points of searching Tutorials Next

50. Considerations prior to your search: • What is the question I am asking? • What population does this encompass? Newborn or adult? • What are the concepts involved in the topic? • What is the focus: diagnosis, treatment, therapy, surgery or other? • Will the answer to my question change how I practice medicine/nursing? • Who is the audience? Next