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Nursing Orientation 2014

Nursing Orientation 2014. Sandra A. Martin, M.L.I.S. Instructor of Library Services Health Sciences Resource Coordinator John Vaughan Library Room 305B marti004@nsuok.edu – 918-444-3263. Knowledge is the Enemy of Disease Sir Muir Gray. Existing Knowledge C an Prevent Waste & Errors

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Nursing Orientation 2014

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  1. Nursing Orientation 2014 Sandra A. Martin, M.L.I.S. Instructor of Library Services Health Sciences Resource Coordinator John Vaughan Library Room 305B marti004@nsuok.edu – 918-444-3263

  2. Knowledge is the Enemy of DiseaseSir Muir Gray • Existing Knowledge Can Prevent • Waste & Errors • Poor Patient Experience • Adoption of low value interventions • Failure to adopt high value interventions

  3. Sandra Martin Provides…. • Instruction • Research Assistance • Small Group Consulting • Database Searches • Collection Development (Selection of print and online books, audiovisuals, journals and databases) • Assistance with any health-related information need • Office Hours: Tuesday 10 am to 4 pm – Tahlequah

  4. From the NSU Libraries Home Page

  5. http://library.nsuok.edu/collegesh/healthpr/nursing/index.htmlhttp://library.nsuok.edu/collegesh/healthpr/nursing/index.html

  6. Remote Access • Enter NT-NSU user id and password to access the library’s electronic resources • Contact your instructor if you have problems with your user id or password • Contact Sandra to report other technical problems or for search assistance

  7. Interlibrary Loan/Document Delivery Services Delivery of journal articles, books, and other items not owned by the library Delivery of books, audiovisuals, and journal articles in the library’s print collection Journal articles delivered electronically if possible ILL Requests Click on Interlibrary Loan link from Nursing Web Page Complete and submit the online registration form Complete the online request form Provide complete information about the journal article or book that you need. Indicate your status as a “distance ed Nursing student” and provide your contact information If you have questions or need assistance, contact: Donna Graham – x3243 – grahamdg@nsuok.edu

  8. Learning Objectives • To provide a mechanism for nursing students to access the most current nursing and health care information • To familiarize nursing students with specific information resources and services to support the nursing curriculum • To familiarize nursing students with evidence-based nursing and lifelong learning skills

  9. Overview of Online Resources • Research and Clinical Databases • e-Journals • e-Books • Consumer Health • Evidence-Based Information Retrieval

  10. Journal Article Databases • CINAHL Plus w/Full Text, Nursing@Ovid, and Mosby’s Nursing Consult are most frequently used resources to find journal articles on nursing topics. • Search this section when you need articles on subjects, e.g., electronic medical record, nursing education, pressure ulcer, etc. • Databases in this section provide links to full text journal articles and other resources • You must start at the library’s Nursing web page to access our subscribed full text http://library.nsuok.edu/collegesh/healthpr/nursing/index.html

  11. Databases – Nursing@Ovid • Comprehensive, integrated Nursing and Allied Health portal with full text from 1950 to the current week • Content includes nursing practice, education, research, and administration • Based on the nursing and allied health subset of Ovid MEDLINE • Ovid Nursing Subject Thesaurusprovides search terms included in MeSH (medical subject headings) as well as those unique to nursing • Link to Tutorial from Nursing Library Page

  12. Databases - CINAHL Plus w/Full Text • CINAHL stands for Cumulative Index to Nursing and Allied Health Literature • Core research tool that contains full text of hundreds of nursing and allied health journals • Use “CINAHL Headings” to search topics for best results, e.g., search “mentorship” to find articles on “mentoring” • Follow links on Nursing Library Web Page for Basic and Advanced Tutorials to get started

  13. Databases – Mosby’s Nursing Consult • All in one resource provides full text of e-Journals, e-Books, drug monographs, and patient education handouts • Unique features include full text evidence-based nursing care sheets and pre-searches of popular health topics for nursing and allied health • Widely used in major hospitals and medical centers • Link to Tutorial from Nursing Library Page

  14. Databases - MEDLINE • Premier biomedical database from the National Library of Medicine • Provides journal articles from 1946 to present in medicine, nursing, health care system, and allied health care practice, education, and research • Link to Tutorial from Nursing Library Page

  15. Databases – Science Direct • Scientific database produced by Elsevier • Provides journal articles from over 2,500 journals and chapters from almost 20,000 books in all life sciences disciplines • Contains full text of nursing journals not found in Ovid or CINAHL Plus w/Full Text

  16. Additional Research Databases • Health and Psychosocial Instruments – assists researchers in identifying tests, questionnaires, rating scales in health and psychosocial sciences. Does not include full text of the instruments • National Library of Medicine – provides access to hundreds of databases covering a wide range of biomedical information resources • Native Health Databases – contains citations and abstracts of documents pertaining to the health care of North American indigenous peoples

  17. Tracking Down the Full Text • If your database search does not provide a link to full text of a relevant article: • Print a list of the citations • Click on the Library e-Journals link on the Library’s Nursing web page • Enter full title of the journal • Click on link to database that contains the full text

  18. e-Books • R2 Digital Library – Nursing and allied health books from Doody’s Core Titles in the Health Sciences • Books@Ovid - full text of nursing and health sciences books published by Lippincott Williams & Wilkins, American Nurses Association, Joanna Briggs Institute, Jones-Bartlett, and Springer Publishing • Mosby’s Nursing Consult – full text of nursing books and handbooks published by Elsevier • Access Medicine - text of leading medical and health sciences books from McGraw-Hill • Mosby’s and Access Medicine contain full text monographs for the health care professional and the patient of all FDA approved drugs

  19. Consumer Health Resources • Current, authoritative, peer-reviewed, and evidence-based resources written specifically for the layperson • MEDLINEPlus – the National Institutes of Health’s web site for patients and families • Joanna Briggs Database - provides full text consumer information sheets • Mosby’s Nursing Consult - includes patient education handouts produced by Elsevier • Access Medicine – contains patient education materials for adults and children and includes handouts for drugs and medicines

  20. Match Resource to Information Need • What is the question? • How will information be used?

  21. Background vs. Foreground Questions • Asking questions about your proposed topic helps to clarify your knowledge gap • Clarifying type of question helps to determine which sources are most likely to have the answers you need

  22. Background Questions • Generally ask who, what, why, where or how about a single concept

  23. Proposed Research Projects • Evaluate the effectiveness of nursing residency programs • Use of mentoring in nursing education to improve retention of nursing faculty

  24. Background Questions • What are methods of evaluating nursing residency programs? • How do mentoring relationships clarify roles experienced by novice nursing faculty?

  25. Answers to Background Questions • Require general knowledge of conceptsand processes • Resources: • Nursing@Ovid • CINAHL Plus w/Full Text • e-Book Collections • Print Books

  26. Information Retrieval to conduct Research • Comprehensive in scope and time • All levels of resources • Current and Retrospective • Background and Foreground Information

  27. Foreground Questions • Usually compare two or more concepts – theories, drugs, treatments, tests, harms or benefits of two approaches

  28. Answers to Foreground Questions • Require precise information about complex issues • Sources should provide current, original clinical research data • Evidence-based resources – begin search at the top levels of the 4S Hierarchy

  29. Evidence Based Databases – Critically Appraised Decision Support Tools • DynaMed – Expert summaries for over 3,000 topics to answer clinical questions at point of care. Based on studies evaluated for clinical relevance and validity. Updated daily • Cochrane Systematic Reviews – Over 900 full text reviews of research studies based on specific quality criteria and produced by the Cochrane Collaboration, an international network of researchers • Joanna Briggs Institute – International research organization provides full text of expert summaries, best practice information sheets, systematic reviews, and consumer information sheets

  30. Information Retrieval for Evidence Based Nursing Care • Using research findings versus conducting research • Retrieving and evaluating information that has direct application to specific patient care problems • Selecting resources that are current, valid and available at point-of-care • Developing search strategies that are feasible within time constraints of clinical practice

  31. Hierarchy of Evidence-Based Resources Evidence Based Summaries: Dynamed, Joanna Briggs Joanna Briggs, Mosby’s Nursing Consult Cochrane and Joanna Briggs Systematic Reviews Nursing@Ovid, CINAHL Plus with Full Text, MEDLINE SOURCE: Haynes, R. B. (2001). Of studies, syntheses, synopses, and systems: the “4S” evolution of services for finding current best evidence. Evidence-Based Medicine, 6 (2), 36-38. Retrieved 2-07-07 from http://ebm.bmj.com/cgi/reprint/6/2/36

  32. Critically Appraised Content

  33. Appraisal Required by User

  34. “Evidence-based medicine is the integration of best research evidence with clinical expertise and patient values” Sackett DL, Rosenberg WMC, Gray JAM, Haynes RB, Richardson WS: Evidence based medicine: what it is and what it isn’t. BMJ 1996;312:71-2. Patient Concerns Best research evidence Clinical Expertise EBM What is EBM?

  35. EBM Process – 5 Steps • ASSESS - Begin with the patient encounter • ASK - clinical questions that address important patient problems • ACQUIRE - the best evidence to answer the questions (Use 4S Approach) • APPRAISE - Evaluate the evidence for validity, importance, and usefulness • APPLY - Does the evidence “fit” your patient’s specific problems and needs? Practice the EBM process in daily patient encounters

  36. Integration of Clinical Research into Patient Care Process

  37. Information Retrieval to Answer Clinical Questions Requires New Skills • Clinical question formulation • Search and retrieval of best evidence • Critical appraisal of study methods

  38. Clinical Questions • Four common types: • Therapy/prevention • Diagnosis • Etiology • Prognosis

  39. Answerable Questions • Select Questions That: • Are most important to the patient’s well being • Fill gaps in your clinical knowledge • Are feasible to answer in the time available

  40. Is All Evidence Created Equal? • Small portion of medical literature is immediately useful to answer clinical questions • Understanding “wedge or pyramid of evidence” is helpful in finding highest level of evidence • High levels of evidence may not exist for all questions due to nature of medical problems and research limitations

  41. As you move up the pyramid the amount of available literature decreases, but it increases in its relevance to the clinical setting. Source:  Sackett, D.L., Richardson, W.S., Rosenberg, W.M.C., & Haynes, R.B. (1996). Evidence-Based Medicine: How to practice and teach EBM. London: Churchill-Livingstone.

  42. Evidence Based Retrieval • Find the answer that is supported by valid studies appropriate to the type of question and that is available in a timely manner • Requires search terms plus best study design for question plus highest level of evidence

  43. Therapy/Prevention Question • Are drug regimens effective in managing or preventing chemotherapy-induced nausea or vomiting in cancer patients? • Are foam overlays versus standard hospital foam mattresses effective in preventing pressure ulcers? • Find the answer that is supported by valid studies, appropriate to the type of question, and that is available in a timely manner.

  44. 1. Possible Search Terms • Chemotherapy, nausea, vomiting • Pressure ulcer, foam, overlay, mattress

  45. 2. Best Study Design for Type of Question

  46. 3. Begin Search at Top Level of Evidence

  47. Dynamed • Summaries for more than 3,000 topics • Monitors >500 medical journals and systematic review databases • Updated daily • Each article evaluated for clinical relevance and scientific validity • Recommendations labeled with Levels of Evidence

  48. Joanna Briggs Institute (JBI) • an international, not-for-profit research organization at the University of Adelaide • collaborates internationally with over 70 entities to promote synthesis and transfer of evidence • contributes to improving health care outcomes by supporting evidence-based practice

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