Infusing Information Literacy Skills By Researching 'Never Events' (NE )

1. Infusing Information Literacy Skills By Researching 'Never Events' (NE) Lin Wu, MLIS, AHIP, Health Sciences Library; Cynthia K. Russell, PhD, RN; Ramona Patterson, MSN, RN (Nursing PhD Student) University of Tennessee Health Science Center, Memphis TN Medical Library Association 2009 Annual Conference May 19, 2009

2. Never Events (NE) 28 Never Events (NQF) • Surgical • Product of device • Patient protection • Care management • Environmental • Criminal National Quality Forum (NQF). Serious Reportable Events in Healthcare 2006 Update. http://www.qualityforum.org/publications/reports/sre_2006.asp

3. Event Inclusion Criteria Concern to public & providers Identifiable, measurable, reportable Occurrence risk influenced by facility policy/ procedures Unambiguous Usually preventable Serious, and/or Adverse Indicates facility safety problem Important for public credibility/ accountability Term Definitions Event: discrete, auditable, clearly defined Adverse: negative care consequence, unintended Preventable: error/ system failure - anticipatable Serious: results- death, loss of body part, disability, bodily function, > 7days …. Unambiguous: clearly defined, easily identifiable Usually Preventable: not always avoidable given complexities of care NE Criteria and Definitions National Quality Forum (NQF). Serious Reportable Events in Healthcare 2006 Update. http://www.qualityforum.org/publications/reports/sre_2006.asp

4. Why Target NE? To improve attitudes, knowledge, and skills in: Information technology (IT) Information literacy (IL) Quality patient care Patient safety The LISTEN project is supported by funds from the Division of Nursing (DN), Bureau of Health Professions (BHPr), Health Resources and Services Administration (HRSA), Department of Health and Human Services (DHHS) under D11HP08392. http://www.listenuphealth.org

5. Information Literacy for Nurses@ 5 Levels • Supports attitudes, knowledge, & skills to: • Recognize you need information • Confidently seek information • Reliably access information • Critically evaluate information • Professionally apply information Nursing profession charged with provision of evidence-based practice for positive patient outcomes! LISTEN Project: http://www.listenuphealth.org

6. Informatics for Healthcare • Nursing informatics is more than technologies • Two credit course • 64 first-year nursing students • Ten weeks • Face-to-face & Online • Collaboration: nursing faculty member, nursing PhD student, & health sciences librarian

7. Strategies Motivating & Engaging • Web 2.0 tools • Social media • Students as content creators

8. Modules Avoiding HIPAA violations Writing in APA Style Never event project Avoiding plagiarism Cerner electronic record system

9. Assessments • Pre- and post-information literacy (InfoLit) surveys • Self report IT and IL competencies using 10 point scales • Ranking statements strongly agree to strongly disagree • Students’ comments • TurningPoint Clickers

10. NE Assignment Area #1: Background Assignment Details Area 1: Background • Definition • Description • NE causes • Groups & organizations focused on the NE -- specific URLs, identify reasons for their involvement • Evidence-based guidelines or other scholarly literature that focused on the never event • Description of what the never event is NOT

11. NE Assignment Area #2: Effects Assignment Details Area 2: Effects • Define from perspective of • Patients & families • Health care professionals • Health care institutions • Insurers • Summarize why the never event was placed on the list

12. NE Assignment Area #3: Arguments Assignment Details Area 3: Arguments & Supportive Strategies • Describe what has been written contrary to including this never event on the official list of never events. • Identify the role that IT and IL competencies have in decreasing or eliminating the never event. • Using scholarly literature • Using healthcare institution-based electronic systems • Using healthcare institution-based technologies (e.g., point of care technologies, devices)

13. Student Collaboration = Areas 1+2+3 • Students were placed in groups of 2-3 students. • Each student had an assigned area & wiki page. • Each group had an assigned NE topic. • Group NE wiki pages facilitated collaboration. • Group NE final project presentations challenged their creativity.

14. Challenges, Frustration, & Overwhelming • We don’t know… • how to search. • what search terms to use for NE. • Nobody has written anything on this • We are getting all this information… How many can we use? • There’s too much stuff published… Which ones do we reference? • Spending time on this isn’t going to help us learn nursing. • I’ve got a lot other things to do. • I often felt like I was on a wild goose chase.

15. Health Sciences Librarian’s Take • Mini-talks/lectures • One-on-one consultations • After class assistance • NE resource wiki

16. Searching for Information • Google • Google Scholar • Wikipedia • PubMed • CINAHL@EBSCOhost • Blogs • Listservs • Other people’s synthesis about the topic

17. Qualifying Information Time with librarian setting up & validating search strategies. Reviewed criteria & evaluated Web sites. Used Wikipedia appropriately. Talked with the faculty member. Learned about journal quality. Special search session with nursing PhD student.

18. InfoLit Survey Results:Skills for Conducting Health Research 0 (completely lacking) 10 (excellent)

19. InfoLit Survey Results:Judging Quality of Health Information 0 (completely lacking) 10 (excellent)

20. InfoLit Survey Results: Finding Quality Information 0 (completely lacking) 10 (excellent) Rate your assessment of your skills in finding high quality information on a specific health topic

21. I Enjoyed a Mini-Talk about using library resources at the beginning of each class

22. My literature searching skills have improved after researching & finding relevant information for my topic

23. Prior to class, I had used a Wiki N=63

24. Wiki was a useful technology in NE assignment

25. Using a wiki for class had a positive effect on my learning and engagement in the course

26. Having a faculty member/instructor/graduate teaching assistant review my assignment on the wiki before due date was helpful to me

27. The whole process of researching & finding relevant information made me feel more competent to search for quality information

28. If I were designing the course I would be sure to keep… • Library expert for teaching/help - a valuable resource (83%) • The information that is provided on how to search the Web and the • library’s resources (76%) • Library skills & information specific to the UTHSC Library (76%) • Guest speakers who came to talk on issues. They were helpful & provided relevant information that was useful for all courses. • Examples: Ms. Wu, Ms. Thorne, Clinical Laboratory Science Faculty and Staff (75%)

29. Compared to when I entered the program, I feel more prepared & can be more successful in…

30. What did students say about the librarian? • Mini-lectures was fantastic and extremely beneficial for our wiki assignments! • The librarian was very helpful for research. • Library staff and Mona Patterson were very helpful with the WIKI research.  • Involvement of librarian was very useful and effective in learning about necessary resources, I enjoyed it very much. • I think introducing a librarian to the course was helpful in giving the accurate impression that these professionals are accessible, helpful and happy to help.  • The librarian was absolutely wonderful.

31. What did students say about the Wiki? • The wiki was a good assignment but I wish we had more guidance about it at the beginning of the semester instead of so close to due date. • I do think working on a wiki page (with more lessons perhaps in formatting) is valuable because as future nurses/researchers we can communicate effectively and quickly with colleagues. • I am glad to have had this experience with using a wiki because I like learning how to do new things with technology, and you never know when a skill like this might be just what you need later on. • The almost instant feedback for the wiki was very helpful. • I would suggest requiring a minimum # of paragraphs or sources for the WIKI.

32. What did students say? Continued • I see the value of it (wiki) as a communication tool & for internal communication. • I like the concept of reading others students opinions & article findings, however, I don't think a wiki is necessarily the best way to go about doing it. • I was glad I got a chance to use the wiki. I had never even heard of a wiki page before this class. • My biggest frustration with the wiki site was fear that someone else was going to make an unintentional change to the information that I had listed on the site and I wouldn't catch it. • The wiki assignment was very helpful. It "forced" me to learn how to evaluate websites & articles effectively & it allowed me to learn valuable information about the medical field & medical errors.

33. Conclusions Researching NE helped improve students: • IT and IL attitudes, skills, and knowledge. • Library research skills. • Knowledge of using information the professional way. • IT and IL skills for life-long learning. Online collaboration using wiki: • Challenged Net Gen students out of their comfort zone. • Presented potential opportunities & skills useful for future nursing roles. • Provided opportunities for students to demonstrate creativity & innovation.

34. Future Directions Integration of LISTEN* Projectmodules & Brief Online Learning Tutorials into the course *Learning Information Seeking and Technology for Evidence-based Nursing

35. Questions? Lin Wu: lwu5@utmem.edu LISTEN team, Health Sciences Librarian Cindy Russell:crussell@utmem.edu LISTEN team, Project Director Ramona Patterson: rpatte16@utmem.edu LISTEN team, Clinical Staff Development Nurse Liaison Visit the LISTEN Web Site @ http://www.listenuphealth.org HRSA-funded Nursing Education, Practice, & Retention Program Grant