Nursing Orientation 2014 Sandra A. Martin, M.L.I.S. Instructor
of Library Services Health Sciences Resource Coordinator John
Vaughan Library Room 305B [email protected]@nsuok.edu
918-444-3263 1
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Knowledge is the Enemy of Disease Sir Muir Gray Existing
Knowledge Can Prevent Waste & Errors Poor Patient Experience
Adoption of low value interventions Failure to adopt high value
interventions 2
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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 3
Remote Access Enter NT-NSU user id and password to access the
librarys 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 8
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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
librarys 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 [email protected]@nsuok.edu
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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 10
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Overview of Online Resources Research and Clinical Databases
e-Journals e-Books Consumer Health Evidence-Based Information
Retrieval 11
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Journal Article Databases CINAHL Plus w/Full Text,
Nursing@Ovid, and Mosbys 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 librarys Nursing web page to
access our subscribed full text
http://library.nsuok.edu/collegesh/healthpr/nursing/index.html
http://library.nsuok.edu/collegesh/healthpr/nursing/index.html
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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 Thesaurus provides search terms
included in MeSH (medical subject headings) as well as those unique
to nursing Link to Tutorial from Nursing Library Page 13
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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 14
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Databases Mosbys 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 15
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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 16
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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 17
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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 18
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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 Librarys
Nursing web page Enter full title of the journal Click on link to
database that contains the full text 19
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e-Books R2 Digital Library Nursing and allied health books from
Doodys 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 Mosbys 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 Mosbys and Access Medicine contain
full text monographs for the health care professional and the
patient of all FDA approved drugs 20
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Consumer Health Resources Current, authoritative,
peer-reviewed, and evidence- based resources written specifically
for the layperson MEDLINEPlus the National Institutes of Healths
web site for patients and families Joanna Briggs Database -
provides full text consumer information sheets Mosbys 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 21
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Match Resource to Information Need What is the question? How
will information be used? 22
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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 23
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Background Questions Generally ask who, what, why, where or how
about a single concept 24
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Proposed Research Projects Evaluate the effectiveness of
nursing residency programs Use of mentoring in nursing education to
improve retention of nursing faculty 25
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Background Questions What are methods of evaluating nursing
residency programs? How do mentoring relationships clarify roles
experienced by novice nursing faculty? 26
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Answers to Background Questions Require general knowledge of
concepts and processes Resources: Nursing@Ovid CINAHL Plus w/Full
Text e-Book Collections Print Books 27
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Information Retrieval to conduct Research Comprehensive in
scope and time All levels of resources Current and Retrospective
Background and Foreground Information 28
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Foreground Questions Usually compare two or more concepts
theories, drugs, treatments, tests, harms or benefits of two
approaches 29
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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 30
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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 31
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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
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Hierarchy of Evidence-Based Resources Evidence Based Summaries:
Dynamed, Joanna Briggs Joanna Briggs, Mosbys 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
http://ebm.bmj.com/cgi/reprint/6/2/36
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Critically Appraised Content
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Appraisal Required by User
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www.cebm.net 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 isnt. BMJ
1996;312:71-2. Patient Concerns Clinical Expertise Best research
evidence EBM What is EBM?
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EBM Process 5 Steps 1. ASSESS - Begin with the patient
encounter 2. ASK - clinical questions that address important
patient problems 3. ACQUIRE - the best evidence to answer the
questions (Use 4S Approach) 4. APPRAISE - Evaluate the evidence for
validity, importance, and usefulness 5. APPLY - Does the evidence
fit your patients specific problems and needs? Practice the EBM
process in daily patient encounters
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Integration of Clinical Research into Patient Care Process
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Information Retrieval to Answer Clinical Questions Requires New
Skills Clinical question formulation Search and retrieval of best
evidence Critical appraisal of study methods
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Clinical Questions Four common types: Therapy/prevention
Diagnosis Etiology Prognosis
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Answerable Questions Select Questions That: Are most important
to the patients well being Fill gaps in your clinical knowledge Are
feasible to answer in the time available
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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
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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.
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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
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Therapy/Prevention Question 1. Are drug regimens effective in
managing or preventing chemotherapy-induced nausea or vomiting in
cancer patients? 2. Are foam overlays versus standard hospital foam
mattresses effective in preventing pressure ulcers? 3. Find the
answer that is supported by valid studies, appropriate to the type
of question, and that is available in a timely manner.
2. Best Study Design for Type of Question Type of QuestionStudy
Design Therapy/preventionRandomized controlled trials
DiagnosisProspective cohort, blind comparison to a gold standard
PrognosisCohort, Case Control, Case Series Etiology/HarmCohort,
Case Control, Case Series
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3. Begin Search at Top Level of Evidence
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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 49
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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 50
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JBI Database Evidence Summaries literature reviews that
summarize existing literature on common health care problems
Evidence-Based Recommended Practices procedures that recommend
practice on clinical topics Best Practice Information Sheets
guidelines produced for practicing health care professionals
Systematic Reviews comprehensive reviews of international research
literature Consumer Information Sheets summaries designed for
patients, clients, and care providers Updated weekly 51
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Mosbys Evidence Based Monographs concise reviews of current
evidence specific recommendations for nursing care include levels
of evidence useful for evidence-based care plans teach staff links
between evidence and practice 52
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Cochrane Database of Systematic Reviews Part of the Cochrane
Library (1996) 916 completed reviews, 1905 protocols Among the
highest level of evidence upon which to base treatment decisions
the Gold Standard Includes Dx since 2008 Access through OVID
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Systematic Review Analyzes data from several primary studies to
answer a specific clinical question Provides search strategies and
resources used to locate studies Includes specific inclusion and
exclusion criteria (results in less bias) Meta-Analysis (subclass)
statistically summarizes results of several individual studies
Access Joanna Briggs and Cochrane Systematic Reviews through Ovid
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Life-Long Learning Selecting and searching online databases is
challenging Information is ever changing Contact Sandra (email
preferred) 55
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Nursing Orientation 2014 Sandra A. Martin, M.L.I.S. Instructor
of Library Services Health Sciences Resource Coordinator John
Vaughan Library Room 305B [email protected]@nsuok.edu
918-444-3263 57
