Kristen L. Young, MLIS, AHIP Georgia Health Sciences University Tuesday October 2, 2012

“Principles of nursing evidence- based information seeking: collaborating and teaching with students, graduate researchers, and faculty”

Nursing Information Specialist Partnerships Program development Open communication Collaboration Identifying and exceeding needs Awareness of services Consultations amd committees Instruction and research education

Know your Institution/Faculty Reference Interview Teach back Method Teachable Moment Office Hours Meetings Lunch and Learns Enhancing Quality Through Information Literacy Orientations Marketing Committee Physical Presence in the Department

Meet demands Traits: organization, foresight, follow up, initiative SWOT analysis of populations/programs served Always be thinking Information literacy Evidence based practice What can I offer that is new, more effective, or exhaustive? Though what medium and how? Evaluation Education

Populations – challenges Pervious experiences Information seeking behaviors Difficulty level Time allotted Starting points

Challenges within information literacy Where do you go to search for information? Database selection What type of information is this? How do I cite this source? When do I have enough information? Understanding database structure and terminology keywords vs. subject headings Boolean operators Comfort level – using the databases

What is the point? “Developing information literacy skills involves being aware of the nursing literature and acquiring the skills to locate and retrieve it. Studies have shown that positive changes in a nurse’s information literacy skills, and confidence in those skills have a direct impact on nurses’ appreciation and application of research. These skills are vital for effective lifelong learning and are a prerequisite to evidence based practice” – Johns Hopkins Nursing evidence-based practice model and guidelines

Information seeking process LibGuide/Information Specialist Ask a specific clinical question Create a search strategy Selecting search terms Boolean operators Levels of evidence Where? Documenting Evaluate the evidence

LibGuide/Information Specialist

Question or problem statement “It is flu season. A teacher stops you in the hall to ask you a question about his 10-year-old daughter, who has a cold. He has heard that Zinc lozenges can help to relieve cold symptoms and is wondering if they really do work and whether it is ok to give them to children.”

Classification of questions

PICO P Patient How would I describe patients like mine? Children with colds I Intervention What intervention or treatment` am I considering? Zinc lozenges C Comparison What is the main alternative to compare to the intervention? Other treatment/no treatment O Outcome What is the desired outcome? Relief of symptoms

Creating a search strategy List main topics and alternate terms from PICO Initial: Zinc, child, cold Related: lozenges, zinc acetate, zinc gluconate Common cold, rhinovirus, children, youth Inclusion criteria Gender, age, year of publication, language

Selecting your search terms Wound Care xxxxxx xxxxxxx wound xxxxxxxxxxxxxxxxxxxxxxxxxxx xxx care xx xxxxx xxxxxxxxxxxxxxxxx xxx xxxxxx wound xxxxxxxxxx xxxxxxxxxxx xxxxxxxxxxx xx wound care xxxxxxxx xxxxxxxxxxxxxxxxxxxxxxxxxx care for wounds xxx xxx xxxxxxxxxxxxxx xxxx xxxxxxx serious burn xx xxxx injuries xxx xxxxxxx xxxxxx xxx xxx dressings xx open sores xxxxxx xxx xxx bandaging xxxxxxx x xxxxxxxx xxxxxx xxx xxx x treatment of wounds x MeSH:Wound Healing Wounds and Injuries Honey Keyword = MY words, wherever they appear Subject = DATABASE’s words, must have tag Subject = consistent; covers many variations

Selecting your terms Wound* Wound Wounds Wounded Wounding

Connector Words Connect words with AND… Connect words with OR… …to find articles that include both words …to find articles that include either or both of the words Back PainAcupuncture acupuncture AND back pain Hypertension OR high blood pressure HypertensionHigh blood pressure

Levels of Evidence Level 1 - Systematic review & meta-analysis of randomized controlled trials; clinical guidelines based on systematic reviews or meta-analyses Level 2 – Single randomized controlled trials Level 3 - Controlled trial (no randomization) Level 4 - Case-control or cohort study Level 5 - Systematic review of descriptive & qualitative studies Level 6 - Single descriptive or qualitative study Level 7 – Opinions of authorities and/or reports of expert committees Source: Melnyk, B.M. & Fineout-Overholt, E. (2011). Evidence-Based Practice in Nursing and Healthcare: A Guide to Best Practice (2 nd Ed.). Philadelphia: Lippincott, Williams & Wilkins.

Levels of evidence

Library Research Databases CINAHL Cumulative Index to Nursing and Allied Health Includes journal articles and many other types of publications about nursing and allied health Contains subject headings specific to nursing Covers literature from 1982-present Medline The largest database available for searching in medicine, nursing and other health fields. Uses Medical Subject Headings (MeSH). Covers literature present. EBM Reviews Important resource for finding systematic reviews Contains four databases, including the Cochran Systematic Reviews Searches by keyword, not subject heading Includes the full text of reviews

Documenting the search Where and when did you search? What terms did you use? How many articles did you locate? Of those articles, how many did you look through and find relevant?

Evaluate Quality of each study Could draw conclusions about overall body of evidence Gaps in the evidence Critiques usually focus on methodologic aspects Did it reflect truth? Biases and flaws undermine? Identification of important themes

Information Management Saving search strategies and results Auto alerts RSS Feeds Evaluating web resources

Texts Newhouse, R. P. (2007). Johns Hopkins nursing evidence-based practice model and guidelines. Indianapolis: Sigma Theta Tau International Honor Society of Nursing. Polit, D. F., & Beck, C. T. (2010). Essentials of nursing research: Appraising evidence for nursing practice. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. Nordenstrom, Jorgen. (2008). Evidence-Based Medicine In Sherlock Holmes' Footsteps. Blackwell Pub. Straus, S. E. (2005). Evidence-based medicine: How to practice and teach EBM. Edinburgh: Elsevier/Churchill Livingstone.