Chapter 9: Information Literacy - A Road to Evidence Based Practice

7 Steps to the Perfect PICO Search

1. Formulate the PICO Question 2. Identify Keywords for each PICO Element 3. Plan the Search Strategy 4. Execute the Search 5. Refine the Results 6. Review the Literature 7. Assess the Evidence

How do you evaluate website health information on the internet?

1. Source 2. Authority 3. Funding 4. Validity and quality 5. Privacy and disclosure

What is the PICOT method used for?

A standard used today to investigate evidence-based care in medicine and nursing;

ACRL Framework for Information Literacy for Higher Education Framework: Frame 1:

Authority is constructed & contextual

What is Evidence-based practice (EBP)?

Clinical decision making that integrates the best available research with clinical expertise and patient values. A cyclical process of moving knowledge from original research into patient care.

Best Research Evidence

Clinically relevant research; includes outcomes + effectiveness of pt care

What is the John Hopkins Nursing Evidence-Based Practice Model?

Consists of 9 tools and uses a 3-step process named PET: Practice Evidence Translation

Clinical Reasoning

Decision making that uses critical thinking skills and considers all factors influencing patient preferences by nurse care provider; the nurse uses clinical reasoning to determine pertinent factors to assist the patient to maintain or attain health.

What is the Stevens Star Model of Knowledge Transformation?

Depicts EBP as a cyclical process of moving knowledge from original research into patient care.

ACRL Framework for Information Literacy for Higher Education Framework: Frame 2:

Info creation as a pocess

Evidenced-based nursing

Nursing care based on scientifically proven nursing research. Integration of the best evidence available with nursing expertise and the values/preferences of the client to increase the quality of care.

What does PICOT stand for?

P: Patient/Problem/Population (age ethnicity, or gender, type of clinical problem) I: Intervention (the types of clinical intervention) C: Comparison (comparison of interventions) O: Outcome (type of pt. care outcome) T: (not required) Time TT: (not required) Type of study and type of question S: (not required) Setting

ACRL Framework for Information Literacy for Higher Education Framework: Frame 4:

Research as inquiry

Information Literacy Competency Standards for Nursing Standard Five

■ Reassess the kind & amount of info needed. ■ Demonstrating awareness of the socioeconomic, ethical, & legal issues for access of the info.

Peer reviewed Articles

A journal article that was blind reviewed by two or more nurse experts to assure the validity, quality, and reliability of information.

Patient values

According to the Institute of Medicine, "refers to the unique preferences, concerns, and expectations, that each patient brings to a clinical encounter" that are used when making clinical decisions.

Government & Not-for-Profit Health & Disease Specialty Organizations The National Institutes of Health (NIH)

Conducts research and provides links to 28 different specialty institutes and centers providing info to the latest research, clinical trials, & grants to promote health

Knowledge Dissemination Definition

Dissemination is the interactive process of communicating knowledge to target audiences so that it may be used to lead to change. ... This means ensuring physical availability of the product to as large a proportion of the target audience as possible and making the product comprehensible to those who receive it.

ACRL Framework for Information Literacy for Higher Education Framework: Frame 3:

Info has value

Nursing Knowledge Definition

Information known to nursing practice, which defines the profession

Online Journals Online Journal of Nursing Informatics

Powered by the HIMSS Foundation and the HIMSS Nursing Informatics Community, the Online Journal of Nursing Informatics is a free, international, peer-reviewed publication that is published three times a year and supports all functional areas of nursing informatics

Government & Not-for-Profit Health & Disease Specialty Organizations Centers for Medicare and Medicaid Services (CMS)

Provides access to manuals, Medicare coverage database, CMS forms, communication of policy changes, & Medicare Learning network resources.

Government & Not-for-Profit Health & Disease Specialty Organizations The Agency for Healthcare Research and Quality

Provides info on EBP, grants, research, & quality and patient safety issues

Government & Not-for-Profit Health & Disease Specialty Organizations Centers for Disease Control and Prevention (CDC)

Provides statistical data and information about diseases & online disease control/prevention journals

Translational Research

Research that uses knowledge derived from basic research to develop and test solutions to real-world problems.

ACRL Framework for Information Literacy for Higher Education Framework: Frame 5:

Scholarship as conversation

ACRL Framework for Information Literacy for Higher Education Framework: Frame 6:

Searching as strategic exploration

What is Clinical Expertise?

The ability to use clinical skills and past experience to rapidly identify each patient's unique health state and diagnosis, individual risks and benefits of potential interventions, and personal values and expectations

What is information technology skills?

The ability to use computers, computer software, and peripherals to access electronic information efficiently.

Government & Not-for-Profit Health & Disease Specialty Organizations CDC Wonder

Wide-ranging Searchable Online Database w/ public health data, morbidity tables, & healthy people 2020

PICO search engine

https://pubmedhh.nlm.nih.gov/nlmd/pico/piconew.php

Information Literacy Competency Standards for Nursing Standard Four

■ Considerations for the cost & the benefits of acquiring necessary info. ■ Using the info to address the clinical practice problem & sharing the findings w/ others

Information Literacy Competency Standards for Nursing Standard One

■ Define & articulate the need for information. ■ Identifying the PICO(T)(TT), the types, formats, location, scope of info resources and the cost benefit for info retrieval What question do I need to ask to assess a practice issue & where are the info resources?

Table 9-1 Health Information Website Checklist Questions to ask: 5. Privacy & Disclosure

■ Does the site include an easy to understand privacy statement or nondisclosure agreement? ■ Does the site meet recognized privacy standard such as "Health on the net"?

Facilitators for the use of EBP EBP course that includes:

■ Face to face orientation ■ Learning activities for searching library databases ■ Reading research journal articles ■ Writing an EBP paper ■ Analyzing research articles

Information Literacy Competency Standards for Nursing Standard Three

■ Have a working knowledge of literature in related fields & how it is produced ■ Synthesizing, summarizing, & evaluating info retrieved to assure whether or not info needs are met How good is the info I found? Do I need to search for more?

Information Literacy Competency Standards for Nursing Standard Two

■ Identify a variety of types and formats of potential sources of info. ■ Retrieving the info using PICO search strategies. ■ Using & managing the appropriate resources What is the problem I am trying to solve & what are the appropriate resources to use?

Table 9-1 Health Information Website Checklist Questions to ask: 3. Funding

■ Is it a not-for-profit site? ■ Any commercial funding? ■ Any conflicts of interest? ■ Any advertisements on the site? ■ If so, are they clearly labeled?

Table 9-1 Health Information Website Checklist Questions to ask: 4. Validity & Quality

■ Is the sites last update date specific? ■ Is there a clear statement of the website purpose? ■ Is the info accurate & referenced to current scholarly nursing & medical resources? ■ Is the info current? ■ Is the info peer reviewed or verified by a qualified editor? ■ Is the site free from content & typing errors? ■ Is the info free from bias & opinion? ■ Are all the links to quality reputable resources?

Open access journals

■ Journals that publish peer-reviewed articles with no user fees ■ Many have limited copyright/licensing restrictions and allow anyone with an Internet connection to download, copy, and distribute the articles

Information Literacy

■ Knowing when and why you need the information, where to find it, how to evaluate, use, and communicate it in an ethical manner ■ A learned competency ■ Requires repeated practice over time to develop expertise.

Barriers to EBP

■ Lack of time, access, or expertise needed to search and analyze research literature to answer clinical questions ■ Lack of exposure to formal research course ■ Findings from research studies may be techinical and difficult to understand ■ Research findings may be difficult to translate into nursing practice ■ Nurses Perceptions ■ Difficulty critiquing literature & applying the findings to practice ■ Difficulty sharing with other nurses ■ Organizational Culture

Scholarly nursing journal

■ Most print journals have online presence ■ Usually have an abstract & include references ■ Name & credentials of author listed in article ■ Only qualified nurses w/ expertise in the subject area write scholarly journal articles for publication ■ Peer review process is rigorous

Online Journals Online Journal for issues in nursing

■ OJIN is a peer-reviewed, online publication that addresses current topics affecting nursing practice, research, education, and the wider health care sector. ■ Sponsered by the ANA

Online journal problems

■ Perception that quality of content is lower than that of print journals ■ Some bibliographic indexes still categorically refuse to index such journals ■ And if not indexed there is a lack of awareness that the journal exists

Facilitators for the use of EBP Education that includes:

■ Search skills ■ Ability to critique literature findings ■ Ability to develop research questions ■ Data analysis skills

Levels of research evidence

■ Systematic reviews ■ Single Randomized Control Trial (RCT) ■ Cohort Studies ■ Case Controlled studies, ■ Case Series/Reports ■ Expert Opinion

What is the EBR tool?

■ Uses a 10-step process that produces an "Integrated Research Review" (IRR) report ■ Uses PICOTS, where S is for setting

Table 9-1 Health Information Website Checklist Questions to ask: 2. Authority

■ Who is the author? ■ Are their credentials noted? ■ Are they an expert in the subject area? ■ Are they qualified to write the information? ■ What is their affiliation? ■ Is there contact info for the author?

Table 9-1 Health Information Website Checklist Questions to ask: 1. Source

■ Who is the website sponsor ■ Who is the website owner

Knowledge Dissemination Software that facilitates knowledge Dissemination

■ Word Processing to create a manuscipt ■ Presentation & graphics programs to develop drawings or create a presentation or poster presentation ■ Spreadsheets to aggregate data & create charts ■ Databases to query, aggregate data, & create reports ■ Web development software to create web documents ■ Statistical software to analyze quantitative data. Qualitative analysis data to analyze descriptive data ■ E-mail to collaborate & share nursing knowledge ■ Wikis & blogs to interact using web-based professional collaboration on nursing knowledge