The Value of Library and Information Services in Nursing and Patient Care

2014 ◽  
Vol 19 (3) ◽  
Author(s):  
Joanne Marshall ◽  
Jennifer Morgan ◽  
Mary Klem ◽  
Cheryl Thompson ◽  
Amber Wells
Keyword(s):  
Patient Care ◽  
Patient Outcomes ◽  
Critical Incident ◽  
Nurse Managers ◽  
Positive Impact ◽  
Survey Methods ◽  
Evidence Based ◽  
Study Results ◽  
Library Resources ◽  
Background Events

Libraries are a primary resource for evidence-based practice. This study, using a critical incident survey administered to 6,788 nurses at 118 hospitals, sought to explore the influence of nurses’ use of library resources on both nursing and patient outcomes. In this article, the authors describe the background events motivating this study, the survey methods used, and the study results. They also discuss their findings, noting that use of library resources showed consistently positive relationships with changing advice given to patients, handling patient care differently, avoiding adverse events, and saving time. The authors discuss the study limitations and conclude that the availability and use of library and information resources and services had a positive impact on nursing and patient outcomes, and that nurse managers play an important role both by encouraging nurses to use evidence-based library resources and services and by supporting the availability of these resources in healthcare settings.

Library and information services: impact on patient care quality

2014 ◽  
Vol 27 (8) ◽  
pp. 672-683 ◽  
Author(s):  
Joanne Gard Marshall ◽  
Jennifer Craft Morgan ◽  
Cheryl A. Thompson ◽  
Amber L. Wells
Keyword(s):  
Patient Care ◽  
Critical Incident ◽  
Large Scale ◽  
Positive Impact ◽  
Information Access ◽  
Care Quality ◽  
Access Methods ◽  
Content Type ◽  
Library Resources ◽  
Patient Care Quality

Purpose – The purpose of this paper is to explore library and information service impact on patient care quality. Design/methodology/approach – A large-scale critical incident survey of physicians and residents at 56 library sites serving 118 hospitals in the USA and Canada. Respondents were asked to base their answers on a recent incident in which they had used library resources to search for information related to a specific clinical case. Findings – Of 4,520 respondents, 75 percent said that they definitely or probably handled patient care differently using information obtained through the library. In a multivariate analysis, three summary clinical outcome measures were used as value and impact indicators: first, time saved; second, patient care changes; and third, adverse events avoided. The outcomes were examined in relation to four information access methods: first, asking librarian for assistance; second, performing search in a physical library; third, searching library's web site; or fourth, searching library resources on an institutional intranet. All library access methods had consistently positive relationships with the clinical outcomes, providing evidence that library services have a positive impact on patient care quality. Originality/value – Electronic collections and services provided by the library and the librarian contribute to patient care quality.

scholarly journals 179 Evaluating a Clinical Pharmacist Service in a Residential Care Unit

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii1-iii16
Author(s):  
Claire Kavanagh ◽  
Eimear O'Dwyer ◽  
Róisín Purcell ◽  
Niamh McMahon ◽  
Morgan Crowe ◽  
...  
Keyword(s):  
Patient Safety ◽  
Patient Care ◽  
Patient Outcomes ◽  
Residential Care ◽  
Clinical Pharmacist ◽  
Comparative Evaluation ◽  
Positive Impact ◽  
Standard Of Care ◽  
Pharmacist Interventions ◽  
Medication Reviews

Abstract Background This study assessed the pharmacist role in an 80 bed residential care unit by: Quantifying the number and type of pharmacist interventions made and their acceptance rate.Assessing impact of pharmacist interventions on patient care.Assessing staff attitudes towards the clinical pharmacist service. Methods This was a non-blinded, non-comparative evaluation of the existing clinical pharmacist service in the unit. All residents were included. All pharmacist interventions over a 10-week period were recorded, then graded according to the Eadon scale1 by a consultant gerontologist and an experienced pharmacist to assess their impact on patient care. Results There were 615 pharmacist interventions. The most common interventions were: Drug Therapy Review, 34% (n=209) Technical Prescription, 26.5% (n=163) Administration, 15.3% (n=94) Drug Interaction, 10.4% (n=64) Medication Reconciliation, 8.5% (n=52) 98% (n=596) of interventions were rated as having significance to patient care, of which: 48.4% (n=298) and 41.8% (n=257) of the interventions rated as ‘significant and resulting in an improvement in the standard of care’1% (n=6) and 0.5% (n=3) rated as ‘very significant and preventing harm’. There was a statistically significant agreement between the evaluators, κw = 0.231 (95% CI, 0.156 to 0.307), p < .0005. The strength of agreement was fair. Of interventions requiring acceptance by medical team (n=335), 89.9% (n=301) were accepted. 95% (n=36) of staff who responded agreed or strongly agreed that improved patient safety resulted from the pharmacist’s involvement in multidisciplinary medication reviews. Over 92% (n=35) agreed or strongly agreed that their experience of the pharmacist was positive. Conclusion The pharmacist has an important role in our residential care unit. Their involvement in the medicines optimisation process positively impacts patient outcomes and prevents harm. Staff perceived a positive impact of the clinical pharmacist service provided on patient care and patient safety.

scholarly journals Implementation of a Quality Improvement Role for Unlicensed Assistive Personnel and Effects on Infection Prevention

2021 ◽  
Vol 1 (S1) ◽  
pp. s73-s74
Author(s):  
Natalie Schnell ◽  
Lauren DiBiase ◽  
Amy Selimos ◽  
Lisa Stancill ◽  
Shelley Summerlin-Long ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Data Collection ◽  
Patient Care ◽  
Patient Outcomes ◽  
Infection Prevention ◽  
Central Line ◽  
Direct Patient Care ◽  
Evidence Based ◽  
Infection Rates ◽  
Process Measure

Background: Care bundles comprise evidence-based practices and interventions that are easily and consistently implemented while improving patient outcomes. As patient acuity and task overload continue to increase, infection prevention bundle and process measure compliance and data collection may become a lower priority for registered nurses (RNs). In early 2019, a certified nursing assistant (CNA) began full-time quality liaison work on a 53-bed inpatient adult oncology unit at UNC Medical Center to provide targeted compliance data collection and to correct deficits in real time when possible and within the appropriate scope of practice. Methods: The quality liaison CNA is highly motivated, with a relevant clinical background and effective communication skills. After conducting a gap analysis, the unit developed specific responsibilities for several areas of quality improvement, including infection prevention. In addition to rounding on all patients daily, the quality liaison (1) performs direct patient care tasks like Foley catheter care, (2) conducts patient education on topics such as chlorhexidine gluconate treatments, (3) performs all relevant process measure audits, and (4) easily relays missed or needed care to RNs with a door sign created as part of this initiative. High-risk findings, such as a loose central-line dressing, prompt immediate communication to the RN, with follow-up and escalation when necessary. Results: Patients and staff received the quality liaison well, and the increased attention to care bundle components and auditing ensured consistent, evidence-based care along with accurate and reliable data collection. Compared to the previous calendar year, the number of central-line audits on the unit increased by >1,400 by the end of 2019. Patient outcomes improved, and during 1 fiscal year, the unit achieved rate reductions between 40% and 55% for central-line–associated bloodstream infections, catheter-associated urinary tract infections, and healthcare-associated C. difficile infections. Staffing and logistical challenges imposed by the COVID-19 global pandemic have hampered this work because the quality liaison was redeployed to direct patient care intermittently. Correspondingly, from July to October 2020, the same infection rates increased between 30% and 353%. Conclusions: Having a designated quality liaison is an effective means to achieving quality improvements while remaining an integral member of the patient care team. As staffing has improved on this unit, the quality liaison has refocused efforts, and infection rates are beginning to improve. Given the success of the quality liaison role in improving quality outcomes on this unit, the hospital is exploring expansion of this model to additional units.Funding: NoDisclosures: None

scholarly journals Orthopedic Research: A golden opportunity to improve patient outcomes

2021 ◽  
Vol 55 (3) ◽  
Author(s):  
Site Administrator ◽  
Czar Louie Gaston
Keyword(s):  
Patient Care ◽  
Patient Outcomes ◽  
Fracture Liaison Service ◽  
The Philippines ◽  
Evidence Based ◽  
The Core ◽  
Fracture Liaison Services ◽  
Randomized Controlled ◽  
Fracture Liaison ◽  
Improve Patient

Research has been one of the core pillars of the Department of Orthopedics of the Philippine General Hospital over its now 50 years of existence. The department established one of the earliest resident’s research contests in the hospital in 1983 and its graduates regularly publish in peer reviewed journals and present their results in international conferences.1 Residents are required to complete 2 original studies prior to graduation and encouraged to document their clinical cases fully for future observational studies. Despite the apparent fascination, questions remain for a lot of trainees and clinicians. “Why do research? How does it  help our patients?” Skepticism abounds as even clinically sound and well-made studies oftentimes do not lead to policy and practice changes needed to improve patient care.2 Given contrarian evidence from randomized controlled trials (RCTs), practices of most established surgeons do not change.3 Hope remains however as evidence-based practice in orthopedics is growing and here to stay.4 Surgeons who accurately examine and diagnose their patient, keep medical records, analyze the medical literature for the best treatment, and explain the available options are subconsciously practicing the scientific methods of observation, documentation, analysis, and reporting conclusions which are the basis of all scientific research. Incorporating research education not just to residency training programs but also to continuing medical education (CME) courses for surgeons may help develop the skills to comprehend new studies and incorporate them into patient care. Reassuringly for the elder surgeon, even old dogs have been shown to learn new tricks for their practice, just not as fast as the younger generation.5 The challenge now presented to Philippine medical practitioners is to develop clinical research that will translate into improved care for patients. As majority of literature dictating treatment for musculoskeletal disorders come from developed countries, case series or observational cohorts reporting local data in our setting is greatly important in guiding patient care.6 The fundamental goal is to produce high quality studies or new breakthroughs that engage discussion amongst a wide audience and lead to system changes that eventually enhance patient outcomes.7 As part of the celebration of the PGH Department of Orthopedics 50th golden anniversary, this orthopedic issue of the ACTA MEDICA PHILIPPINA represents work from the different orthopedic subspecialities of the department and its graduates. Pioneering studies on brachial plexus injuries, computer navigated spine surgery, rotationplasty, artificial intelligence, pedagogy, and much more highlight the growth of orthopedics in the Philippines. A study on one of the newest fields in Philippine orthopedics, orthogeriatrics, exemplifies the importance of blazing a new trail. The publication by Reyes et al. on a multidisciplinary orthogeriatric approach to the treatment of fragility hip fractures has shown improved outcomes consistent with the positive results of other fracture liaison services in Asia and worldwide.8,9 Their work has since led to the UPM-PGH Orthogeriatric Multidisciplinary Fracture Management Model and Fracture Liaison Service being adopted by PGH as a clinical pathway and has served as a model for other hospitals in the Philippines to improve their care of patients with fragility hip fractures. With the follow-through from the initial clinical study to administrative and policy changes, this example aptly illustrates the power of research to effect significant improvements in clinical outcomes and inspires all of us to continue to strive for better care for our patients.   Czar Louie Gaston, MD, FPOA Department of Orthopedics Philippine General Hospital University of the Philippines Manila   REFERENCES College of Medicine University of the Philippines Manila. Orthopedics [Internet]. [cited 2021 May]. Available from: https://cm.upm.edu.ph/p/orthopedics/ Buchbinder R, Maher C, Harris IA. Setting the research agenda for improving health care in musculoskeletal disorders. Nat Rev Rheumatol. 2015 Oct;11(10):597-605. doi: 10.1038/nrrheum.2015.81. Epub 2015 Jun 16. PMID: 26077917. Sonntag J, Landale K, Brorson S, Harris IA. Can the results of a randomized controlled trial change the treatment preferences of orthopaedic surgeons? Bone Jt Open. 2020 Sep 11;1(9):549-555. doi: 10.1302/2633-1462.19.BJO-2020-0093.R1. PMID: 33215153; PMCID: PMC7659699. Griffin XL, Haddad FS. Evidence-based decision making at the core of orthopaedic practice. Bone Joint J. 2014 Aug;96-B(8):1000-1. doi: 10.1302/0301-620X.96B8.34614. PMID: 25086112. Niles SE, Balazs GC, Cawley C, Bosse M, Mackenzie E, Li Y, et al. Translating research into practice: is evidence-based medicine being practiced in military-relevant orthopedic trauma? Mil Med. 2015 Apr;180(4):445-53. doi: 10.7205/MILMED-D-14-00296. PMID: 25826350. Elliott IS, Sonshine DB, Akhavan S, Slade Shantz A, Caldwell A, Slade Shantz J, et al. What factors influence the production of orthopaedic research in East Africa? A qualitative analysis of interviews. Clin Orthop Relat Res. 2015 Jun;473(6):2120-30. doi: 10.1007/s11999-015-4254-5. Epub 2015 Mar 21. PMID: 25795030; PMCID:PMC4419000. Tchetchik A, Grinstein A, Manes E, Shapira D, Durst R. From research to practice: Which research strategy contributes more to clinical excellence? Comparing high-volume versus high-quality biomedical research. PLoS One. 2015 Jun 24;10(6):e0129259. doi: 10.1371/journal.pone.0129259. PMID: 26107296; PMCID: PMC4480880. Chang LY, Tsai KS, Peng JK, Chen CH, Lin GT, Lin CH, et al. The development of Taiwan Fracture Liaison Service network. Osteoporos Sarcopenia. 2018 Jun;4(2):47-52. doi: 10.1016/j.afos.2018.06.001. Epub 2018 Jun 7. PMID: 30775542; PMCID: PMC6362955. Barton DW, Piple AS, Smith CT, Moskal SA, Carmouche JJ. The clinical impact of fracture liaison services: A systematic review. Geriatr Orthop Surg Rehabil. 2021 Jan 11;12:2151459320979978. doi: 10.1177/2151459320979978. PMID: 33489430; PMCID: PMC7809296

Practical Steps for Evidence-Based Practice

2008 ◽  
Vol 19 (3) ◽  
pp. 314-324
Author(s):  
Bradi B. Granger
Keyword(s):  
Professional Development ◽  
Patient Care ◽  
Patient Outcomes ◽  
Systematic Approach ◽  
Evidence Based Practice ◽  
Evidence Based ◽  
Nursing Research ◽  
Clinical Area ◽  
Clinical Questions

Evidence-based practice is a goal for all institutions and often an accreditation requirement. However, moving forward to “just do it” poses a problem for nurses in most patient care units. In spite of increased focus on evidence-based practice initiatives, creation of a systematic approach that effectively integrates the evidence for our practice into the minute-by-minute activities of patient care is still needed. In this article, the steps for accomplishing evidence-based practice in the clinical area are described, beginning with establishing a system to identify, evaluate, and prioritize clinical questions and existing research. Although conducting new, unit-based nursing research may seem a distant goal, beginning with initiatives to increase the use of existing evidence in practice is a first step to this goal, one that contributes to professional development and improved patient outcomes.

scholarly journals A randomized controlled dismantling trial of post-workshop consultation strategies to increase effectiveness and fidelity to an evidence-based psychotherapy for posttraumatic stress disorder

2021 ◽  
Author(s):  
Shannon Wiltsey Stirman ◽  
Norman Shields ◽  
Josh Deloriea ◽  
Meredith S. H. Landy ◽  
Jennifer M. Belus ◽  
...  
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Patient Outcomes ◽  
Stress Disorder ◽  
Secondary Outcome ◽  
Clinical Settings ◽  
Evidence Based ◽  
Clinical Consultation ◽  
Study Results ◽  
Evidence Based Psychotherapy

Background: Posttraumatic Stress Disorder (PTSD) is a serious mental health condition with substantial costs to individuals and society. Among military veterans, the lifetime prevalence of PTSD has been estimated to be as high as 20%. Numerous research studies have demonstrated that short-term cognitive-behavioral psychotherapies, such as Cognitive Processing Therapy (CPT), lead to substantial and sustained improvements in PTSD symptoms. Despite known benefits, only a minority of clinicians provide these therapies. Transferring this research knowledge into clinical settings remains one of the largest hurdles to improving the health of veterans with PTSD. Attending a workshop alone is insufficient to promote adequate knowledge transfer and sustained skill; however, relatively little research has been conducted to identify effective post-training support strategies. Methods: The current study investigates whether clinicians receiving post-workshop support (six-month duration) will deliver CPT with greater fidelity (i.e., psychotherapy adherence and competence) and have improved patient outcomes compared with clinicians receiving no formal post-workshop support. The study conditions are: technology-enhanced group tele-consultation; standard group tele-consultation; and fidelity assessment with no consultation. The primary outcome is independent assessment (via audio-recordings) of the clinicians’ adherence and competence in delivering CPT. The secondary outcome is observed changes in patient symptoms during and following treatment as a function of clinician fidelity. Post-consultation interviews with clinicians will help identify facilitators and barriers to psychotherapy skill acquisition. The study results will inform how best to implement and transfer evidence-based psychotherapy (e.g., CPT) to clinical settings to attain comparable outcomes to those observed in research settings. Discussion: Findings will deepen our understanding of how much and what type of support is needed following a workshop to help clinicians become proficient in delivering a new protocol. Several influences on clinician learning and patient outcomes will be discussed. An evidence-based model of clinical consultation will be developed, with the ultimate goal of informing policy and influencing best practice in clinical consultation. Trial registration: ClinicalTrials.gov: NCT01861769

scholarly journals Take Care and Care Well

2017 ◽  
Vol 49 (2) ◽  
pp. 43-45
Author(s):  
Mary Coughlin McNeil
Keyword(s):  
Clinical Practice ◽  
Best Practices ◽  
Patient Care ◽  
Patient Outcomes ◽  
Healthcare Professionals ◽  
Care Process ◽  
Evidence Based ◽  
Quality And Safety ◽  
Patient Values ◽  
Patient Care Process

Evidence-based practice supports the patient care process by integrating patient values and preferences with clinician expertise and the best available evidence. This approach to patient care focuses on quality and safety with the aim of improving patient outcomes. Despite its obvious value, healthcare professionals struggle to integrate evidence-based best practices into their clinical practice

scholarly journals Evolution of Evidence-Based Medicine in Stroke

2021 ◽  
pp. 1-12
Author(s):  
Graeme J. Hankey
Keyword(s):  
Medical Research ◽  
Patient Care ◽  
Patient Outcomes ◽  
Evidence Based Medicine ◽  
Stroke Care ◽  
The State ◽  
Evidence Based ◽  
Empirical Testing ◽  
Based Medicine ◽  
Scientific Endeavour

The introduction and evolution of evidence-based stroke medicine has realized major advances in our knowledge about stroke, methods of medical research, and patient outcomes that continue to complement traditional individual patient care. It is humbling to recall the state of knowledge and scientific endeavour of our forebears who were unaware of what we know now and yet pursued the highest standards for evaluating and delivering effective stroke care. The science of stroke medicine has evolved from pathophysiological theory to empirical testing. Progress has been steady, despite inevitable disappointments and cul-de-sacs, and has occasionally been punctuated by sensational breakthroughs, such as the advent of reperfusion therapies guided by imaging.

scholarly journals A randomized controlled dismantling trial of post-workshop consultation strategies to increase effectiveness and fidelity to an evidence-based psychotherapy for posttraumatic stress disorder

2021 ◽  
Author(s):  
Shannon Wiltsey Stirman ◽  
Norman Shields ◽  
Josh Deloriea ◽  
Meredith S. H. Landy ◽  
Jennifer M. Belus ◽  
...  
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Patient Outcomes ◽  
Stress Disorder ◽  
Secondary Outcome ◽  
Clinical Settings ◽  
Evidence Based ◽  
Clinical Consultation ◽  
Study Results ◽  
Evidence Based Psychotherapy

Background: Posttraumatic Stress Disorder (PTSD) is a serious mental health condition with substantial costs to individuals and society. Among military veterans, the lifetime prevalence of PTSD has been estimated to be as high as 20%. Numerous research studies have demonstrated that short-term cognitive-behavioral psychotherapies, such as Cognitive Processing Therapy (CPT), lead to substantial and sustained improvements in PTSD symptoms. Despite known benefits, only a minority of clinicians provide these therapies. Transferring this research knowledge into clinical settings remains one of the largest hurdles to improving the health of veterans with PTSD. Attending a workshop alone is insufficient to promote adequate knowledge transfer and sustained skill; however, relatively little research has been conducted to identify effective post-training support strategies. Methods: The current study investigates whether clinicians receiving post-workshop support (six-month duration) will deliver CPT with greater fidelity (i.e., psychotherapy adherence and competence) and have improved patient outcomes compared with clinicians receiving no formal post-workshop support. The study conditions are: technology-enhanced group tele-consultation; standard group tele-consultation; and fidelity assessment with no consultation. The primary outcome is independent assessment (via audio-recordings) of the clinicians’ adherence and competence in delivering CPT. The secondary outcome is observed changes in patient symptoms during and following treatment as a function of clinician fidelity. Post-consultation interviews with clinicians will help identify facilitators and barriers to psychotherapy skill acquisition. The study results will inform how best to implement and transfer evidence-based psychotherapy (e.g., CPT) to clinical settings to attain comparable outcomes to those observed in research settings. Discussion: Findings will deepen our understanding of how much and what type of support is needed following a workshop to help clinicians become proficient in delivering a new protocol. Several influences on clinician learning and patient outcomes will be discussed. An evidence-based model of clinical consultation will be developed, with the ultimate goal of informing policy and influencing best practice in clinical consultation. Trial registration: ClinicalTrials.gov: NCT01861769

Libraries as Gateway for Academic Excellence: Students and Teachers Perceptions in Different Colleges of Imphal, Manipur

2018 ◽  
Vol 8 (2) ◽  
pp. 81-84
Author(s):  
Aruna Chanu Oinam
Keyword(s):  
Positive Impact ◽  
Randomized Study ◽  
Academic Excellence ◽  
Academic Quality ◽  
Cross Sectional ◽  
Once Daily ◽  
Teachers Perceptions ◽  
Study Results ◽  
Library Resources ◽  
Effective Use

The purpose of this paper was to examine the present status of academic libraries in and around Imphal in bringing academic excellence thereby uplifting the relevance of libraries in academic platform. The size of the collection is used as the indicator of academic quality but it should be mentioned that effective use of library resources by students will boost the academic performance. The study was cross sectional randomized study and students, librarians, teachers across various colleges were participated with their informed consent. The study results showed that all the libraries were having required number of books along with newspapers for general knowledge. All the students agreed library is must for learning process and also use of library improved their performance and recommended others to use the library for achieving the academic excellence. Majority of students visited the library once daily and 65% visited library to understand the subjects and 71% were visited even there were no scheduled examinations. Majority agreed that teacher motivated them to visit the library (41%) but stay in the library by majority was 1-2 hours (71%). Library and information centers have become important channels for disseminating the information available in multiple formats to those who are in need of information. For any library to succeed in implementing knowledge management will require a strong leadership and vision from the top administration, which has positive impact in knowledge sharing and thereby academic excellence.

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