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MEDLIB-L  February 2018, Week 2

MEDLIB-L February 2018, Week 2

Subject:

Summary:Re: Chat: EBP & Nurses

From:

"Harris, Tonia O." <[log in to unmask]>

Reply-To:

Harris, Tonia O.

Date:

Thu, 8 Feb 2018 20:36:13 +0000

Content-Type:

text/plain

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text/plain (139 lines)

Good Afternoon,


I received a few replies and was asked to summarize for the list. We are still working on the agenda for the class and this will help me with my teaching.  By the way NNLM's NTO has a PubMed EBP WebEx.  It's not just just for nurses though.  It was held yesterday and was recorded.  The recording should be up soon.


I hope this is helpful to some.


>>>>>

Our EBP class begins today – it’s a ~3 month program where we lead nurses through the EBP process, then work with them on implementing their project and then on to dissemination. The class has been going on about 8 years.  We generally meet once a week. We are using more the Ohio State U EBP modell/process. They have a  MOOC if you want to see it:

https://www.canvas.net/browse/osu/courses/foundations-of-evidence-based-practice<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.canvas.net%2Fbrowse%2Fosu%2Fcourses%2Ffoundations-of-evidence-based-practice&data=02%7C01%7Ctoharris%40srhs.com%7C91e1fad347f9499242ac08d5632e4742%7C3ab267a62b644df386b68e6b81b88853%7C0%7C0%7C636523972786373541&sdata=JCWaqeyIogXrzrWAwkvnMtnxE7AVpa7lxXY8rFTIA2g%3D&reserved=0>



Our institution has been offering an “EBP Scholars” program for Nurses for 10 years. It is about a semester long, and has met weekly for 2 hours / 12 weeks. (This year we are trying something different – longer/fewer sessions).  Nurses are asked to apply to the program and come with a “burning question” – although that doesn’t always happen. We have an instructor from the University of Illinois –Chicago College of Nursing (they have a branch in Urbana) teach much of the class, but I do a session on literature searching (and lots of coaching)  and am considered a co-instructor, along with our Research Nurse Specialist.



The Nursing budget pays for the instructor, the printing of posters, and Unit budgets are supposed to cover time away from the unit.  We are an integrated organization, so try to get ambulatory and hospital nurses involved, and have occasionally had non-nursing staff join the course.



I have been here 4 years and I think my first full day on the job went to a session of the class.  Over time I have found the nurses really prefer CINAHL, but I teach PubMed as well, because it is so much bigger – and I tell them if they are ever working at a place that doesn’t have a library (heaven forbid) they can still get access to it. I point out the CINAHL EBP limiter, but also recommend they try both with and without it.  I do show the subject headings (especially in CINAHL) and point out that they can vary between databases.  I spend a fair amount of time trying to get them to think of alternate ways to word their topic, as they seem to stick to 1 way of wording things (my standard spiel is “what do you call this” while holding up a bottle of (pop/soda/carbonated beverage/soft drink/coke). And I talk about how terms change over time – pressure ulcers is morphing into pressure injuries.



I tend to talk about searching in terms of shopping – comparing Subject headings to “where do you find raisins in your grocery store – produce or baking aisle? And “am I wearing a shirt/blouse/top etc.) I do “human Boolean” logic – stand up if you are wearing X OR y.  Stand up if you are wearing X AND Y.  And I use doughnuts as another example – show an image of a box – and if I want a donut w/ chocolate icing AND nuts AND sprinkles AND coconut – I may end up with nothing, so I need to back off an AND or two.



Up until 2 years ago, the final product for this program was an EBP poster, but  then we began expecting implementation. We have 1 project from last year that will be presented at a conference this year, and 1 that has become a research project. We offer workshops as the year goes on – about getting your implementation team together, overcoming hurdles, writing an abstract, creating a presentation, and writing a manuscript.  The Research Nurse Specialist is the major player for that part. She’s been with the organization a long time, and really knows the ins and outs of things. We have an in-house EBP Conference in December, and feature some of the best projects in the afternoon session. We expect everyone to bring their poster.



We are relying heavily on the work done at Ohio State – Melnyk, etc.  They offer a MOOC if anyone is interested –

https://www.canvas.net/browse/osu/courses/foundations-of-evidence-based-practice<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.canvas.net%2Fbrowse%2Fosu%2Fcourses%2Ffoundations-of-evidence-based-practice&data=02%7C01%7Ctoharris%40srhs.com%7C34475c63913c499079b808d56500be30%7C3ab267a62b644df386b68e6b81b88853%7C0%7C0%7C636525976231907166&sdata=6PvLEbhZd4gExQSzl57%2BOKAuRkXKZFfRBAu%2FJ5UBinM%3D&reserved=0>



I don’t use the EBP subject headings because I think searching those brings up articles about the topic of EBP, not articles that ARE EBP.  I show how they can limit to RCTs for example, but most of the time, I think that is more useful in Evidence based medicine, not in Nursing EBP.  Some questions are more clinical – this page has examples of “clinical vs practice” questions:

http://libguides.ecu.edu/c.php?g=17486&p=97639<https://na01.safelinks.protection.outlook.com/?url=http%3A%2F%2Flibguides.ecu.edu%2Fc.php%3Fg%3D17486%26p%3D97639&data=02%7C01%7Ctoharris%40srhs.com%7C00cd91c7dc3048995af608d5674317ff%7C3ab267a62b644df386b68e6b81b88853%7C0%7C0%7C636528460235517926&sdata=FRfSK8vSisA51el6inaS6hnd3hFHz%2Fgk3zpY2X7QOkE%3D&reserved=0>



We don’t usually ask them to distinguish the type of question -  therapy/diagnosis/prognosis – which I would if I were working on EBM.



To me, that’s the purpose of the pyramid – to take the articles, then appraise their level of evidence –

http://libguides.ecu.edu/c.php?g=17486&p=97640<https://na01.safelinks.protection.outlook.com/?url=http%3A%2F%2Flibguides.ecu.edu%2Fc.php%3Fg%3D17486%26p%3D97640&data=02%7C01%7Ctoharris%40srhs.com%7C00cd91c7dc3048995af608d5674317ff%7C3ab267a62b644df386b68e6b81b88853%7C0%7C0%7C636528460235517926&sdata=9kH3vRP2py0B1%2B%2FwgNVz777Wr36u6h6rSgkNR4SKFO0%3D&reserved=0>



Our instructor talks about quantitative/qualitative info, but I think it’s over the head of many beginners to get into that too heavily.  Some topics just don’t lend themselves to a quantitative study. I would want people to be able to recognize one if they ran into them, but not necessarily have to figure out “do I need a quant or a qual to answer my question?



I hope that makes sense.



Ebsco did a workshop a while back on EBP and CINAHL – they used the topic of  - In postoperative patients does chewing gum (vs not chewing gum) prevent ileus.



It worked pretty well – a nice size of results to work with.

>>>>>>
I am a partner with our EBP mentors (nurses who are experienced/trained in EBP) for our EBP workshops, and it sounds similar to what you'll be doing.  We use Melnyk & Fineout-Overholt and the ARCC model for EBP implementation for our nurses.  We also have the AJN EBP series as required reading (although it's from 2009-2010, so I'm currently looking for something more recent to replace it).
We offer 6 hour workshops several times a year (these also give CE for nurses as well).  During the workshops, I only have 2 hours to teach them searching, so it is very overwhelming for them to be completely honest (I'd prefer to have much, much more time!).
I do show them both CINAHL and PubMed (we do not have Nursing Reference Center Plus) and discuss the differences between keywords/controlled vocabulary, best search techniques, and the content differences between our major databases.  Our workshops break down as such:

Our first session discusses the general tenets of EBP, our organizational philosophy, etc, and they work on their PICO questions.  They have 2 weeks to continue working on their questions.
I ask them to have questions ready by the 2nd session, because I find it's more impactful to work their searches out during my search instruction (I've actually found it helpful to try and get their questions early via email, so I can pre-select a solid example for PubMed and one for CINAHL).  I like to show them searching both via keyword and subject heading...and pointing out the differences in results (most feel relatively comfortable with keywords so I think subject headings offer a new perspective for them).  I've found that having them offer suggestions for the search terms I should use keeps them engaged in the process as well.  I try to make it as interactive as possible.  In the final 1/2 hour or so I have them work on their searches individually or in groups while I and the EBP mentor wander and offer help and suggestions.  Sometimes I'll pop back to the projected screen and show everyone an interesting search technique based on someone's search.
They then have another 2 weeks to work on their searches and find at least 1 article that fits their PICO question.  I'm always available in between the sessions to work with them as well.  Our 3rd session works over their article critiques using a rapid critical appraisal foundation, and we discuss next steps for their projects.  They are not required to complete a project in order to take the workshop, but we definitely encourage that!
>>>>>>>>

At my institution and our affiliated medical school, there is a combined fellowship program for nurses on evidence based practice, and is essentially what you've outlined below. I'm currently the librarian who teaches the EBP searching, etc. as part of the course. I do mention MeSH/CINAHL subject headings, narrowing down, evaluating articles, etc., in the lecture-style sessions that we provide once/month (I don't go over all of them every month). I also offer to sit down with each one in a one-on-one session to help them build a search about their specific topic, and that session seems to be much more productive. We go over things like MeSH, etc. in that personal setting to, but I'm having them "drive" during the search. Then I set them loose and encourage them to come back to me if they get stuck.

Our fellowship program includes: monthly presentation seminars that run 8am-noon. These presentations include – in no particular order -  my part (I’m slated for an hour for the session which first introduces literature searching and concepts to consider), as well as things like different models of change (PDSA, Lean/A3 methodology, etc.), how to create a PICOT question, creating elevator speeches, finding stakeholders and engaging them, small tests of change, determining the difference between quality improvement and research (and if it’s research, how to get IRB approval), local institutional requirements (do you need union approval? Etc.), synthesizing the evidence, etc.



I present on the library/searching information for 45-60 minutes the first month, and after that give just a brief section (5-10 minutes) and then am available for other questions. The one-on-one sessions are where the real teaching/learning happens.

>>>>>>>>>>



We are doing a lot in this  -- I teach evidence based resources.


>>>>>>>>>



Tonia Harris, MLIS

Manager of Library Services | Health Sciences Library

Spartanburg Regional Healthcare System

101 East Wood Street | Spartanburg, SC 29303
<http://www.spartanburgregional.com/>

o: 864-560-6220 | f: 864-560-6791

e: [log in to unmask]<mailto:[log in to unmask]> | w: SpartanburgRegional.com<http://www.spartanburgregional.com/>


________________________________
From: Harris, Tonia O.
Sent: Tuesday, January 23, 2018 12:06 PM
To: MEDLIB-L
Subject: Chat: EBP & Nurses

Hi Medlibbers,

Our hospital is implementing a quality improvement program in which bedside nurses complete EBP research projects related to a problem/condition on their floor or with certain cases.  The program is optional.  We are looking at the Johns Hopkins Nursing Evidence Based-Practice Tool, but curious as to others that might be out there or if any of your hospitals have developed your own tool.  We want to develop our tool based on what is included in others.  Such steps within the tool will include PICO question formation, what is current practice, what is the problem and why is it important, focus of problem, what evidence is gathered, etc.

Related to this, nurses in the program will be required to take a class on EBP, locating specific articles, lit review etc.  I will be teaching the part about searching for EBP articles, how to identify those, critiquing the lit., which resources to use, etc.  We have PubMed LinkOut and EBSCOHost databases here, along with DynaMed and Nursing Reference Center Plus.  For those of you who have done this kind of teaching, do you have any pointers to share, do you teach MeSH/CINAHL subject headings, narrowing down to EBP articles in PubMed and CINAHL, etc?  I know this type of teaching can be over the heads of those who are not used to it, so a fun, easy way of teaching this might pique their interest more.  Any help or comments is helpful.

Many thanks in advance!

Tonia

Tonia Harris, MLIS
Manager of Library Services | Health Sciences Library
Spartanburg Regional Healthcare System
101 East Wood Street | Spartanburg, SC 29303
o: 864-560-6220 | f: 864-560-6791
e: [log in to unmask] | w: SpartanburgRegional.com

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June 2008, Week 5
June 2008, Week 4
June 2008, Week 3
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June 2008, Week 1
May 2008, Week 5
May 2008, Week 4
May 2008, Week 3
May 2008, Week 2
May 2008, Week 1
April 2008, Week 5
April 2008, Week 4
April 2008, Week 3
April 2008, Week 2
April 2008, Week 1
March 2008, Week 5
March 2008, Week 4
March 2008, Week 3
March 2008, Week 2
March 2008, Week 1
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February 2008, Week 4
February 2008, Week 3
February 2008, Week 2
February 2008, Week 1
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January 2008, Week 3
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December 2007, Week 3
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November 2007, Week 4
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November 2007, Week 1
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October 2007, Week 4
October 2007, Week 3
October 2007, Week 2
October 2007, Week 1
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September 2007, Week 4
September 2007, Week 3
September 2007, Week 2
September 2007, Week 1
August 2007, Week 5
August 2007, Week 4
August 2007, Week 3
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August 2007, Week 1
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July 2007, Week 4
July 2007, Week 3
July 2007, Week 2
July 2007, Week 1
June 2007, Week 5
June 2007, Week 4
June 2007, Week 3
June 2007, Week 2
June 2007, Week 1
May 2007, Week 5
May 2007, Week 4
May 2007, Week 3
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May 2007, Week 1
April 2007, Week 4
April 2007, Week 3
April 2007, Week 2
April 2007, Week 1
March 2007, Week 5
March 2007, Week 4
March 2007, Week 3
March 2007, Week 2
March 2007, Week 1
February 2007, Week 4
February 2007, Week 3
February 2007, Week 2
February 2007, Week 1
January 2007, Week 5
January 2007, Week 4
January 2007, Week 3
January 2007, Week 2
January 2007, Week 1
December 2006, Week 5
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December 2006, Week 3
December 2006, Week 2
December 2006, Week 1
November 2006, Week 5
November 2006, Week 4
November 2006, Week 3
November 2006, Week 2
November 2006, Week 1
October 2006, Week 5
October 2006, Week 4
October 2006, Week 3
October 2006, Week 2
October 2006, Week 1
September 2006, Week 5
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September 2006, Week 3
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September 2006, Week 1
August 2006, Week 5
August 2006, Week 4
August 2006, Week 3
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August 2006, Week 1
July 2006, Week 5
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July 2006, Week 2
July 2006, Week 1
June 2006, Week 5
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June 2006, Week 3
June 2006, Week 2
June 2006, Week 1
May 2006, Week 5
May 2006, Week 4
May 2006, Week 3
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May 2006, Week 1
April 2006, Week 4
April 2006, Week 3
April 2006, Week 2
April 2006, Week 1
March 2006, Week 5
March 2006, Week 4
March 2006, Week 3
March 2006, Week 2
March 2006, Week 1
February 2006, Week 4
February 2006, Week 3
February 2006, Week 2
February 2006, Week 1
January 2006, Week 5
January 2006, Week 4
January 2006, Week 3
January 2006, Week 2
January 2006, Week 1
December 2005, Week 5
December 2005, Week 4
December 2005, Week 3
December 2005, Week 2
December 2005, Week 1
November 2005, Week 5
November 2005, Week 4
November 2005, Week 3
November 2005, Week 2
November 2005, Week 1
October 2005, Week 5
October 2005, Week 4
October 2005, Week 3
October 2005, Week 2
October 2005, Week 1
September 2005, Week 5
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September 2005, Week 3
September 2005, Week 2
September 2005, Week 1
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August 2005, Week 3
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August 2005, Week 1
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July 2005, Week 3
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July 2005, Week 1
June 2005, Week 5
June 2005, Week 4
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June 2005, Week 2
June 2005, Week 1
May 2005, Week 5
May 2005, Week 4
May 2005, Week 3
May 2005, Week 2
May 2005, Week 1
April 2005, Week 5
April 2005, Week 4
April 2005, Week 3
April 2005, Week 2
April 2005, Week 1
March 2005, Week 5
March 2005, Week 4
March 2005, Week 3
March 2005, Week 2
March 2005, Week 1
February 2005, Week 4
February 2005, Week 3
February 2005, Week 2
February 2005, Week 1
January 2005, Week 5
January 2005, Week 4
January 2005, Week 3
January 2005, Week 2
January 2005, Week 1
December 2004, Week 5
December 2004, Week 4
December 2004, Week 3
December 2004, Week 2
December 2004, Week 1
November 2004, Week 5
November 2004, Week 4
November 2004, Week 3
November 2004, Week 2
November 2004, Week 1
October 2004, Week 5
October 2004, Week 4
October 2004, Week 3
October 2004, Week 2
October 2004, Week 1
September 2004, Week 5
September 2004, Week 4
September 2004, Week 3
September 2004, Week 2
September 2004, Week 1
August 2004, Week 5
August 2004, Week 4
August 2004, Week 3
August 2004, Week 2
August 2004, Week 1
July 2004, Week 5
July 2004, Week 4
July 2004, Week 3
July 2004, Week 2
July 2004, Week 1
June 2004, Week 5
June 2004, Week 4
June 2004, Week 3
June 2004, Week 2
June 2004, Week 1
May 2004, Week 4
May 2004, Week 3
May 2004, Week 2
May 2004, Week 1
April 2004, Week 5
April 2004, Week 4
April 2004, Week 3
April 2004, Week 2
April 2004, Week 1
March 2004, Week 5
March 2004, Week 4
March 2004, Week 3
March 2004, Week 2
March 2004, Week 1
February 2004, Week 5
February 2004, Week 4
February 2004, Week 3
February 2004, Week 2
February 2004, Week 1
January 2004, Week 5
January 2004, Week 4
January 2004, Week 3
January 2004, Week 2
January 2004, Week 1
December 2003, Week 5
December 2003, Week 4
December 2003, Week 3
December 2003, Week 2
December 2003, Week 1
November 2003, Week 5
November 2003, Week 4
November 2003, Week 3
November 2003, Week 2
November 2003, Week 1
October 2003, Week 5
October 2003, Week 4
October 2003, Week 3
October 2003, Week 2
October 2003, Week 1
September 2003, Week 5
September 2003, Week 4
September 2003, Week 3
September 2003, Week 2
September 2003, Week 1
August 2003, Week 5
August 2003, Week 4
August 2003, Week 3
August 2003, Week 2
August 2003, Week 1
July 2003, Week 5
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July 2003, Week 3
July 2003, Week 2
July 2003, Week 1
June 2003, Week 5
June 2003, Week 4
June 2003, Week 3
June 2003, Week 2
June 2003, Week 1
May 2003, Week 5
May 2003, Week 4
May 2003, Week 3
May 2003, Week 2
May 2003, Week 1
April 2003, Week 5
April 2003, Week 4
April 2003, Week 3
April 2003, Week 2
April 2003, Week 1
March 2003, Week 5
March 2003, Week 4
March 2003, Week 3
March 2003, Week 2
March 2003, Week 1
February 2003, Week 4
February 2003, Week 3
February 2003, Week 2
February 2003, Week 1
January 2003, Week 5
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January 2003, Week 3
January 2003, Week 2
January 2003, Week 1
December 2002, Week 5
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December 2002, Week 3
December 2002, Week 2
December 2002, Week 1
November 2002, Week 5
November 2002, Week 4
November 2002, Week 3
November 2002, Week 2
November 2002, Week 1
October 2002, Week 5
October 2002, Week 4
October 2002, Week 3
October 2002, Week 2
October 2002, Week 1
September 2002, Week 5
September 2002, Week 4
September 2002, Week 3
September 2002, Week 2
September 2002, Week 1
August 2002, Week 5
August 2002, Week 4
August 2002, Week 3
August 2002, Week 2
August 2002, Week 1
July 2002, Week 5
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July 2002, Week 3
July 2002, Week 2
July 2002, Week 1
June 2002, Week 5
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June 2002, Week 3
June 2002, Week 2
June 2002, Week 1
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May 2002, Week 3
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May 2002, Week 1
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April 2002, Week 3
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April 2002, Week 1
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January 2002, Week 4
January 2002, Week 3
January 2002, Week 2
January 2002, Week 1
December 2001, Week 5
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December 2001, Week 3
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December 2001, Week 1
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November 2001, Week 3
November 2001, Week 2
November 2001, Week 1
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October 2001, Week 3
October 2001, Week 2
October 2001, Week 1
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August 2001, Week 4
August 2001, Week 3
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June 2001, Week 3
June 2001, Week 2
June 2001, Week 1
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May 2001, Week 2
May 2001, Week 1
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April 2001, Week 3
April 2001, Week 2
April 2001, Week 1
March 2001, Week 5
March 2001, Week 4
March 2001, Week 3
March 2001, Week 2
March 2001, Week 1
February 2001, Week 4
February 2001, Week 3
February 2001, Week 2
February 2001, Week 1
January 2001, Week 5
January 2001, Week 4
January 2001, Week 3
January 2001, Week 2
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December 2000, Week 5
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October 2000, Week 2
October 2000, Week 1
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September 2000, Week 1
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April 2000, Week 3
April 2000, Week 2
April 2000, Week 1
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March 2000, Week 4
March 2000, Week 3
March 2000, Week 2
March 2000, Week 1
February 2000, Week 5
February 2000, Week 4
February 2000, Week 3
February 2000, Week 2
February 2000, Week 1
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October 1999, Week 1
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May 1999, Week 2
May 1999, Week 1
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April 1999, Week 3
April 1999, Week 2
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March 1999, Week 3
March 1999, Week 2
March 1999, Week 1
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February 1999, Week 3
February 1999, Week 2
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January 1999, Week 4
January 1999, Week 3
January 1999, Week 2
January 1999, Week 1
December 1998, Week 5
December 1998, Week 4
December 1998, Week 3
December 1998, Week 2
December 1998, Week 1
November 1998, Week 5
November 1998, Week 4
November 1998, Week 3
November 1998, Week 2
November 1998, Week 1
October 1998, Week 5
October 1998, Week 4
October 1998, Week 3
October 1998, Week 2
October 1998, Week 1
September 1998, Week 5
September 1998, Week 4
September 1998, Week 3
September 1998, Week 2
September 1998, Week 1
August 1998, Week 5
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August 1998, Week 1
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July 1998, Week 3
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July 1998, Week 1
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June 1998, Week 4
June 1998, Week 3
June 1998, Week 2
June 1998, Week 1
May 1998, Week 5
May 1998, Week 4
May 1998, Week 3
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May 1998, Week 1
April 1998, Week 5
April 1998, Week 4
April 1998, Week 3
April 1998, Week 2
April 1998, Week 1
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March 1998, Week 4
March 1998, Week 3
March 1998, Week 2
March 1998, Week 1
February 1998, Week 4
February 1998, Week 3
February 1998, Week 2
February 1998, Week 1
January 1998, Week 5
January 1998, Week 4
January 1998, Week 3
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March 1997, Week 4
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April 1996, Week 3
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April 1996, Week 1
March 1996, Week 5
March 1996, Week 4
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December 1995, Week 5
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