A Practical Approach to Nursing Evidence<br />UWHC Nurse Residents ‘09<br />Stephen Johnson, MLSEbling LibraryUniversity o...
“The rate and magnitude of change is such that the contents of a student, like the contents of a text-book, are partly out...
“…conscientious, explicit and judicious use of the current best evidence in making decisions about the care of individual ...
Ebling basics<br /><ul><li>50 clinical and literature databases
400 online books
4200 online journals
Linked via Find It </li></ul>Free document delivery <br />Journal articles – via pdfs to email (Library Express)<br />Book...
Getting help<br />UWHC Department of Nursing Liaison:      Stephen Johnsonstjohnson@library.wisc.edu	608.262.8255<br /><ul...
Email askebling@library.wisc.edu
Reference Librarian on duty 608.262.2020
Text msg
Chat </li></li></ul><li>Remote access<br /><ul><li>11 digit ID
Net ID and Password
to activate go to https://www.mynetid.wisc.edu/activate
Any problems? Contact DoIT 608.264.HELP (4357) </li></li></ul><li>Finding basic info (who, what,           when, where, wh...
A scenario<br />Patient with history of ischemic cardiomyopathy and a GFR of 40 is admitted with unstable angina.  It is d...
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09 Nurse Residents2

  1. 1. A Practical Approach to Nursing Evidence<br />UWHC Nurse Residents ‘09<br />Stephen Johnson, MLSEbling LibraryUniversity of Wisconsin<br />
  2. 2. “The rate and magnitude of change is such that the contents of a student, like the contents of a text-book, are partly out of date at the time of publication.”<br />C. Sidney Burwell, Dean of Harvard Medical School, 1947<br />“The fact that an opinion has been widely held is no evidence whatever that it is not utterly absurd.”<br /> Bertrand Russell (1872-1970)<br />
  3. 3. “…conscientious, explicit and judicious use of the current best evidence in making decisions about the care of individual patients…”<br />Sackett DL et al. Evidence-based medicine: how to practice and teach EBM. Edinburgh: Churchill Livingstone, 1998, p.2.<br />
  4. 4. Ebling basics<br /><ul><li>50 clinical and literature databases
  5. 5. 400 online books
  6. 6. 4200 online journals
  7. 7. Linked via Find It </li></ul>Free document delivery <br />Journal articles – via pdfs to email (Library Express)<br />Book chapters – via pdfs to email (Library Express)<br />
  8. 8. Getting help<br />UWHC Department of Nursing Liaison: Stephen Johnsonstjohnson@library.wisc.edu 608.262.8255<br /><ul><li>Other help
  9. 9. Email askebling@library.wisc.edu
  10. 10. Reference Librarian on duty 608.262.2020
  11. 11. Text msg
  12. 12. Chat </li></li></ul><li>Remote access<br /><ul><li>11 digit ID
  13. 13. Net ID and Password
  14. 14. to activate go to https://www.mynetid.wisc.edu/activate
  15. 15. Any problems? Contact DoIT 608.264.HELP (4357) </li></li></ul><li>Finding basic info (who, what, when, where, why, how) about diseases, therapies, etc.<br />Digging deeper on a specific topic, therapy, diagnostic test (EBM).<br /> Keeping an eye on the literature for new findings, etc.<br />3-pronged approach<br />Background Resources<br />Lifelong Learning<br />Keeping Current<br />PrimaryResearch/ Clinical Resources<br />
  16. 16. A scenario<br />Patient with history of ischemic cardiomyopathy and a GFR of 40 is admitted with unstable angina. It is determined that he needs to go to the cath lab. <br />Vague question: How might the risk of acute renal insufficiency be minimized?<br />
  17. 17. Background<br /><ul><li>Electronic Sources
  18. 18. UptoDate– contains over 70,000 pages of text
  19. 19. NursingConsult– includes 30 clinical texts (full text)
  20. 20. STAT!Ref – includes 20 clinical texts (full text)
  21. 21. Stedman’s Medical Dictionary
  22. 22. BMJ Clinical Evidence – covers 4000 interventions/230+ conditions
  23. 23. Harrisons – the textbook for Internal Medicine
  24. 24. MICROMEDEX – collection of drug databases
  25. 25. More
  26. 26. Print Sources
  27. 27. UW  MadCat (UW-Madison Library Catalog)</li></li></ul><li>Focusedquestion<br />P patient with renal insufficiency going for angiography<br />I does acetylcysteine plus saline infusion…<br />C compared to saline infusion alone…<br />O decrease the incidence of contrast induced nephropathy<br />
  28. 28. Hierarchy of articles<br />high<br />Evidence-based guidelines (best, current)<br />Clinical summaries<br />Systematic reviews<br />Meta analyses<br />Controlled trials (CTs and RCTs)<br />Prospective cohort studies<br />Case-control (retrospective cohort) studies<br />Case studies<br />Opinion of authorities, editorials<br />Level of Evidence<br />low<br />11<br />
  29. 29. “EBP is a problem-solving approach to clinical decision making in a healthcare organization that integrates the best available scientific evidence with the best available experiential (patient and practitioner) evidence, considers internal and external influences on practice, and encourages critical thinking in the judicious application of such evidence to care of the individual patient, patient population, or system.”<br />Newhouse, R, Dearholt S, Poe S, Pugh LC, White K. The Johns Hopkins Nursing Evidence-Based Practice Model. Baltimore: The Johns Hopkins Hospital, Johns Hopkins University School of Nursing; 2005.<br />
  30. 30. UWHC Nurses have adopted the Iowa Model of EBP<br />Research Not Sufficiently Developed to Guide Practice<br />Conduct Research<br />Consult with Experts<br />Determine Scientific Principles<br />
  31. 31. Finding basic info (who, what, when, where, why, how) about diseases, therapies, etc.<br />Digging deeper on a specific topic, therapy, diagnostic test (EBM).<br /> Keeping an eye on the literature for new findings, etc.<br />3-pronged approach<br />Background Resources<br />Lifelong Learning<br />Keeping Current<br />PrimaryResearch/ Clinical Resources<br />
  32. 32. Keeping Current with RSS<br />Decide what information you need/want<br />tables of contents from journals<br />nursing and medical blogs<br />subject searches in PubMed and other databases<br />health and nursing news<br />
  33. 33. Keeping Current with RSS<br />Decide how you want to view your feeds<br />Personalized page from Google/Yahoo/Netvibes<br />Google Reader, Bloglines, or other feed reader<br />Feeds to e-mail<br />Subscribe to feeds<br />Look for <br />Use your reader to find feeds<br />

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