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Nurses utilisation of evidence to                       inform practiceDr Chris Hendry             (NUEIP)         Karen B...
The projectTwo projects were sponsored by the Ministry of Health to improvenurses access to and use of evidence to support...
The context• One third of nurses and related health staff do not  work for DHBs.• They do not have access to intranets and...
The project process1. Literature search.2. Pre-service audit     -    Information on use of the internet.     -    Current...
The intervention             www.nursingevidence.org.nzDevelopment of a ‘one stop shop’ website which:  directs staff to h...
Tips and Tricks• Introduction                  • Features of a search engine• Internet Explorer               results page...
Examples of browse categories• Browse everything              • Multiple health subjects  (recommended for new users!)   •...
Monitoring
Monitoring                         Most popular web pagesWebpageNursing EvidenceSearch « Nursing EvidenceTips & tricks « N...
MonitoringRegions site accessed from
The post service auditA survey tool was designed using Survey Monkey® and aimed toidentify• demographic information;• the ...
Demographics from 94 Nurses
Nurse Respondents• 93% of respondents were NZ European• 88% aged between 36 and 59 years and half over 47 years.• All were...
Practice setting• 32% DHB (Acute)• 17% Primary Health Care/Non DHB• 12.5% Rest Home/Residential Care• 38.5% worked in PHOs...
Resources used to                          inform practice.Internet (could be more than 1)• 96.9% used free access website...
Barriers to gaining up to date             information to inform practice.Lack of time•39.1% at work,No resources on site•...
Type of information searched• 96% for ‘information about a condition’.• 96% searched for ‘information on treatment/managem...
Skill at searching for                         informationSelf defined ‘good ability’• 84% felt their ability to find info...
Time spent searching for                     information• 85% indicated they spent between 11 and 30 minutes on  evidence ...
Usefulness of the Nursing   Evidence Website.
Still in developmentAn area of the site which will require registration This area aims to:           allow access to evide...
Improving Nurses’ Electronic Access to Evidence to Inform Practice
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Improving Nurses’ Electronic Access to Evidence to Inform Practice

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Chris Hendry
New Zealand Institute of Community Health Care
(Thursday, 3.00, Innovation in Practice 1)

Nurses, like other health professionals, are reliant on current evidence to inform their practice. Almost a third of nurses are employed by NGOs and other non-DHB providers and most do not have easy access to electronic databases and evidence based search engines. In 2010, a project was undertaken to enable all South Island nurses to access evidence to inform practice regardless of their practice setting.
Prior to commencing the project, a convenience survey was completed asking nurses from a variety of practice settings to describe the barriers and enablers to accessing the internet to search for evidence to inform their practice. Similar to literature on the subject, nurses stated that time, convenience and confidence in searching for evidence on-line hindered their use of this medium. This project enabled the development of an openly available website for nurses www.nursingevidence.org.nz containing a range of ‘best evidence’ websites and advice on how to be discerning in searching the web for evidence to inform practice. During the past 12 months information has been gained profiling the use of this website by nurses, which will be presented at the conference.

Published in: Health & Medicine
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Improving Nurses’ Electronic Access to Evidence to Inform Practice

  1. 1. Nurses utilisation of evidence to inform practiceDr Chris Hendry (NUEIP) Karen BetonyDirectorNZ Institute of Community Nurse EducatorHealth Care NZ Institute of Community Health Care
  2. 2. The projectTwo projects were sponsored by the Ministry of Health to improvenurses access to and use of evidence to support their practiceSuccessful proposals:•North Island (Waikato DHB ): Fund access for all nurses working in pilotDHB regions to a recognised clinical procedure database – LippincottNursing manual.•South Island: Canterbury DHB supported by the NZ Institute ofCommunity Health Care mananged the development of a website,www.nursingevidence.org.nz, to provide a repository for links to highquality, evidence based web resources as well as clinical procedures andto be an access point to a funded database.
  3. 3. The context• One third of nurses and related health staff do not work for DHBs.• They do not have access to intranets and/or hospital libraries and health related databases to search for evidence.• Many of the available search engines have little easily available information for nurses to apply to their practice.
  4. 4. The project process1. Literature search.2. Pre-service audit - Information on use of the internet. - Current barriers to access work and home. - Ideas for website design and content.3. Implement intervention (website) and monitor use.4. Post service audit. - knowledge of the project - barriers to access - ideas for improvement
  5. 5. The intervention www.nursingevidence.org.nzDevelopment of a ‘one stop shop’ website which: directs staff to high quality, reputable web resources which can be accessed anywhere, by anyone, at any time educates staff on how to efficiently search the internet and identify quality resources enables nurses to share resources
  6. 6. Tips and Tricks• Introduction • Features of a search engine• Internet Explorer results page (e.g bing)• Mozilla Firefox • Finding Information quickly• Using a search engine (e.g • URLs and Hyperlinks Yahoo Xtra) • What makes an internet• Features of a search engine resource reliable? results page(e.g Google) • Glossary of terms
  7. 7. Examples of browse categories• Browse everything • Multiple health subjects (recommended for new users!) • Nursing care and• Anatomy and Physiology procedures• Cancer and Palliative care • Pharmacology• Consumer health information • Psychiatric-mental• Guidelines • Research based evidence• Health policy and statistics • Signs and Symptoms• Managing conditions • Teaching packages
  8. 8. Monitoring
  9. 9. Monitoring Most popular web pagesWebpageNursing EvidenceSearch « Nursing EvidenceTips & tricks « Nursing EvidenceEditor’s choice « Nursing EvidenceNews & views « Nursing EvidenceCatheter Care Guidelines « Nursing Evidence> Browse everything « Nursing EvidenceNursing care and procedures « Nursing EvidenceLibrary services « Nursing EvidenceMedical conditions « Nursing EvidenceWaikato DHB Policies and Procedures Manuals « Nursing EvidenceCare Guides for Residential Aged Care « Nursing EvidencePharmacology « Nursing Evidenceresearch based evidence « Nursing EvidenceTeaching Packages « Nursing Evidence
  10. 10. MonitoringRegions site accessed from
  11. 11. The post service auditA survey tool was designed using Survey Monkey® and aimed toidentify• demographic information;• the type of information nurses search for using internet resources;• barriers there are to using internet resources;• how nurses determine the quality of information;• nurses’ awareness and usage of the website, Nursing Evidence.
  12. 12. Demographics from 94 Nurses
  13. 13. Nurse Respondents• 93% of respondents were NZ European• 88% aged between 36 and 59 years and half over 47 years.• All were registered Nurses• 32% first qualified in the 1980’s.• 30% had no post graduate qualification• 43% had a Pg Cert or PgDip.
  14. 14. Practice setting• 32% DHB (Acute)• 17% Primary Health Care/Non DHB• 12.5% Rest Home/Residential Care• 38.5% worked in PHOs, Maori Providers, Rural services, DHB community, Govt. Agencies eg. Prisons, ACC.• Registered Nurse was the most common job title description (45%)• 38% described their job as being either a managerial, specialist or educator role.
  15. 15. Resources used to inform practice.Internet (could be more than 1)• 96.9% used free access websites through Google.• 80% used an intranet when available.• 50.9% subscription websites.Other sources (could be more than 1)• 97.1% also used colleagues and other health professionals as sources of knowledge.• 78.5% used text books and journals at work.• 60.3% used text books at home
  16. 16. Barriers to gaining up to date information to inform practice.Lack of time•39.1% at work,No resources on site•39% lack of subscriptions to databases•34% lack of up to date journals at work,•28.1% no library on site (absent for non-acute hospital nurses)•24.6% lack of up to date texts at work•17.5% lack of a computer at work (residential care settings hadmost access problems)Only 6.1% had problems accessing a computer at home.
  17. 17. Type of information searched• 96% for ‘information about a condition’.• 96% searched for ‘information on treatment/management of a condition’.• 90% for drug information.• 87% nursing care for specific conditions.• 47% searched for information for patients.• 46% procedure guidelines.• 43% for Government/health policy news and health related articles.Only one respondent ‘never’ used the internet for findinginformation.
  18. 18. Skill at searching for informationSelf defined ‘good ability’• 84% felt their ability to find information via a search engine such as Google was ‘good’ or ‘very good’,• 73% were good using the Nursing Evidence site• 63% were good using the intranet• 49% for evidence based websites• 40% and databasesAge, qualification, employment setting had no influence oneffectiveness of use of the internet, though those with no postgraduate qualification appeared to find information they wantedquickly when they used their favourite sites.
  19. 19. Time spent searching for information• 85% indicated they spent between 11 and 30 minutes on evidence based websites and databases to find information they were looking for.• Respondents indicated that they could halve the searching time by using the intranet, a search engine or favourite website.• Of respondents using the Nursing Evidence site, all but two found the information they wanted in under 30 minutes, with most doing so with 10 minutes.
  20. 20. Usefulness of the Nursing Evidence Website.
  21. 21. Still in developmentAn area of the site which will require registration This area aims to: allow access to evidence based subscription site provide a central point for policies and proceduresNurses can currently: make content suggestions highlight new articles

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