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SEA Currents

Newsletter of the NN/LM Southeastern/Atlantic Region

What I Learned – Summer Institute in Nursing Informatics (SINI) 2014, Baltimore

Written By: PJ Grier, Outreach/Access Coordinator, National Network of Libraries of Medicine, Southeastern/Atlantic Region

Contact PJ at: pgrier@hshsl.umaryland.edu.

Last month I attended The University of Maryland, Baltimore – School of Nursing’s conference entitled the Summer Institute in Nursing Informatics (SINI): Informatics enabling patient-centered care across the continuum. This event is a nationally recognized forum that is focused on the informatics needs of nurses. This conference interested me as nurses represent a significant outreach population for the Regional Medical Library. This action-packed conference is in its 24th year and the planning committee was stacked with leaders in the nursing profession. The SINI educational tracks and objectives were fourfold:

  • Describe ways of using informatics tools to support patient engagement and patient-centered care.
  • Identify new and evolving roles for clinicians and informaticians in providing patient-centered care across the continuum.
  • Address ongoing challenges in achieving interoperability, with consideration for devices and apps individuals and families use to monitor and manage their health.
  • Address ongoing challenges in using data from diverse sources to improve patient care and health outcomes and to control costs.

Those familiar with the Technology Informatics Guiding Education Reform (TIGER) initiative will be pleased to know that during the general session it was announced that the Healthcare Information and Management Systems Society (HIMSS) would now lead TIGER’s efforts. TIGER’s vision was to enable nurses to use informatics and emerging technologies to make healthcare safer, more effective, efficient, patient-centered, timely and equitable by interweaving evidence and technology seamlessly into practice, education and research.

The opening plenary speaker was Philip Fasano – Executive Vice President and Chief Information Officer, Kaiser Permanente (KP), who spoke on “Teaming to transform healthcare.” He felt that consumers demanded transparency, affordability and convenience using accessible e-tools such as secure messaging and desired a care-anywhere experience in their homes, schools, hospitals, etc. Some technologies that addressed consumers’ needs included telehealth, mhealth, predictive analytics and EHR real-time analyses. Notably 84% of U.S. hospitals were still implementing EHRs, however, all KP hospitals were at Stage 7 of EHR adoption (a HIMMS electronic medical record adoption model).

I attended a session that featured Patricia Dykes – Senior Nurse Scientist from Brigham and Women’s Hospital who presented “Participatory design and development of a patient-centered toolkit…in their plan of care.” Her program included a distillation of the research question, aims of the study, a review of the design methods used for the patient-centered toolkit, results and challenges. An outside foundation provided the demonstration funds used to develop and deploy the toolkit in the intensive care and acute care oncology units of the hospital. Interestingly, Dr. Dykes mentioned MedlinePlus in a positive way multiple times during her session. Engaging patients in the design process, having an awareness that patients wanted to be knowledgeable about their health conditions, plus a desire to have the appropriate tools for communication were valuable lessons learned.

Susan Matney – Informaticist from 3M Health Information Systems gave a talk on “Coding nursing assessments using Systematized Nomenclature of Medicine – Clinical Terms (SNOMED CT) and Logical Observation Identifiers Names and Codes (LOINC) to support national standards for interoperability.” Because Meaningful Use drove the adoption of comprehensive terminologies, Dr. Matney’s approach crystallized the need to use the Office of the National Coordinator for Health Information Technology’s (ONC) approved standard terminologies to bridge nursing vocabularies in various healthcare settings. As a useful tool to assist with terminology mapping, she discussed the Nursing Problem List Subset of SNOMED CT, which is available through National Library of Medicine’s Unified Medical Language System.

Several speakers delivered their perspectives on “Health IT adoption in home health agencies”. Home health agencies (HHAs) did not receive financial incentives through the Health Information Technology for Economic and Clinical Health (HITECH) Act. As a result, many struggled to adopt new health information technology solutions. HHAs must correctly identify challenges to reduce costs, improve quality, and optimize health outcomes. It was also important for HHAs to define clear procedures that enumerated their IT needs and created structured assessments for evaluating vendor products and services.

Lastly I listened to Heather Carter-Templeton’s presentation “Using mobile devices to access evidence-based information in a rural health clinic.” According to Heather, the literature contained few reports of systematic roll-outs of mobile devices providing evidence-based resources and offered little guidance for teaching nurses how to use mobile devices within the clinical setting. Thus the need for this qualitative descriptive study conducted in a rural Alabama health clinic with seven nurses recruited as subjects. Preliminary findings suggested: (a) perceptions that nurses demonstrated limited use of electronic evidence-based information programs (EEIBP) via mobile devices, (b) differences in interpretations of information literacy and evidence-based practice, and (c) past experience with mobile devices was an indicator of how enthusiastically EEIBP was embraced.

I gained a better understanding of the challenges nurses undergo while adopting new approaches to patient-care delivery and in furthering their reporting and research needs. I observed that their challenges and opportunities are not that different from our own. For network members having nursing constituencies, you may want to put the Summer Institute in Nursing Informatics on your “to-do” list (funds permitting) or make sure that institutional nurse “champions” are aware that this conference exists. If you, or your colleagues desire greater detail on any of these sessions please let me know, as I am happy to share.

The Value Study as a Tool for Library Advocacy (Boost Box session)

Presenters:

  • Joanne Gard Marshall, Distinguished Research Professor, School of Information and Library Science, University of North Carolina at Chapel Hill
  • Julia Sollenberger, Associate Vice President and Director, Medical Center Libraries and Technologies, University of Rochester Medical Center

Date / Time: Tuesday, August 12, 2014 / Noon – 1 pm (ET)

Where:             https://webmeeting.nih.gov/boost2/

Online / No Registration Required

Summary: The speakers will present the results of the Value Study the most useful for library advocacy and discuss how results are being used by librarians across the country. Over 16,000 physicians, residents and nurses served by 56 libraries participated in the study. As a result, the findings can be used by both participating and non-participating libraries.

Librarians are using the results to advocate for the importance of the library through posters, presentations, newsletters and personal contacts with administrators, educators and clinicians. Time saved by health professionals is also being also converted into dollars saved to show cost-effectiveness. Our examples show that librarians are using the results, but customizing their advocacy efforts so that they have maximum impact on their institution.

Librarians are making frequent use of the resources available on the Value Study website: http://nnlm.gov/mar/about/value.html, containing an overview of the study results suitable for presentation. Librarians are welcome to use the full presentation or key slides as needed.  Specialized PowerPoint summary reports are also available based on geographic region, as well as AAHSL and non-AAHSL sites, and the profession of respondents. The site provides access to the data and all supporting materials, including the survey. Features encourage data use, benchmarking with similar types of libraries, as well as study replication. Links to peer reviewed journal articles based on the study results are also available on the site. Two new publications, one in a nursing journal and one in a health care management journal are about to appear. Results from these additional analyses will be discussed.

Beyond the SEA: August 20, 2014 – Can You Trust Figure 7? and a PubMed Update – Recording Now Available

Recording: https://webmeeting.nih.gov/p80w6akgwtx/

Date and Time: Wednesday, August 20, 2014, Noon to 1:00 pm (EST)

Presentation 1: Can You Trust Figure 7?  – Using Library Promotion to Build the Profile of the Hospital Library by Hosting a Symposium.

Presenter: Jan Orick, Director of Biomedical Library, St. Jude Children’s Research Hospital, Memphis, TN.

Jan T. Orick, MLS, AHIP received her degree in Library and Information Science from Louisiana State University. After working as a solo librarian in Lafayette, LA and then Methodist Hospitals in Memphis, TN, she began work at St. Jude Children’s Research Hospital as the Biomedical Librarian in 1995. She serves in her current position as Director of the Biomedical Library since 1998 where she manages a staff of 4 and a library collection of over 4,000 electronic journals, books and multiple databases.  Jan is a member of the Medical Library Association (MLA) and served as an officer of the Hospital Libraries Section. She is also active in the Southern Chapter of the MLA.

Summary: Jan Orick will share her approach in communicating the value of the St. Jude Biomedical Library (TN) through a yearly symposium targeted to pique the interest of her customers. Jan utilized funds received from the National Network of Libraries of Medicine, Southeastern/Atlantic Region (NN/LM SE/A) Express Hospital Library Promotion Award to promote a symposium on plagiarism and scientific misconduct and remind their customer base of the library’s services.

Presentation 2: PubMed Update

Presenter: Rebecca Brown, Trainer/Curriculum Content Specialist, National Library of Medicine Training Center, Salt Lake City, UT.

Rebecca Brown has worked for the National Network of Libraries of Medicine since 2007. She started as the Kansas Technology and Outreach Coordinator for the MidContinental Region and then became a trainer for the National Library of Medicine Training Center in 2011.

Summary: Rebecca will provide an update of changes and features available in PubMed, showcasing MeSH on Demand and share additional user tips.

Upon completion of the Beyond the SEA Webinar, each participant will receive 1 hour of continuing education credit awarded by the Medical Library Association. Certificates will be available electronically following completion of the online survey supplied at the end of the webinar.

What do you need to join these conferences?
• A computer (with Flash installed)
• A telephone

How do I connect?

Go to this URL: http://webmeeting.nih.gov/beyondthesea
• Enter as a Guest
• Sign in with your first and last name.

Follow the instructions in the meeting room to have Adobe Connect call your phone or call 1-800-605-5167 and enter the participant code 816440 when prompted.

Finding an Evidence-Based Medicine Study in PubMed

Written by Tony Nguyen, Outreach/Communications Coordinator, National Network of Southeastern/Atlantic Region

Contact Tony at: tnguyen@hshsl.umaryland.edu

If you’re familiar with Evidence-Based Medicine, you are aware of the acronym PICO. For those unfamiliar with the term, it is a convenient way to organize a well-built and answerable clinical question. This is important for medical and health professionals in formulating a search strategy prior to investigating the vast amount of available medical and scientific literature. PICO is broken down as follows:

          P Patient, Population, or Problem
          I Intervention, Prognostic Factor, or Exposure
         C Comparison, Control, Context, or Intervention (if appropriate)
         O Outcome you would like to measure or achieve
        (T) Time, Therapy, or Type of Article (This could be optional)

As you become more familiar with PICO, note the different types of studies available within medical literature: Therapy, Diagnosis, Prognosis, Etiology, Prevention, and Quality Improvement. Once the study type is determined, choose the best study design or methodology to address a clinical question.

     Type of Question      Best Type of Study/Methodology
     Therapy
  • Systematic Review
  • Meta-Analysis
  • Double-Blind Randomized Controlled Trial
     Diagnosis
  • Controlled Trial
     Prognosis
  • Cohort Studies
  • Case Control Studies
  • Case Series
     Etiology
  • Cohort Studies
  • Case Control Studies
  • Case Series
     Prevention
  • Randomized Controlled Trial
  • Cohort Studies
     Quality Improvement
  • Randomized Controlled Trials

After using PICO to determine an answerable clinical question and the potentially highest level of study to look for, the next step is to search PubMed for the various studies. How do you locate each of the different studies?

A simple search in PubMed allows access a side bar of options to target specific article types.

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Scrolling through these options, you’ll locate Case Reports, Comparative Studies, Guidelines, Meta-Analyses, Randomized Controlled Trials, and Systematic Reviews. Selecting these study types prior to executing a search string may cause confusion when they disappear in PubMed results. It simply means that your search string located Randomized Controlled Trials but no Systematic Reviews, for example.

Publication Type [PT] is another option in locating both study characteristics and publication types. A full list of Publication Characteristics (Publication Types) can be found here: http://www.nlm.nih.gov/mesh/pubtypes2006.html.

Examples of Study Characteristics within Publication Type [PT]
  • Case Reports
  • In Vitro
  • Clinical Conference
  • Meta-Analysis
  • Clinical Trial +
  • Multicenter Study
  • Comparative Study
  • Scientific Integrity Review
  • Census Development Conference
  •  Twin Study
  • Evaluation Studies
  •  Validation Studies

Utilizing MeSH (Medical Subject Headings) is another way to locate studies not retrieved when searching for a Publication Type or Study Characteristic. These items are not listed within the filters or the [PT] field. In MeSH, you’ll be able to locate:

  • Crossover Studies
  • Cohort Studies
  • Random Allocation
  • Placebos
  • Treatment Outcome

Knowing that “Cohort Studies” is a MeSH term will give you the chance of locating the potential Prognosis, Etiology, and Prevention studies not found in the Article Type or [PT] section. Try searching with MeSH if you’re having a difficulty locating an article type or characteristic.

Finally, one last option would be to add a keyword within the search string and look at the “Search Details” section to see how PubMed interpreted the keyword entry.

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Locating a particular study or study type characteristic can be tricky in PubMed. However, we’re happy to provide tips and suggestions to help you navigate PubMed and other NLM resources. If your organization is interested utilizing PubMed to locate evidence-based medicine resources, NN/LM SE/A is pleased to offer PubMed and the Evidence-Based Universe. This course is available as a 2 hour and 4 hour course. To schedule this course, please contact Tony Nguyen at tnguyen@hshsl.umaryland.edu.

 

 

 

Free Online Class Announcement: Public Health Information on the Web

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Class:  Public Health Information on the Web

Where: Free, Online via Moodle. Moodle does not require a software download.

Presenter: Sheila Snow-Croft, MLIS, MA, Public Health Coordinator. National Network of Libraries of Medicine, Southeastern Atlantic Region (NN/LM SE/A)

Contact Sheila at: ssnowcro@hshsl.umaryland.edu

Register: http://nnlm.gov/sea/training/register.html

Date/Time: August 5-26, 2014

Three webinars will be broadcast during this class:

  • Thursday, 8/07/14: 11am – 12pm  ET
  • Thursday, 8/14/14: 11am – 12pm  ET
  • Thursday, 8/21/14: 11am – 12pm  ET

Summary:  The field of public health encompasses a wide array of disciplines including health education, epidemiology, and nursing. Digital literacy and the effective utilization of online information are among the core public health informatics competencies of the 21st century. This course will highlight web resources tailored to the public health workforce and public health information specialists.

The course uses Moodle, a free online course management system that does not require a software download. There will be three 1 hour Adobe Connect webinars along with discussions and assignments. If attending the live webinars is not possible, recordings will be available for viewing afterwards.

Participants who complete all requirements will be eligible for 4 Medical Library Association Contact Hours.

Last updated on Friday, 22 November, 2013

Funded by the National Library of Medicine under contract HHS-N-276-2011-00004-C with the Health Sciences and Human Services Library of the University of Maryland