REALISE‐ing their potential?: implementing local library projects to support evidence‐based health care

Librarian involvement in Evidence‐based Health Care provides many opportunities at a local level. Unfortunately, the potential for innovative projects to inform future developments is generally lost by a failure to ‘pass the baton’—to identify lessons learnt and transferable principles. The ‘Library Support for Evidence‐based Health Care’ Project, funded by the NHS Executive Northern and Yorkshire, resulted in the implementation of locally responsive packages of hardware and software in six of the Region’s libraries. The opportunity to evaluate the collective experience of these sites, and to synthesize principles of good practice, was provided by a separately funded post‐hoc evaluation, the Research Evaluation to Audit Library and Information Support for EBHC (REALISE). This paper reports on how this evaluation was conducted, documents the strengths and weaknesses of the Project itself, and attempts to provide a checklist for use in similar projects. The paper concludes by outlining the relevance of the findings to the introduction of planned organizational approaches to quality (clinical governance) and the development of local implementation strategies across the UK, required by the NHS Information Strategy, Information for Health.     

Evidence‐based design for discoverability: A case study

Key points

• Lean methods can give rich insights: Even a few, short sessions with a handful of users can generate useful inputs for a user‐centric design process.
• Design for beginners: An interface that supports novices will also support experts.
• Keep it simple: Focus on functionality that supports core search and discovery tasks.
• Popular or high‐value features should have prime position and rarely used or low‐value features should be hidden or removed.
• Visual cues are important for usability, as is balancing the visual space.

     

Levels of consciousness and awareness about evidence‐based medicine among consultants in tertiary health care institutions in Nigeria

Aims and objectives: Evidence‐based medicine (EBM) incorporates results of health care research when making decisions about the clinical care of individuals. Information and communication technologies now play significant roles in organizing available research results in EBM software suites. This study examines the level of consciousness and awareness about EBM of consultants in tertiary health institutions in Nigeria. Methods: A total of 100 consultants were randomly selected from 10 of the 29 teaching hospitals in Nigeria and data were collected using a questionnaire and an interview schedule. From this data, 64 EBM awareness and utilization variables were identified and data on the dynamics of their inter‐relationships were reported by 89 of the participants. Results: Of the 89 respondents, less than half (47.19%) have knowledge about EBM that could be considered as high, while EBM knowledge is low for the remaining respondents (52.81%). Evidence Summaries appear to be a more popular tool among the respondents than the resources of Journals and Clinical Guidelines. Conclusions: Consultants in the teaching hospitals appeared not to have the high level of EBM consciousness and awareness that would be expected of them, although there is a consciousness that EBM will foster ease of access and promote equity in health care services.     

Controlled before‐after study to evaluate change in evidence‐based practice of speech and language therapy students

Background

The integration of evidence‐based practice (EBP) into speech and language therapy (SLT) curricula has been increasingly encouraged in recent years.

Objectives

The study aimed to evaluate whether an educational module on EBP for undergraduate SLT students can improve their EBP competencies.

Methods

The EBP module, taught by a SLT faculty member and a librarian, was delivered over 2 months. All fourth year SLT students (trained group) and all fourth year psychology students (control group) of the University of Liège (Belgium) were asked to participate in the study. Their performance on an adapted Fresno test was measured before and after the module. In addition, the SLT students took a computer‐based searching task. They were also asked to share their perceptions towards the module.

Results

All the 47 SLT students and 57/108 psychology students took the pre‐ and post‐tests. Although both groups performed similarly at the baseline, only the trained students gained new skills and knowledge. Furthermore, 36 SLT students shared their perceptions on the module and offered suggestions on ways to improve it.

Discussion‐Conclusion

Trained students improved their EBP competencies. Nevertheless, the module could be strengthened along with better integration of EBP into clinical modules and across the curriculum.

     

A rapid evidence‐based service by librarians provided information to answer primary care clinical questions

Background: A librarian consultation service was offered to 88 primary care clinicians during office hours. This included a streamlined evidence‐based process to answer questions in fewer than 20 min. This included a contact centre accessed through a Web‐based platform and using hand‐held devices and computers with Web access. Librarians were given technical training in evidence‐based medicine, including how to summarise evidence. Objectives: To describe the process and lessons learned from developing and operating a rapid response librarian consultation service for primary care clinicians. Methods: Evaluation included librarian interviews and a clinician exit satisfaction survey. Results: Clinicians were positive about its impact on their clinical practice and decision making. The project revealed some important ‘lessons learned’ in the clinical use of hand‐held devices, knowledge translation and training for clinicians and librarians. Conclusions: The Just‐in‐Time Librarian Consultation Service showed that it was possible to provide evidence‐based answers to clinical questions in 15 min or less. The project overcame a number of barriers using innovative solutions. There are many opportunities to build on this experience for future joint projects of librarians and healthcare providers.     

Adopting evidence-based practice in clinical decision making: nurses' perceptions, knowledge, and barriers

Objective:

Evidence-based practice (EBP) provides nurses with a method to use critically appraised and scientifically proven evidence for delivering quality health care to a specific population. The objective of this study was to explore nurses'' awareness of, knowledge of, and attitude toward EBP and factors likely to encourage or create barriers to adoption. In addition, information sources used by nurses and their literature searching skills were also investigated.

Method:

A total of 2,100 copies of the questionnaire were distributed to registered nurses in 2 public hospitals in Singapore, and 1,486 completed forms were returned, resulting in a response rate of 70.8%.

Results:

More than 64% of the nurses expressed a positive attitude toward EBP. However, they pointed out that due to heavy workload, they cannot keep up to date with new evidence. Regarding self-efficacy of EBP-related abilities, the nurses perceived themselves to possess moderate levels of skills. The nurses also felt that EBP training, time availability, and mentoring by nurses with EBP experience would encourage them to implement EBP. The top three barriers to adopting EBP were lack of time, inability to understand statistical terms, and inadequate understanding of the jargon used in research articles. For literature searching, nurses were using basic search features and less than one-quarter of them were familiar with Boolean and proximity operators.

Conclusion:

Although nurses showed a positive attitude toward EBP, certain barriers were hindering their smooth adoption. It is, therefore, desirable that hospital management in Southeast Asia, particularly in Singapore, develop a comprehensive strategy for building EBP competencies through proper training. Moreover, hospital libraries should also play an active role in developing adequate information literacy skills among the nurses.

Highlights

• Nurses in Singapore, as in other countries, support the idea of evidence-based practice (EBP) but have limited skills in the area of literature searching and understanding evidence, which limits their use of evidence-based practice.
• Only a small number of nurses were able to pick an appropriate search strategy for a given topic, indicating a lack of basic literature searching skills.
• Sufficient literature searching knowledge is essential to retrieve current, relevant, and accurate evidence. However, a majority of nurses do not know how to properly use Boolean and proximity operators, indexing, truncation, or limits.

Implications

• Librarians need to be part of providing ongoing training for clinical nurses in searching the evidence, especially in hospitals promoting EBP or seeking Magnet status.
• Training is needed for clinical nurses to be able to achieve the use of EBP, and librarians can support this goal by teaching the search strategies portion of an EBP skills course.
• This study''s instrument could be used by librarians as a needs assessment tool to measure their own clinical nurses'' information literacy skills, if justification is needed locally.

     

Leadership competencies and the importance of research methods and statistical analysis in decision making and research and publication: A study of citation patterns

The roles of academic librarians and administrators include the use of statistical analysis and general analytical abilities in their decision-making processes, as well as in their roles as researchers, in developing research collections, and in providing instruction and reference assistance for students and other researchers. The research presented in this article addresses the original research published in frequently cited library and information science (LIS) journals to consider the extent to which academic librarians and administrators conduct and publish original research and to evaluate the range of research methodologies used and the level of collaboration among academic librarians, LIS faculty members, and others. The research results extend the prior self-report research in this area and indicate that academic librarians, administrators, and LIS faculty are authors of most of the published research in highly ranked journals. The level of collaboration among those in different types of roles is limited, however. In addition, most of the research articles have been authored or coauthored by those in research university libraries.     

Using research evidence in mental health: user‐rating and focus group study of clinicians’ preferences for a new clinical question‐answering service

Background and objectives: Clinicians report difficulties using research in their practices. The aim of the study was to describe needs and preferences for a mental health clinical question‐answering service designed to assist this process. Method: Multi‐disciplinary clinicians participated in a focus group; users of the service supplied feedback. Results: Fifty‐four clinicians received answers to 84 questions about mental health treatments. User ratings showed that the answers had multiple uses: informing health care (43), education (22), staff development (28) and research (12), and were considered useful, clear, relevant and helpful. Focus group participants appreciated critically appraised summaries of evidence and stressed the time‐saving benefit of the service. Clinicians without a medical training were least confident in applying evidence. Attitudes to research were positive, but concern was expressed about its potential misuse for political purposes. This appeared to arise from an ambiguity around the term ‘insufficient evidence’, which participants felt is widely misinterpreted as ‘evidence of no effect’. Conclusions: A highly valued, responsive service has been developed. A range of clinicians find critically appraised summaries of research useful. Education about the use of research may help clinicians to be more evidence based.