Web-based PDA downloads for clinical practice guidelines and decision support tools

The extraordinary volume of health-related information made available on the Internet comes at a high cost for effectively storing and accessing clinical information resources. Additionally, the ability to use critical patient care information is limited to the availability of computer access. Physicians and other health care professionals have readily adopted personal digital assistants (PDAs), also known as handheld computers, because the devices provide succinct critical patient care information at the point of need. Clinical practice guidelines available through the Internet for use with PDAs present health professionals, who have little time, with powerful information already formatted for point-of-care devices. This paper will review several strategies for finding and accessing point-of-care clinical information.     

The use of personal digital assistants in the health sciences: results of a survey.

OBJECTIVES: The purpose of this study is to determine how personal digital assistants (PDAs) are used on an academic health sciences campus to define the level of training and support the library can provide to the students and faculty. METHOD: A Web-based questionnaire was developed. A total of 1,538 health sciences faculty and residents were sent an email message requesting participation. Data from the returned surveys were analyzed with SPSS. RESULTS: Sixty-one percent of survey respondents used PDAs. The address book, date book, and calculator were the most common uses reported for PDAs. Residents also reported a high use of drug databases on their PDAs. Most survey respondents indicated they would like to learn more about clinical resources for PDAs. CONCLUSIONS: Many opportunities exist for librarians to provide training and support for PDAs, in addition to evaluation and promotion of clinical software for PDAs.     

Pharmacists’ utilization and interest in usage of personal digital assistants in their professional responsibilities

Background and objectives: Pharmacists use PDAs for performing various activities related to their profession. The objective of this study was to examine pharmacists’ utilization pattern and interest in usage of personal digital assistants (PDAs) in various facets of health care. Methods: A cross‐sectional survey was conducted by distributing a pre‐validated 23‐item instrument to a convenience sample of pharmacists (n = 295) in the Houston area. Usage frequency (0 = never to 5 = frequently) and interest in future use (1 = extremely disinterested to 5 = extremely interested) of PDAs for various activities were evaluated and compared across pharmacy practice settings. Results: Most pharmacists reported maximum use of PDAs, as personal organizers (3.7 ± 1.8), in obtaining drug information (2.9 ± 1.8) and as medical calculators (2.6 ± 1.9). Similar results were obtained while evaluating interest of pharmacists who did not have PDAs and have never used PDAs for these three activities. Hospital pharmacists owned and used PDAs significantly (P < 0.05) more often than community pharmacists. Conclusions: Pharmacists used PDAs for basic functions in their profession role. Application of PDA technology in community pharmacy settings may result in its better adoption in both the settings.     

Implementation of the Clinical Encounters Tracking system at the Indiana University School of Medicine

The Indiana University School of Medicine (IUSM) Office of Medical Education &Student Services directed the IUSM Educational Technology Unit to develop a Clinical Encounters Tracking system in response to the Liaison Committee on Medical Education's (LCME) updated accreditation standards. A personal digital assistant (PDA) and centralized database server solution was implemented. Third-year medical students are required to carry a PDA on which they record clinical encounter experiences during all clerkship clinical rotations. Clinical encounters data collected on the PDAs are routinely uploaded to the central server via the PDA HotSyncing process. Real-time clinical encounter summary reports are accessed in the school's online curriculum management system: ANGEL. The resulting IUSM Clinical Encounters Tracking program addresses the LCME accreditation standard which mandates the tracking of medical students' required clinical curriculum experiences.     

Information-seeking behavior of nursing students and clinical nurses: implications for health sciences librarians.

OBJECTIVES: This research was conducted to provide new insights on clinical nurses' and nursing students' current use of health resources and libraries and deterrents to their retrieval of electronic clinical information, exploring implications from these findings for health sciences librarians. METHODS: Questionnaires, interviews, and observations were used to collect data from twenty-five nursing students and twenty-five clinical nurses. RESULTS: Nursing students and clinical nurses were most likely to rely on colleagues and books for medical information, while other resources they frequently cited included personal digital assistants, electronic journals and books, and drug representatives. Significantly more nursing students than clinical nurses used online databases, including CINAHL and PubMed, to locate health information, and nursing students were more likely than clinical nurses to report performing a database search at least one to five times a week. CONCLUSIONS AND RECOMMENDATIONS: Nursing students made more use of all available resources and were better trained than clinical nurses, but both groups lacked database-searching skills. Participants were eager for more patient care information, more database training, and better computer skills; therefore, health sciences librarians have the opportunity to meet the nurses' information needs and improve nurses' clinical information-seeking behavior.     

Clinical librarianship in the UK: temporary trend or permanent profession? Part II: present challenges and future opportunities

BACKGROUND: This article is the second part of a two-part series reporting a study of the role of the Clinical Librarian (CL) in the UK. METHODS: A qualitative method of semi-structured interviews was used to explore in-depth the role of the CL. The interviews provided a rich source of data and give insight into this new and emerging role as practised in the National Health Service (NHS). Similarities and differences are examined between the CL population and reported within themes, specifically: personal qualities and skills required, training for the CLs, marketing the CL service, working in the clinical environment, monitoring and evaluation and the acceptance of the CL in the NHS. RESULTS: A common understanding of the skills and knowledge required to undertake the CL role was shared by the respondents. However, practice differed as this was often dictated by local circumstances. The study confirmed the need for the CLs to work with clinical colleagues in the clinical setting to enhance patient care. CONCLUSION: The importance of using best evidence to support patient care is a message that is slowly becoming the norm in the NHS and the CL role in this practice is demonstrated by this study.     

CD-ROM use by rural physicians

A survey of 131 eastern Washington rural family physicians showed that 59.5% owned a personal computer with a CD-ROM drive. There was an inverse correlation between the physicians' years in practice and computer ownership: 10 years or less (80.6%), 11 to 20 years (72.2%), 21 to 30 years (55.6%), and more than 30 years (32.4%). Those physicians who owned a computer used their CD-ROM for entertainment (52.6%), medical textbooks (44.9%), literature searching software (25.6%), drug information (17.9%), continuing medical education (15.4%), and journals on CD-ROM (11.5%). Many rural doctors who owned computers felt that CD-ROM software helped them provide better patient care (46.8%) and kept them current on new information and techniques (48.4%). Indications for medical education, libraries and CD-ROM publishers are noted.     

Design and evaluation of a personal digital assistant- based alerting service for clinicians.

PURPOSE: This study describes the system architecture and user acceptance of a suite of programs that deliver information about newly updated library resources to clinicians' personal digital assistants (PDAs). DESCRIPTION: Participants received headlines delivered to their PDAs alerting them to new books, National Guideline Clearinghouse guidelines, Cochrane Reviews, and National Institutes of Health (NIH) Clinical Alerts, as well as updated content in UpToDate, Harrison's Online, Scientific American Medicine, and Clinical Evidence. Participants could request additional information for any of the headlines, and the information was delivered via e-mail during their next synchronization. Participants completed a survey at the conclusion of the study to gauge their opinions about the service. RESULTS/OUTCOME: Of the 816 headlines delivered to the 16 study participants' PDAs during the project, Scientific American Medicine generated the highest proportion of headline requests at 35%. Most users of the PDA Alerts software reported that they learned about new medical developments sooner than they otherwise would have, and half reported that they learned about developments that they would not have heard about at all. While some users liked the PDA platform for receiving headlines, it seemed that a Web database that allowed tailored searches and alerts could be configured to satisfy both PDA-oriented and e-mail-oriented users.     

Consumer Health Informatics--integrating patients,providers, and professionals online

Consumer Health Informatics (CHI) means different things to patients, health professionals, and health care systems. A broader perspective on this new and rapidly developing field will enable us to understand and better apply its advances. This article provides an overview of CHI discussing its evolution and driving forces, along with advanced applications such as Personal Health Records, Internet transmission of personal health data, clinical e-mail, online pharmacies, and shared decision-making tools. Consumer Health Informatics will become integrated with medical care, electronic medical records, and patient education to impact the whole process and business of health care.     

Going mobile: free and easy

After almost two decades, mobile technologies are now such a part of the fabric of the hospital environment that hospital libraries must take this opportunity to continue to positively impact health outcomes by providing health professionals with valuable information and services via personal digital assistants (PDAs) and smartphones. This article provides background information on mobile technology use and handheld devices. It describes how hospital librarians, regardless of staff, budget, or access to technology, can position the hospital library to connect health professionals to clinically relevant mobile resources and library services. Suggestions for the promotion of mobile resources are included, as well as tips for keeping current. A significant amount of free content is identified.     

常态化疫情防控下个人电子健康档案建设:问题与措施

电子健康档案是个人健康管理、医疗诊断、临床治疗的重要依据,其规范建设是推动我国国民健康和医疗卫生发展的重要手段之一。通过阐释电子健康档案内涵,梳理国内外个人电子健康档案建设概况,揭示常态化疫情防控背景下个人电子健康档案建设的意义及存在问题,提出加强制度保障、宣传教育、技术维护、自我管理等常态化措施,为实现健康中国战略提供信息基石。     

Evaluating information skills training in health libraries: a systematic review

Introduction: Systematic reviews have shown that there is limited evidence to demonstrate that the information literacy training health librarians provide is effective in improving clinicians’ information skills or has an impact on patient care. Studies lack measures which demonstrate validity and reliability in evaluating the impact of training. Aim: To determine what measures have been used; the extent to which they are valid and reliable; to provide guidance for health librarians who wish to evaluate the impact of their information skills training. Methods: Data sources: Systematic review methodology involved searching seven databases, and personal files. Study selection: Studies were included if they were about information skills training, used an objective measure to assess outcomes, and occurred in a health setting. Results: Fifty‐four studies were included in the review. Most outcome measures used in the studies were not tested for the key criteria of validity and reliability. Three tested for validity and reliability are described in more detail. Conclusions: Selecting an appropriate measure to evaluate the impact of training is a key factor in carrying out any evaluation. This systematic review provides guidance to health librarians by highlighting measures used in various circumstances, and those that demonstrate validity and reliability.     

Participating in Communities of Practice

ABSTRACT

Hospital librarians understand they need to move outside the four walls of the physical library and provide information support for clinicians in various settings. Librarians round with patient care teams as clinical librarians. They sit on quality improvement and patient safety committees in order to provide information to those groups. Many are members of their organization's Institutional Review Board. Some of these activities are done for a specific purpose and are short-lived. Other activities become institutionalized as the value of the librarian's contribution is recognized. This article will describe examples in which hospital librarians are part of multidisciplinary teams created to improve patient care in their hospital.     

Librarians as hidden gems in a clinical team

Medical librarians typically contribute to patient care from the confines of the library in response to practitioners' requests for literature searches, information pearls, and evidence-based information. While this model has long served the needs of active clinicians, the learning environment of residency programs is ripe for innovative librarian involvement. This paper illustrates how the librarian can become part of a clinical team outside of the library and provide real-time reference services while teaching by example. Benefits of the alliance include the integration of disciplines to provide enhanced resident learning and improved patient care.     

DynaMed Plus®: An Evidence-Based Clinical Reference Resource

DynaMed Plus^® from EBSCO Health is an evidence-based tool that health professionals can use to inform clinical care. DynaMed Plus content undergoes a review process, and the evidence is synthesized in detailed topic overviews. A unique three-level rating scale is used to assess the quality of available evidence. Topic overviews summarize current evidence and provide recommendations to support health providers at the point-of-care. Additionally, DynaMed Plus content can be accessed via a desktop computer or mobile platforms. Given this, DynaMed Plus can be a time-saving resource for health providers. Overall, DynaMed Plus provides evidence summaries using an easy-to-read bullet format, and the resource incorporates images, clinical calculators, patient handouts, and practice guidelines in one place.     

The role of assertiveness,personal control,and participation in the prediction of nurse Burnout

The research reported here considered a critical problem facing today's hospital: burnout and commitment of nurses. A review of the literature revealed that nurse communication, particularly participation or collaboration in patient care decisions, had rarely been considered in models of nurse commitment. A model was proposed in which nurse participation and assertiveness were key predictors of emotional exhaustion, commitment and intent to remain, and the theoretical construct of personal control was used as a moderating variable in predicting these outcomes. The model was tested on a sample of nurses from a large hospital Results were generally supportive of the proposed model. Implications of the model for theory were discussed in terms of the role of personal control and the importance of nurse assertiveness, and applications for nurse and physician training were considered.     

Clinical medical librarian impact on patient care: a one-year analysis.

The primary role of the clinical medical librarian (CML)--locating and providing quality-filtered, patient-specific information to physicians--has been questioned recently because of the dramatic rise in end-user searching. This study administered a questionnaire to evaluate the current impact of this service in a major hospital setting with a long established CML program. The study showed that the CML provided house officers with information that affected patient care (defined as diagnosis, diagnostic tests, or treatment) between 40% and 59% of the time. This was true even though most physicians reported they generally researched the question prior to consulting the CML. In addition, the house officers in this study indicated that they distributed the CML-provided information to other health care providers 56%-96% of the time. Based on these limited results, it appears that CMLs can continue to provide information that has a strong impact on patient care, despite the availability of an end-user local MEDLINE system.     

Information-seeking behavior changes in community-based teaching practices.

A National Library of Medicine information access grant allowed for a collaborative project to provide computer resources in fourteen clinical practice sites that enabled health care professionals to access medical information via PubMed and the Internet. Health care professionals were taught how to access quality, cost-effective information that was user friendly and would result in improved patient care. Selected sites were located in medically underserved areas and received a computer, a printer, and, during year one, a fax machine. Participants were provided dial-up Internet service or were connected to the affiliated hospital's network. Clinicians were trained in how to search PubMed as a tool for practicing evidence-based medicine and to support clinical decision making. Health care providers were also taught how to find patient-education materials and continuing education programs and how to network with other professionals. Prior to the training, participants completed a questionnaire to assess their computer skills and familiarity with searching the Internet, MEDLINE, and other health-related databases. Responses indicated favorable changes in information-seeking behavior, including an increased frequency in conducting MEDLINE searches and Internet searches for work-related information.