In this module I had the opportunity to use the CINAHL electronic index, the National Guideline Clearinghouse (NGC) index, and Google Scholar search engine.
As previously mentioned in an earlier response, I originally searched with PubMed. Given my topic (neutropenia and dietary restrictions) was more relevant to nursing I discovered CINAHL to be better suited for nursing interventions. The use of MeSH topics helped to further my search to include related subjects. I also liked the ease of use for even the most novice nurse to be albe to readily add to my folder and later choose to either export to ENDNOTE or email my self a copy of the text. I believe this index would be relative easy to refer to for frontline nurses.
In comparison, I found Google scholar did not provide me as much assistance in narrowing my search. I also felt there was less evidence of reliable research in this search engine. For example, I found it difficult to determine if entries were peer reviewed. Many of the links were books for purchase from a variety of vendors, and fewer entriess were linked to journal articles. This was a dissatisfier for me. I do not want to join a multitude of libraries, or pay for copies I may not find useful.
I was excited to discover the NGC. In our work setting we have unit-based clinical practice councils comprised of frontline nurses. Often, as a result of this forum, the nurses are given the task of performing a literatire review. It is a useful tool to have written guidelines for specific diseases, interventions, or national measures from the Agency for Healthcare Research and Quality (AHRQ). It was not so long ago I used to have to refer to specific AHRQ guidelines in multiple paperback books. Another thing I found user friendly about the NGC site was the ability to view the data in a simple outline form, clearly divided in sections which help identify the scope, methodology, supporting evidence, and even the risk vs benefits of the intervention. In addition, if you desire to discover what does a particular organization, such as the American Cancer Society recommend, you can even look up a guideline from their organization's posted list.
In summary, I am embarrassed to admit I was fearsul of this assignment, due to the difficulties I have experienced in the past with search engines. I recognize the need to be open to using a variety of electronic indexes and not limit myself to using only MEDLINE as I have done in the past. I further understand the way I set up the search strategy will determine the sensitivity of the result to context of a specific clinical problem. Narrowing the search using related topics, MeSH terms, and the correct index will retrieve relevant reference data.
Friday, February 13, 2009
Thursday, February 12, 2009
Module 2 Question 2
CINAHL has several features which I found helpful such as being able to ask for full text, dates, application to specific pupulations, ages, as well as types of articles (research verses review). As a nurse manager of an inpatient unit, I really appreciate the filter for inpatients. The ability to further narrow the search by adding more rows seems much easier to me than remembering to aype in AND/OR in the search. Another feature I found interesting was the "Cited References" which drew me to other articles realted to my subject. The simplicity of clicking on the ADD to FOLDER button was very easy so I did not have to remember to send to my clipboard first. when I open my folder view the references are easily exported to Endnote via the use of icons at the top of the screen.
Module 2 Question 1
Being a long time oncology nurse, I felt the need to research the question of whether or not dietary restrictions are effective for neutropenic patients. I originally searched PubMed, but discovered more nursing information was available on CINAHL. Having never used this index, I was challenged and found myself having to go back and forth to fully appreciate the value the advanced search options. I appreciated the first screen asking me what other libraries or sources of information I would like to search. I did not notice this the first two times I tried and couldn't figure out why there was no references, only to learn I was only searching "business" topics. Given my novice level with this index, my search was rather time consuming, but I believe this was due to my inexperience. I also found there was less information available than I had anticipated.
I believe this is an excellent index for use in daily practice for nurses. The other indexes I tried were not as helpful in finding literature on my subject. I also attempted a Google Scholar search, but found this more frustrating as there were less opportunities to narrow down the search to my defined population (neutropenic).
I believe this is an excellent index for use in daily practice for nurses. The other indexes I tried were not as helpful in finding literature on my subject. I also attempted a Google Scholar search, but found this more frustrating as there were less opportunities to narrow down the search to my defined population (neutropenic).
Friday, February 6, 2009
N6004 Module 1
1. Introduction:
A quick glance to my profile shows I am no "Spring chicken"! I have a keen interest in medical oncology and have chosen to work towards my master's degree in the Clinical Nurse Leader (CNL) program. As a nurse manager in the ever changing world of healthcare, I am acutely aware of the need for information management. Nurse leaders must not only value the use of information technology (IT), but also be able to understand how the nurses workflow can be changed (hopefully for the better) to allow more time to be spent with the patients.
2. IT in our clinical setting:
We are anxiously awaiting the "go-live" date (May 2nd) for our Computerized Provider Order Entry (CPOE) system. Last March the insitution had to pull the plug on the system the evening before our intended date of implementation. Recognizing the need to assure patient safety, the use of the computerized system for provider orders is our next giant step to eliminating unnecessary medical errors due to illegible handwriting, use of unappproved abbreviations, etc. About 20 months ago, nursing documentation was converted to electronic charting. This documentation allows for more standardized documentation through use of checklists whenever possible, with minimal narrative entries. This was a rather difficult transition initially, especially for those of us (aged 50 and up) who had mastered the paper forms. The hardest concept for the nurse to fully understand was the need to help us quantify patient outcomes. Once it was recognized that reports could be generated to assist with quality improvement initiatives, they have become less resistant to this change in their workflow.
Another thing we are doing is trying to become more and more "green" in our immediate work area. For example, instead of having multiple paper copies of our unit's newsletter or other notices, I am developing our own website which will provide a secured access for such private information as employee contact numbers. I have been helping staff utilize the functions of the electronic scheduling system so RNs can assist in self-scheduling on-line. Ridding ourselves of the paper copies of the everchanging unit schedule has improved staff morale due to reduced errors.
A quick glance to my profile shows I am no "Spring chicken"! I have a keen interest in medical oncology and have chosen to work towards my master's degree in the Clinical Nurse Leader (CNL) program. As a nurse manager in the ever changing world of healthcare, I am acutely aware of the need for information management. Nurse leaders must not only value the use of information technology (IT), but also be able to understand how the nurses workflow can be changed (hopefully for the better) to allow more time to be spent with the patients.
2. IT in our clinical setting:
We are anxiously awaiting the "go-live" date (May 2nd) for our Computerized Provider Order Entry (CPOE) system. Last March the insitution had to pull the plug on the system the evening before our intended date of implementation. Recognizing the need to assure patient safety, the use of the computerized system for provider orders is our next giant step to eliminating unnecessary medical errors due to illegible handwriting, use of unappproved abbreviations, etc. About 20 months ago, nursing documentation was converted to electronic charting. This documentation allows for more standardized documentation through use of checklists whenever possible, with minimal narrative entries. This was a rather difficult transition initially, especially for those of us (aged 50 and up) who had mastered the paper forms. The hardest concept for the nurse to fully understand was the need to help us quantify patient outcomes. Once it was recognized that reports could be generated to assist with quality improvement initiatives, they have become less resistant to this change in their workflow.
Another thing we are doing is trying to become more and more "green" in our immediate work area. For example, instead of having multiple paper copies of our unit's newsletter or other notices, I am developing our own website which will provide a secured access for such private information as employee contact numbers. I have been helping staff utilize the functions of the electronic scheduling system so RNs can assist in self-scheduling on-line. Ridding ourselves of the paper copies of the everchanging unit schedule has improved staff morale due to reduced errors.
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