Friday, December 28, 2007

What are RSS feeds?

Not really sure what RSS feeds are or how they might help you keep updated? If your library has OVID databases, the new OVID SP has the capability to subscribe to tables of contents of OVID journals through the RSS technology.

Burlew Medical Library at St. Joseph Hospital in Orange, California has developed a brief document that will explain the RSS technology and give you some ideas as to how you might use RSS.

For instance, some of the RSS feeds to which I subscribe are:

Nursing Research table of contents
Krafty Librarian blog
Pubmed search on autistic disorder
Shifted Librarian blog
Consumer Health Forum
Reuters Health

I valiantly try to set time aside once a week to visit my bloglines reader and catch up on all my new feeds. It's really a " one stop" approach to shopping for the new information that meets your particular interests.

Does anyone in the blogosphere want to share how they use RSS technology and what their favorite nursing feeds are?

Wednesday, December 12, 2007

Systematic Review Made Simple for Nurses

There is an excellent article in SGH Proceedings v 16(2):104-110 2007 by Leong Siew Teing titled Systematic Review Made Simple for Nurses. This article is available as free full text. The SGH Proceedings is a refereed scientific journal of the Singapore General Hospital. The article also highlights a three phase lit search strategy recommended by the Joana Briggs Institute (JBI).

Friday, December 07, 2007

Cochrane Collaboration on YouTube

Evidenced based resources on YouTube-- who would have thought!!

View this brief 7 minute videotape that gives a great overview of the Cochrane Collaboration and the Cochrane Library.

Wednesday, December 05, 2007

Abstract with Commentary

Abstract and Commentary

Robinson, S. et al. (2007). Development of an evidence-based protocol for reduction of indwelling urinary catheter usage. MEDSURG Nursing, 16, 157-161.

Author’s Abstract

Studies indicate 40% of indwelling urinary catheters are unnecessary in hospitalized patients (Gardam, Amihod, Orenstein, Consolacion, & Miller, 1998; Gokula, Hickner, & Smith, 2004). The results of a protocol developed to limit catheter use are described.

Commentary by Dana Rutledge, RN, PhD, Nursing Research Facilitator

The project was framed in the Iowa Model of Evidence-Based Practice (EBP; Titler et al., 2001), the same model adopted at St. Joseph Hospital. Nurses at a large tertiary care center identified a potential problem: inappropriate use of indwelling urinary catheters. The trigger to action was guidelines developed by the Nurses Improving Care to Health System Elderly (NICHE). The guidelines recommend limiting catheters to elders with very specific problems such as urinary retention.

Chart audits of patients with indwelling catheters found 17% with documented urinary tract infections (UTI). A team was formed to develop a protocol to encourage more appropriate use of indwelling catheters. This group reviewed 32 articles on the topic, about half of which were rated as strong evidence sources. Based upon the evidence, they determined when urinary catheters are appropriate in hospitalized patients.[1]

A pre-protocol chart audit indicated that 35% of patients had a urinary catheter at some time during hospitalization. Of these, 42% had no appropriate reason for catheter use. Only 70% had an order for insertion. Almost 40% were inserted in the emergency department. Almost 2/3 were not removed until day of discharge. Symptoms of UTI developed in 38% of patients.

A 2-week pilot test was done with nurses requesting an order for removal of the catheter unless it was used for one of the criteria in the footnote below, along with use in patients 48 hours post surgery. Afterwards, mean days that catheters were in place dropped from 8.6 to 4.5 days, orders to remove increased (43% to 93%), documentation of removal increased (57% to 87%), and only 7% of patients had catheters in on discharge day. In the pilot group, only13% had UTI symptoms.

To institute this change in practice (nurses asking for catheter removal), a multi-method educational effort ensued. Pilot outcomes were disseminated, along with findings from the literature. Physicians were educated at several formal gatherings. This manuscript does not describe outcomes from the full scale implementation.

Can you think of which patients at SJH may have inappropriate urinary catheters? What methods could be used to decrease their use? What resources would be needed to implement these methods?

Titler, M.G. et al. (2001). The Iowa Model of Evidence-Based Practice to Promote Quality Care.
Critical Care Nursing Clinics of North America, 13, 497-509.

[1] For bladder irrigation or instillation of medication; to provide relief of urinary tract obstruction; to permit drainage in persons with neurogenic bladder dysfunction or urinary retention not manageable by other means; to obtain accurate intake and output in critically ill patients; to aid in urologic or related surgery; to manage urinary incontinence in persons with stage 3 or 4 pressure ulcers; and to promote comfort care in the terminally ill

Tuesday, December 04, 2007

Medcal Library Association's white paper on magnet recognition

Our blog is mentioned in the Medical Library Association's white paper: Magnet Recognition Program Collaboration Proposal: The American Nurses Credentialing Center and the Medical Library Association. One of the sections deals with Librarians' contributions to their institutions' magnet journey and gives examples of nurse/librarian collaborations. Our blog is mentioned at the end of this section and is the only activity of this kind listed in the contribution section. Way cool!!