1. A Practical Approach to Nursing Evidence UWHC Nurse Residents ‘09 Stephen Johnson, MLSEbling LibraryUniversity of Wisconsin

2. “The rate and magnitude of change is such that the contents of a student, like the contents of a text-book, are partly out of date at the time of publication.” C. Sidney Burwell, Dean of Harvard Medical School, 1947 “The fact that an opinion has been widely held is no evidence whatever that it is not utterly absurd.” Bertrand Russell (1872-1970)

3. “…conscientious, explicit and judicious use of the current best evidence in making decisions about the care of individual patients…” Sackett DL et al. Evidence-based medicine: how to practice and teach EBM. Edinburgh: Churchill Livingstone, 1998, p.2.

5. 400 online books

6. 4200 online journals

7. Linked via Find It Free document delivery Journal articles – via pdfs to email (Library Express) Book chapters – via pdfs to email (Library Express)

9. Email askebling@library.wisc.edu

10. Reference Librarian on duty 608.262.2020

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14. to activate go to https://www.mynetid.wisc.edu/activate

16. A scenario Patient with history of ischemic cardiomyopathy and a GFR of 40 is admitted with unstable angina. It is determined that he needs to go to the cath lab. Vague question: How might the risk of acute renal insufficiency be minimized?

18. UptoDate– contains over 70,000 pages of text

19. NursingConsult– includes 30 clinical texts (full text)

20. STAT!Ref – includes 20 clinical texts (full text)

21. Stedman’s Medical Dictionary

22. BMJ Clinical Evidence – covers 4000 interventions/230+ conditions

23. Harrisons – the textbook for Internal Medicine

24. MICROMEDEX – collection of drug databases

25. More

26. Print Sources

28. Hierarchy of articles high Evidence-based guidelines (best, current) Clinical summaries Systematic reviews Meta analyses Controlled trials (CTs and RCTs) Prospective cohort studies Case-control (retrospective cohort) studies Case studies Opinion of authorities, editorials Level of Evidence low 11

29. “EBP is a problem-solving approach to clinical decision making in a healthcare organization that integrates the best available scientific evidence with the best available experiential (patient and practitioner) evidence, considers internal and external influences on practice, and encourages critical thinking in the judicious application of such evidence to care of the individual patient, patient population, or system.” Newhouse, R, Dearholt S, Poe S, Pugh LC, White K. The Johns Hopkins Nursing Evidence-Based Practice Model. Baltimore: The Johns Hopkins Hospital, Johns Hopkins University School of Nursing; 2005.

30. UWHC Nurses have adopted the Iowa Model of EBP Research Not Sufficiently Developed to Guide Practice Conduct Research Consult with Experts Determine Scientific Principles

31. Finding basic info (who, what, when, where, why, how) about diseases, therapies, etc. Digging deeper on a specific topic, therapy, diagnostic test (EBM). Keeping an eye on the literature for new findings, etc. 3-pronged approach Background Resources Lifelong Learning Keeping Current PrimaryResearch/ Clinical Resources

32. Keeping Current with RSS Decide what information you need/want tables of contents from journals nursing and medical blogs subject searches in PubMed and other databases health and nursing news

33. Keeping Current with RSS Decide how you want to view your feeds Personalized page from Google/Yahoo/Netvibes Google Reader, Bloglines, or other feed reader Feeds to e-mail Subscribe to feeds Look for Use your reader to find feeds