Partner with these professionals to aid evidence-based practice.
As a nurse in the emergency department (ED), you notice that patient falls have doubled over the past month. You wonder how they could have been prevented. You don’t want to presume your experience holds all the answers. Perhaps someone has completed a study on fall prevention in the ED? You’ve heard that implementing evidence-based care has been shown to improve patient outcomes and even reduce costs, but you’re not sure what that means or how to identify it. You’re not alone. According to a recent study in Worldviews on Evidence-Based Nursing, a significant number of practicing nurses report that they don’t believe they’re meeting evidence-based practice competencies in the workplace.
You want to use evidence-based practice to develop a falls prevention program, but you don’t know where to start and you’re not sure how you’ll find the time. Is there someone you could ask?
Yes. Ask a librarian.
The librarian’s role
Health science librarians are important members of the healthcare team. Many hospitals have their own librarian or have access to one through their associated university. However, librarians’ job responsibilities frequently are misunderstood. Searching the literature is what comes to mind most frequently, but that’s only one aspect of the role. Many librarians also manage collections (including print and electronic materials), plan events and programs, and provide instruction. They form partnerships with hospital staff, attend rounds with healthcare practitioners, collaborate on systematic reviews, and serve on hospital-wide councils.
Some of the services librarians may perform include:
- conducting literature searches to support and inform nursing guidelines and protocols
- teaching healthcare professionals how to navigate and use databases such as CINAHL and PubMed
- identifying resources for professional development and internal education
- collaborating with healthcare professionals on research, grants, patient care initiatives, and hospital councils
- ordering articles or materials that aren’t online or maintaining consumer health collections for patients and families who visit the hospital
- serving on nursing or hospital-wide councils that focus on evidence-based practice, informatics, or patient care experiences.
Librarians also may recommend resources to determine where to disseminate findings, suggest data management strategies, and partner with hospital leadership to ensure healthcare professionals have access to the resources they need for continuing education, patient care, and point-of-care.
Librarian education and training
Librarians’ education and training prepare them to efficiently locate answers to clinical questions within the scholarly literature. In addition to a graduate degree in library and information science (which includes classes in information access, organization, and retrieval), librarians may receive training in cataloging, data management, and document preservation.
Librarians may or may not have a background in health sciences. If they don’t, they acquire health science knowledge through experience, not unlike some areas of nursing. unlike some areas of nursing.
Be prepared
When you want to ensure your practice is evidence-based, consider contacting your librarian. To make the best use of your and the librarian’s time, prepare for the meeting, using the following questions as a guide.
- What’s your question? Consider using the PICOT (Patient/Population, Intervention, Comparison intervention, Outcomes, and Timeframe [optional]) acronym to guide you, and use concise phrases to clearly express parts of your question. Remember that this is a starting point. The librarian can help you refine your question or think through options.
- What are you going to do with the information? For example, do you want to develop policies and procedures, improve care quality, or design patient education? This will help the librarian know how comprehensive the search should be.
- What kind of research have you already done? If you’ve already done some searching on your own, where did you look and what were your search terms? What search terms would you suggest? This provides helpful insight to your librarian.
- What kinds of information are you looking for? Are you looking for guidelines, literature reviews, or original research studies? Although it’s not always possible for librarians to locate high levels of evidence for every question, this will help the librarian know where to focus.
- How far back in the literature do you want to go? Although more recent results are preferred, keep in mind that some of the most appropriate literature to answer a question may be over 5 years old.
- When do you need the information? Naturally you want it as soon as possible, but the librarian may have other pending projects; suggest a 1- to 2-week timeline.
Before your meeting, share your questions so the librarian has an opportunity to familiarize themselves with your topic. Your meeting may be in the librarian’s office, a conference room near your unit, via conference call, or through email. Begin by ensuring you’re both on the same page with regard to expectations and the question’s scope. Be specific about the types of articles you’re interested in, the scope of the search, and the timeframe.
After completing the search, the librarian may email you citations, PDFs, or a link to the search they developed. If you use a citation or bibliography manager like EndNote or Zotero, the librarian may send you a link or a file that you can download. (These tools create a database of your references so that you can easily sort, format, and access them.)
Partner for success
You and the librarian are partners in this project. The librarian is the search expert, but you’re the content expert. Even if you and the librarian correspond by email only, you’ll need to provide input beyond an explanation of your questions and expectations. The best results are obtained when both parties are actively engaged.
You and the librarian team up to identify several studies on falls prevention in the ED. Because the studies come from scholarly literature databases and not a general internet search, you know the resources are credible and peer-reviewed. After reading through them, you initiate change in your department, knowing that the care you provide is based on the most current evidence in clinical nursing practice.
The authors are faculty and nursing liaison librarians at the University of Illinois at Chicago.
References
American Association of Nurse Practitioners. Why choose evidence-based practice? October 26, 2018. aanp.org/news-feed/why-choose-evidence-based-practice
American Journal of Nursing. Evidence-based practice, step by step. June 17, 2021. journals.lww.com/ajnonline/pages/collectiondetails.aspx?TopicalCollectionId=10
Melnyk BM, Gallagher‐Ford L, Zellefrow C, et al. The first U.S. study on nurses’ evidence‐based practice competencies indicates major deficits that threaten healthcare quality, safety, and patient outcomes. Worldviews Evid Based Nurs. 2018;15(1):16-25. doi:10.1111/wvn.12269
Nurse.com. Evidence-based practice. nurse.com/evidence-based-practice
