AW Library Newsletter - September 2022: The 5As of Evidence-Based Practice - New eBooks - Nurses Choice

  

Ascension Wisconsin Librarians support your health care decisions with evidence-based research and full text resources.  

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Catch up on the latest news from Ascension Wisconsin Library Services:

How to Find Library Services on the New GDA-Wisconsin Intranet

The 5 As of Evidence-Based Practice (Series)

Evidence-Based Practice: A Quick Overview (Part 1)

The 5 As of Evidence-Based Practice: Ask (Part 2)

The 5 As of Evidence-Based Practice: Acquire (Part 3)

The 5 As of Evidence-Based Practice: Appraise (Part 4)

The 5 As of Evidence-based Practice: Apply & Assess (Part 5)

New eBooks: 

• Atlas of Procedures in Neonatology 
• Hale's Mother's Milk 2023
• Pediatric Clinical Practice Guidelines & Policies 2022
• Current Medical Diagnosis & Treatment 2023

Clinical Key Content Updates - August 2022

Nurses Choice Recommended Reading - September 2022

Student Debt Relief's Effect on Physicians & Nurses

Link to the August 2022 AW Library Newsletter.

Diabetes News Flash - September 2022 

Questions, comments, or search requests, contact Your Ascension Wisconsin Librarians: 

 Michele Matucheski   &   Kellee Selden

Our AW Library website is available 24/7.

Nurses Choice Recommended Reading - September 2022

 

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September 2022 See what your fellow nurses are reading! Browse this month's round-up of 10 top articles from Lippincott's prestigious list of nursing journals. Sepsis Resources for Nurses

Simplifying neurologic assessment Nursing made Incredibly Easy!, September/October 2022 Increasing Racial and Ethnic Diversity in the Nursing Workforce: One Pediatric Hospital's Strategic Approach MCN, The American Journal of Maternal/Child Nursing, September/October 2022 Seven Strategies for Optimizing End-of-Life Skin and Wound Care Advances in Skin & Wound Care: The Journal for Prevention and Healing, September 2022 Reduction of Catheter-Associated Urinary Tract Infections: A Multidisciplinary Approach to Driving Change Critical Care Nursing Quarterly, October/December 2022 Chest X-Ray Findings in Patients With COVID-19 Pneumonia Advanced Emergency Nursing Journal, July/September 2022 Shared decision-making to improve medication adherence The Nurse Practitioner, August 2022 Nurses suffering in silence: Addressing the stigma of mental health in nursing and healthcare Nursing Management, August 2022 Risks of practicing without professional liability insurance Nursing 2022, August 2022 Delays in Door-to-Diuretic Time and 1-Year Mortality Among Patients With Heart Failure Journal of Cardiovascular Nursing, September/October 2022 CLABSI Rounding Team: A Collaborative Approach to Prevention Journal of Nursing Care Quality, July/September 2022 * Questions about access, contact your Ascension Wisconsin Librarians:   Michele Matucheski        Kellee Selden

Clinical Key Content Updates - August 2022

The content of Clinical Key is constantly being updated.  Here are the August highlights. Clinical Key Clinical Key Search Tips & Tutorials Clinical Key Content Updates - August 2022

Updated Clinical Overviews – Selected Topics

• Central Nervous System Tuberculosis
• Compartment Syndrome
• Gastric Cancer
• Hiatal Hernia
• HIV Infection and AIDS in Adults

Books Added – CK Global

• Comparative Management of Spine Pathology (Chaichana, Kaisorn L.) 1st ed; ISBN: 9780323825573; Package/Collection: Neurosurgery; New to CK; 
• Handbook of Dialysis Therapy (Nissenson, Allen R.) 6th ed; ISBN: 9780128205525; Package/Collection: Nephrology; New edition (replaces 9780323391542); 
• Movement Disorders in Childhood (Singer, Harvey S.) 3rd ed; ISBN: 9780128205525; Package/Collection: Urology; New edition (replaces 9780124115736); 
• Taylor and Hoyt’s Pediatric Ophthalmology and Strabismus (Lyons, Christopher J.) 6th ed; ISBN: 9780702082986; Package/Collection: Ophthalmology; New edition (replaces 9780702066160); 
• The Technique of Total Knee Arthroplasty (Mihalko, William M.) 1st ed; ISBN: 9780323713023; Package/Collection: Orthopedics Extended; New to CK; 

Books Removed – CK Global

• Cardiovascular Therapeutics: A Companion to Braunwald’s Heart Disease (Antman, Elliott) 4th ed; ISBN: 9781455701018; Package/Collection: Cardiovascular Disease Essentials.
• Molecular Medicine: Genomics to Personalized Healthcare (Trent, Ronald) 4th ed; ISBN: 9780123814517; Package/Collection: Advanced Basic Science.
• Musculoskeletal Emergencies (Browner, Bruce) 1st ed; ISBN: 9781437722291; Package/Collection: Orthopedics Extended.
• Rennie and Roberton’s Textbook of Neonatology (Rennie, Janet M.) 5th ed; ISBN: 9780702034794; Package/Collection: Neonatal-Perinatal Medicine.

Questions or comments, contact Your Ascension Wisconsin Librarians: 

 Michele Matucheski        Kellee Selden

The 5 As of Evidence-Based Practice (Series)

The 5 As of Evidence-Based Practice - The Series

The following articles act as an introduction to the basic steps of evidence-based practice.

Evidence-Based Practice: A Quick Overview (Part 1)

The 5 As of Evidence-Based Practice: Ask (Part 2)

The 5 As of Evidence-Based Practice: Acquire (Part 3)

The 5 As of Evidence-Based Practice: Appraise (Part 4)

The 5 As of Evidence-based Practice: Apply & Assess (Part 5)

Visit The EBP LibGuide for more info.

Comments or Questions? Ask your Ascension Wisconsin Medical Librarians:

            Michele.Matucheski@ascension.org or Kellee.Selden@ascension.org

* This series was written by Gabriel Merckx, a practicum student at the Mercy Library in the summer of 2019.

The 5 As of Evidence-based Practice: Apply & Assess (Part 5)

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The Five A’s of Evidence Based Practice:

Apply and Assess

Guest post by Gabriel Merckx, MLIS* 

Welcome to the final article of Ascension Wisconsin Library Services’ series on Evidence Based Medicine! This is the fifth (and final) article in the series. See the whole 5-part series: The 5As of Evidence-based Practice.

You've acquired all your articles.

You’ve appraised the evidence.

Now you can finally apply them! But wait ...

Can the results can actually be applied to the patient?

You may find great articles, great solutions, but they might not truly be the best for the situation at hand. Why?

There are three things that to consider before you apply your understanding to your situation:

• Economic cost: Sometimes the solution could just be too expensive. Yes, maybe that $1,000,000 new treatment would be better than the current standard of care, but it just isn’t feasible. 

• Demographic: If the patient is an elderly man and all your papers are on treatments for young women, there’s a possibility that treatment won’t work for him.

• Patient beliefs: The patient comes first. Even if best evidence says they should get surgery, if it’s not something they want, you won’t be able to do it.

If all of those things are clear (you have enough money for the treatment, the demographics match, and patient beliefs align with this new course of action), then you can apply your findings to practice.

Assess

After that, reflect on the process. What was difficult? What would you have done differently? What would be the same? What new questions have come up because of this process?

No matter what, your Ascension Wisconsin Medical Librarians are here to help you!

Michele Matucheski and Kellee Selden

And remember, our Evidence Based Practice Guide has all the resources on the entire process for you to access at any time.

> See the whole 5-part series: The 5As of Evidence-based Practice

* Gabriel Merckx was a practicum student at the Mercy Library in the summer of 2019 when he wrote this series.

The 5 As of Evidence-Based Practice: Appraise (Part 4)

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Guest post by Gabriel Merckx, MLIS* 

The Five A’s of Evidence Based Practice: Appraise

Welcome back to Ascension Library Services’ series on Evidence Based Practice! This is the fourth article in the series. See the whole 5-part series: The 5As of Evidence-based Practice.

Once you start to look things up, now you have to pick things out. But when you have hundreds of papers, how do you even get started?

First, look for the best evidence. In order to do that, search for

• systematic reviews
• meta-analysis
• randomized controlled trials (RCTs) / double blind studies

These are considered to have the highest levels of evidence based on their careful approach, which helps to eliminate bias.

In PubMed, limit what is shown by using the customizing tools on the sidebar on the left. By choosing Systematic Reviews and Meta-Analyses only articles that fit systematic reviews or meta-analyses should be shown in the results list.

If you don't get any systematic reviews or meta-analyses, try the next level of best evidence: Randomized Controlled Trials (RCTs).

If using a database other than PubMed that does not have these limiters, take a look at the title and the methods. Oftentimes, the title will include “A Systematic Review," and the methods will list if it was a double-blind study or not. Either way, read through the methods to make sure. 

After reading through the paper, ask these questions:

• Were the methods clear?

• Is this backed by other studies?

• Is the conclusion actually supported by the result?

• Are the results valid?

• Is there a high risk of bias based on the method?

Worksheets such as the ones on our EBP LibGuide can help answer these questions.

If the answer to any of these questions is no, it might not be a good source.

Want more resources on appraisal? Our EBP LibGuide has several compilations of resources for your use.

> See the whole 5-part series: The 5As of Evidence-based Practice

Have questions that might need a more personal explanation? 

Ask your Ascension Wisconsin Medical Librarians:

Michele.Matucheski@ascension.org or Kellee.Selden@ascension.org

* Gabriel Merckx was a practicum student at the Mercy Library in the summer of 2019 when he wrote this series.

The 5 As of Evidence-Based Practice: Acquire (Part 3)

Guest post by Gabriel Merckx, MLIS*

Welcome back to Ascension Wisconsin Library Services’ series on Evidence Based Practice! This is the third article in the series. See the whole 5-part series: The 5As of Evidence-based Practice.

If you’ve made it to this step, you’ve already formed a question using PICO. After that, it’s time to start searching for articles. Let’s look at our example question from last time.

• Does taking rizatriptan lower migraine rates in middle aged women more than over the counter remedies?

Now, plugging this question as it is into Google won’t get all the evidence you'd need to answer the question.  So, today, we’re going to talk about how to break that question down into search terms that can be used in our databases, such as PubMed or CINAHL. 

The first thing to do is decide what parts of the question are essential to the search. Not every part of the question needs to be a part of the initial search, but what does need to be included is the topic of the question and at least one other element of the question. PICO itself is an amazing way to stay on target, because PICO-formed questions break the question down into easily searched and essential parts.

The topic we’re trying to study is migraines, so that will be part of the search.

Another part could be rizatriptan, since that’s the treatment.

So where would you plug these search terms in?

In PubMed, using Boolean phrases (detailed in picture below) can be particularly helpful. In this instance, I would type in “rizatriptan” AND “migraines”.

• Putting the words in quotations makes sure the database looks for that exact word or phrase.

• Using ‘AND’ only looks for articles that contain both rizatriptan AND migraines. 

Filters or Limiters can help limit the amount of information or hits a search gets. In PubMed and CINAHL, these are found on the left-hand side. Limiters/ filters can include:

• Language

• Human Studies 

• Year Published (Try to limit the search to the last five or ten years)

• Systematic Reviews or Meta-Analysis

Another popular tool is PubMed Clinical Queries, which uses predefined filters to help you quickly refine PubMed searches on clinical or disease-specific topics to pull up clinical trials, which are considered higher quality evidence. Give it a try!

Need help with your search, but don’t have time to stop in?  Our EBP LibGuide can give you more search tips on the go.

> See the whole 5-part series: The 5As of Evidence-based Practice

Have questions that you need answered sooner? Ask your Ascension Wisconsin Medical Librarians:

Michele.Matucheski@ascension.org or Kellee.Selden@ascension.org

* Gabriel Merckx was a practicum student at the Mercy Library in the summer of 2019 when he wrote this series.

The 5 As of Evidence-Based Practice: Ask (Part 2)

Guest post by Gabriel Merckx, MLIS*

Hello again! Back for more on Evidence Based Practice? If you missed the introduction on EBP, you can read it here before going onto this article. This is the 2nd article in the series.

> See the whole 5-part series: The 5As of Evidence-based Practice

The first step of Evidence Based Practice is to ask a question based on your clinical experience. However, it’s not just about forming the question, but forming it in the right way so that it’s easier to acquire literature in the next step. 

So, how do you do that? One method is to formulate the question using PICO.

PICO stands for:

• P: Patient OR Problem: How would you describe your patient demographically? OR what is the problem you are trying to solve?

• I: Intervention: What are you doing to the patient or problem?

• C: Comparison: What other treatment could you try? (The answer can be “nothing” or “not treating it”)

• O: Outcome: What do you want to happen?

Sometimes, we add a T: 

• T: Time: In what time period do you want this to happen in?

An example of a question formulated with PICO might be:

• Does taking rizatriptan (I) lower migraine rates (O) in middle aged women (P) more than over the counter remedies?(C)

Another example:

• Does aromatherapy (I) calm (O) patients who are agitated (P) [In comparison to not treating it] (C)? 

As you can see, they don’t have to be in the exact order, but they do need to have the PICO components.

Confused by PICO?  Our EBP LibGuide should help clear up the process.

> See the whole 5-part series: The 5As of Evidence-based Practice

Have questions that you need answered sooner? Ask your Ascension Wisconsin Medical Librarians:

Michele.matucheski@ascension.org or kellee.selden@ascension.org

* Gabriel Merckx was a practicum student at the Mercy Library in the summer of 2019 when he wrote this series.

Evidence-Based Practice: A Quick Overview (Part 1)

Guest post by Gabriel Merckx, MLIS *

Evidence Based Practice is essential to anybody working in health care. This series on Evidence Based Practice will help you develop skills related to the task, as well as point you to Ascension Wisconsin Library tools that can help along the way.

So what is Evidence Based Practice?

Evidence Based Practice, also known as EBP for short, is a way to make informed clinical decisions, allowing for the best medical care for the patient. It is a process by which medical practice is based on evidence you find in response to a question, in addition to the patient’s wishes and clinical expertise.

This process is broken up into five sections, known as the five A’s:

• Ask
• Acquire
• Appraise
• Apply
• Assess

Each of these will get their own article in the series, but let’s go over a brief scenario.

You are treating a patient who recently had a hip fracture, and you are wondering if physical therapy will help lower their fall risk.

• Formulate this into a question using the PICO format. (Ask)

• Using our databases, such as CINAHL, NRC Plus, Cochrane Library or PubMed, look for literature related to your question.  (Acquire)

• Looking at the sources collected using critical appraisal skills (with the help of handy worksheets), determine whether the literature found is appropriately backed by research or not. (Appraise)

• After looking at the evidence that is trustworthy, can answer question, and use that answer to make a decision related to the patient, making sure to keep their desires in mind. (Apply)

• After you see the result of your decision, reflect back on the process and think about what you would do differently, what worked well, and what you have questions about after the process. (Assess)

Sound confusing? No problem! Our EBP LibGuide and article series in the following weeks should help clear up the process.

> See the whole 5-part series: The 5As of Evidence-based Practice

Have questions that you need answered sooner? Ask your Ascension Wisconsin Medical Librarians:

Michele.Matucheski@ascension.org or Kellee.Selden@ascension.org

* Gabriel Merckx was a practicum student at the Mercy Library in the summer of 2019 when he wrote this series.