increasing library usage by nurses strategies based on nursing knowledge translation research

Increasing Library Usage

by Nurses

Strategies based on Nursing

Knowledge Translation Research

Outline

The Ottawa HospitalNursing Knowledge Translation Working GroupStrategies we have tried

Strategies you have tried

Introduction

The Ottawa Hospital

Clinical Nurses 3517 FTE

Advanced Practice Nurses

31

Clinical Managers 70

Nursing Professional Practice

15

Nurse Educators 56

5

The Ottawa Hospital

Educational Level of Nurses

RegisteredPracticalNurseRN no Bacc.

RN - Bacc orhigher

Library Services @ TOH

• 10.2 FTE• $1.1 million• 2 medical libraries and 3 patient libraries• Provide services to regional hospitals and

Ottawa Public Health on a contractual basis

Library Services @ The Ottawa Hospital

Electronic access transformation

Client service transformation

Increased emphasis on healthcare professionals (nursing, allied health)

Nursing Knowledge Translation Working Group

Climate

1. ↑ need for evidence-based practice

2. ↑ in workload and acuity

3. Shortage of nurses

4. Explosion of information

Mandate

• Provide direction for the – Access – Integration and – Utilization of Nursing knowledge resources to support

theclinical, educational, research and managerial endeavors at TOH

• Administered to – Clinical Nurses (random sample) 33% return – Clinical Practice Committee 100% return– TOH Nursing Leadership Retreat 100%

return• Research Utilization Survey

– Used with permission of Drs. Estabrooks and Wolf

– Validated Likert Scale

Nursing Knowledge Translation Working Group - Survey

Years of Experience in Nursing

<1

1-5

6-10

11-15

19-20

21-25

>26

17%

30%

15%

8%

16%

4%

10%

Distribution of Times New Knowledge Sought by Years of Practice

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

Years of Practice

Per

cen

t

0 times 1-5 times 6-10 times > 10 times

0 times 6%

1-5 times 14% 40% 40% 75% 57% 38% 44%

6-10 times 10% 23% 13% 29% 25% 31%

> 10 times 86% 50% 37% 13% 14% 31% 25%

<1 Year 1-5 Years 6-10 years 11-15 years 16-20 years 21-25 years 26 + years

What sources of information do you use when seeking new knowledge?

83% 81% 79%

51%

86%

0%

20%

40%

60%

80%

100%

Colleague (peer) Internet SearchEngines

Educator Unit Manuals Centre forNursing

Excellence

Type of Information Sought

76%

51% 51%

31%22%

8%

76%

0%

20%

40%

60%

80%

100%

NursingPolicies andProcedures

PatientDiagnoses

andTreatments

PatientEducation

Specialtyinformation

ClinicalPractice

Guidelines

Professionalinformation

(CNA, RNAO,CNO)

Other

When, how did you carry out your last literature Search?

65% had carried out a lit. search within the past 6 months.

64% Internet Search engines (e.g. Google, Yahoo, MSN)

20% Indexed Database (e.g OVID, CINAHL, Medline)

19% TOH Reference Librarian14% Never did a literature search

Use of Indexed Databases to Carry Out Literature Searches by Years of Experience

86%

45%

17%

6%14%

25%

8%

0%10%20%30%40%50%60%70%80%90%

<1 Year 1-5 years 6-10 years 11-15years 16-20years

21-25years

26 or moreyears

Years of Experience

Barriers

Rank Barriers % (n)

1 Workload/Not enough time 76 (147)

2 Limited research skills 32 (61)

3 Not aware of what resources are available 31 (60)

4 Limited computer skills 30 (58)

5 Limited computer access 22 (43)

6 Difficulty determining if information obtained is valid /current /applicable to clinical situation

21 (41)

7 Other 6 (12)

Changes that would assist you in Accessing Information? Rank Changes Required % (n)

1 Remote off campus access to electronic resources (e.g. from my home computer)

58 (111)

2 More Information on TOH InfoNet 41 (79)

3 More computer workstations 38 (74)

4 More electronic journals 32 (62)

5 Automatic e-mail updates 29 (56)

6 More electronic books 22 (42)

7 Other 16 (31)

8 Access to Knowledge synthesis programs 12 (24)

9 Access to Knowledge broker 8 (16)

What did we find that is consistent with previous studies

• Preference to obtain knowledge through personal experiences and interactions– Experience of caring for patients over time– Peers/Nurse Educator – In-services(Spenceley et al, 2008; Estabrooke 2005; Estabrooke 1998; Baessler 1994)

• Nurses use a variety of strategiesColleague, Search Engines, Educators, Unit Manuals

• Least UsedJournals including Medical and Nursing ResearchPopular Media (magazines, Television and Internet)

What is new about what we found• Increased use of search engines as a source

and a preferred source of information – Our survey specifically asked about internet

search engines as a (preferred) source of new knowledge, and was ranked within the top 2.

Survey results

What does that mean for libraries?

Failed strategies

• Open houses– Do not have time to go to these

• Scheduled training session– Usually doesn’t fit their schedules

• In library displays, flyers, etc.– They don’t come in, so they don’t see

Inservice sessions

10 minute sessions done on the wards

Focus on tools they can use from their workstation

Relationship building session

Support Nurse educators

• Quarterly book lists sent to the educators

• Table of contents service • Show them cool internet tools such as

delicious, wikis that they can implement with their nurses

• Participate in their committees• Believe in the trickle down effect

Pathfinders

Tool for educators to offer to clinical nurses who want to change areas

Nursing Librarian

Mixed blessing• Builds tremendous relationships• Creates more work than you can imagine• Problem keeping up in a timely way

Accessibility

• 24 hour access to library• Remote access via Athens• PDA compatible resources• Training in the evening shift

Strategies: other

Raising more awareness by writing articles for the nursing newsletter

Focussing on the new grads who are aware of the benefits of database searching **

Measuring Success

• Who are you reaching and who is using the resources?

• Do not underestimate the trickle down effect of information sharing

• No longer relevant to only measure who is coming to your library or if certain books are taken out

• Need to talk to the nurse educators to get more accurate measurements

30

Measure of Success

Occupational Title(self-identified)

# nurses registered as users in 2007

# nurses registered as users in 2010

Nurse 498 703

Nurse Educator 30 50

Clinical Manager 25 29

Senior Management

5 8

31

Segmentation of your population

Nurses play different roles with different information needs

Maybe we need to target different segments with different tools and resources to meet those needs

Your strategies – what works / what doesn’t