Computerized Information Resources

Computerized Information Resources

This chapter presents information about electronic sources that are easily available and accessible and in assist nurses in maintaining and enhancing their professional practices. These resources aid in keeping current with the published literature, in developing a list of sources for practice, research and/or education, and in collaborating with colleagues.

To maintain professional credibility, nursing professionals must be:

1.      Keep current with the published literature,

2.      Develop and maintain a list of bibliographic and other sources on specific topics of interest for practice, research, and/or education,

3.      Collaborate and network with colleagues regarding specifics of professional practice.

Essential computerized resources are those resources that are vital and necessary to the practitioner to accomplish the specific goal. Supportive computerized resources are those that are helpful and interesting and supply good information but are not necessarily essential for professional practice. There are many resources available to meet each other for professional credibility.

Maintaining Currency with the Published Literature

It is obvious that one of the most important obligations a nurse must meet is to maintain currency in his/her field of practice. Information is needed about current treatments, trends, medications, safety issues, business practices, and new health issues, among other topics.

The purpose of the information retrieved from the sources listed below is to enable nurses to keep abreast of the latest and most evidenced-based information in their selected field. Both quantity and quality must be considered.

When using a resource, check that:

1.      The resources covers the required specialty/field

2.      The primary journals and peripheral material in the field are included

3.      The resource is updated regularly and is current

4.      The resource covers the appropriate period

5.      The resource covers material published in different countries and languages

6.      There is some form of peer review, reference checking, or other means of evaluation

Essential Computerized Resources

Essential computerized resources for maintaining currency include bibliographic retrieval systems for the journal literature, current awareness services, and review services of the journal literature and currently published books. All of these assist the nurse in gathering the most current and reliable information.

Bibliographic Retrieval Systems       One of the most useful resources for accessing information about current practice is the journal literature. The best way to peruse this literature is through a bibliographic retrieval system, since there is far too much literature published to read it all. Bibliographic retrieval systems also allow filtering and sorting of this vast amount of published material.

A bibliographic retrieval system database allows the nurse to retrieve a list of citations containing bibliographic details of the material indexed, subject headings, and author abstracts. Most bibliographic retrieval systems have a controlled vocabulary, also known as a thesaurus or subject heading list, to make electronic subject searching much easier. Key word searching is necessary when there are no subject headings to cover the concepts being searched. In bibliographic retrieval systems has its own specific content, a nurse may have to search several systems to retrieve a comprehensive list of citations on a particular topic. Directories of descriptions of bibliographic retrieval systems can be found on the World Wide Web.

 

MEDLINE/PubMed    Covers 4,700 journals in 40 languages with over 12 million references from 1966 to the present in the fields of medicine, nursing, preclinical sciences, healthcare systems, veterinary medicine, and dentistry. The nursing subset in MEDLINE covers 200 nursing journals. The database is updated weekly on the World Wide Web and monthly on CD-ROM. MEDLINE and the nursing subset are available free over the World Wide Web through the NLM’s home page. The NLM Gateway is a Web-based system that allows users to search multiple NLM retrieval systems simultaneously. The database is also available through the commercial vendors mentioned below. All of these options allow the nurse to search by subject, key word, author, title, or a combination of these.

Loansome Doc allows the nurse to place an order for a copy of an article from a medical library through PubMed or the NLM Gateway. The full text of articles for some journals is available via a link to the publisher’s Web site from the PubMed abstract or record display. Some of the full text is available free of charge. The links indicating free full text display on the Loansome Doc order page prior to order placement and on the Loansome Doc Order Sent page immediately after the order is finalized. As of May 12, 2004, a total of 117 providers supplied free full text for 455 journals. A list of these titles is available on the NLM Web site.

CINAHL           The CINAHL database, produced by Cinahl Information Systems, a division of EBSCO Publishing, Inc., provides comprehensive coverage of the literature in nursing and allied health from 1982 to the present. It also covers chiropractic, podiatry, health promotion and education, health services administration, biomedicine, optometry, women’s health, consumer health and alternative therapy.

The CINAHL database also uses a controlled vocabulary for effective subject searching. There are approximately 4,686 unique CINAHL terms for nursing and the allied health discipline. An essential part of research papers is listed of reference pointing to prior publications. Cited references from selected nursing and allied health journals are searchable in the CINAHL database.

ERIC     ERIC (Educational Resources Information Center) database is published by the United States Department of Education and contains more than 1,200,000 citations covering education-related literature. It covers virtually all types of print materials, published and unpublished, from 1966 to the present day. This database gives the nurse a more comprehensive coverage of education than any other bibliographic retrieval system. The database underwent reengineering in 2004. A controlled vocabulary of more than 10,000 terms, Thesaurus of Eric Descriptors, assists with computer searches of this database on the internet through the World Wide Web.

PsychINFO      PsychINFO database, produced by the by the American Psychological Association, provides access to psychological relevant literature from journals, dissertations, reports, scholarly documents, books, and book chapters with more than 1.9 million references from the 1880s to the present. Updated weekly, most  of the records have abstracts or content summaries from material published in over 50 countries. using the Thesaurus of Psychological Index Terms of more than 7,000 controlled terms and cross references, the nurse can search for specific concepts effectively. Key word and specific field searching are also available.

Social SciSearch       Produced by the Institute for Scientific Information (ISI), the Social SciSearch database is an international multidisciplinary bibliographic retrieval system that covers 1,500 journals in the social, behavioral, and related sciences. The nurse can search the cited references as in the citation index in the CINAHL database. The database covers from 1972 to the present and is updated weekly. A few other bibliographic retrieval systems to keep in mind are databases such as CHID online (Combined Health Information Database), produced by the federal government, the American Association of Retired Persons (AARP) database, and the UMI Proquest Digital Dissertations.

Current Awareness Services       Most bibliographic retrieval systems are updated monthly or quarterly. Some are even updated weekly. In addition to the delay between the writing and publishing of the material that is indexed in the database, there is also a delay between the receipt of material, the indexing, and finally the inclusion of the citations for the indexed material in the database. To obtain access to more current material than that available in a bibliographic database, the nurse should use a current awareness service.

Current awareness services are helpful when used in addition to bibliographic retrieval systems. These services provide access to tablets of contents of journals and allow individuals to request articles of interest. They may include not only journal articles of interest but also proceedings from conferences, workshops, symposia, and other meetings. Often. Hospitals or university librarians may provide these services as well.

Some current awareness services or databases are Current Contents Connect, Reference Update, UnCover, the in0process database for MEDLINE (formerly PRE-MEDLIN), the DINAHLdirect current awareness database, and preCINAHL on EBSCOHost.

Current Contents Connect from ISI provides a current awareness service to over 8,000 journals and 2,000 recently published books and conference proceedings in the fields of science, social science, technology, and arts and humanities. Complete bibliographic information with English language author abstracts and publisher names and addresses are provided.

UnCover, from the UnCover Company, is an online current awareness alerting service covering nearly 25,000 English language periodicals.

PubMeds in-process records (formerly PREMEDLINE) provide basic information and abstracts before the citations are indexed. These records are added daily (National Library of Medicine, 2004).

The current awareness service offered by Cinahl Information Systems, a division of EBSCO Publishing, Inc., publishers of the CINAHL database, is available on the CINAHLdirect online service and EBSCOHost (PreCINAHL). This service is similar to that described above which contains citations of those articles received but not yet indexed with CINAHL thesaurus. The fields that are key word searchable include the article title, author, and journal title. There is no additional charge to subscribers to use this database.

The second type of current awareness provided by Cinahl Information Systems is within the bibliographic database itself, where the searcher is able to choose from a group of over 30 specific or special interest categories, which actually function as “virtual” databases. Possibilities include such areas as advanced nursing practice, case management, home healthcare, or military/uniformed services. By selecting one of these categories, documents are retrieved that are either in specific journals in the field or have been selected by indexers as being of interest to those in that field. The results can be limited by any of the available limits on the database. A nurse with limited time can peruse the latest literature in one of the fields.

Review Services               Although the bibliographic retrieval systems and the current awareness services and databases act as filters to the ever-exploding volume of literature, sometimes the information retrieved needs to be evaluated to determine whether or not it is appropriate. Supportive computerized resources that synthesize the literature include the Online Journal of Clinical Innovations, the Joanna Briggs Institute for the Best Practice, Clinical Evidence or the Cochrane Library Database of Systematic Reviews. Review services such as Doody's Review Service or reviews noted in bibliographic databases or review journals, such as Bandolier, Evidence-Based Nursing, Evidenced-Based Practice, Best Practice, an ACP Journal Club, can also be used to evaluate sources. Review services provide information to searchers about recently published books, journal articles, audiovisuals, and software. These reviews may also include ratings, opinions, or commentaries about the material.

Doody's Review Service is a service offered as a membership benefit to those belonging to Sigma Theta Tau and other nursing professional groups. Doody's Book Review Service develops a profile on its members and sends a weekly electronic mail (e-mail) bulletin describing books and software that meet the parameters of the profile. The service currently over 70,000 print and electronic titles. The searcher can use author names, title, specialty, publisher, and keywords to find books of interest. Materials are rated using a star system questionnaire that assesses the extent to which objectives are met and the appropriateness of the work's readability, among other criteria. Another Website, www.nursingbooks.com, described as designed  for nurses by nurses, allows for searching by key word, author, and title. Tied to the Barnes & Noble Website and search engine, the site categorizes books into various areas, including those intended to help clients, increase knowledge, or shape one's career, Although reviews are not always present, the tablets of contents for individual books, along with synopses, are included.

Supportive Computerized Resources

Supportive computerized resources that assist the nurse in maintaining currency provide additional information and enhance the value of the essential computerized resources described previously.

Document Delivery Services       Obtaining a bibliographic list of citations is only the first step in obtaining information on a particular topic. After carefully evaluating the citations, either from the title and/or the abstracts, or after using one of the review processes described previously, the nurse will need to get the full text of the sources retrieved. A local library would be the first place to got to locate the items retrieved in a search. Publishers of journals or books, database vendors and providers (NLM, American Psychological Association, Ovid Technologies, EBSCO Publishing, Proquest Information and Learning), and document delivery services (UnCover, ISI, Cinahl Information Systems) are secondary sources through which full text of items can be obtained for a fee. Fees differ depending on the service, the urgency of the request, and the publisher's charges. Hard copy is usually sent via fax, mail or electronic delivery.

Electronic Publishers    Another resource option is publications, such as electronic journals and Morbidity and Mortality Weekly Repot (MMWR), that are available on the World Wide Web. Sparks (1999) presents an excellent case for the importance of including electronically published information in a search for information. These advantages are important; however, because a document is published quickly it does not necessarily mean it is accurate. The credibility and accuracy of the source of electronically published material must always be considered.

Nursing publishers and organizations have their own Websites, which have details about new publications, sometimes full text of some of the latest journal articles, official position statements of organizations, and/or practice guidelines. To identify the Web sites of nursing publishers and organizations, search Web site lists on Web sites such as Yahoo or Google. Lippincott Williams & Wilkins has placed over 30 journals including the American Journal of Nursing, Nursing Research, CIN: Computers, Informatics, Nursing, and JONA (Journal of Nursing Administration).

Many nursing organizations provide a significant amount of support to practicing nurses. Many publish journals and provide these as a member benefit. They also provide access to the full text of their position statements and/or practicing guidelines.

Metasites on the World Wide Web    Since there is so much information on the World Wide Web, identification and evaluation of Web sites is very important to determine which provide valid information. One of the ways to identify Web sites is to consult a metasite. There are several Web sites that can be classified as metasites concerning the same specific topic. The Hardin Meta Directory of Internet Health Sources, sponsored by the Hardin Library for the Health Sciences at the University of Iowa is one of these as is the National Information Center on Health Services Research & Health Care Technology.

Once the Web sites have been identified, it is very important to evaluate them. At a minimum, the nurse should ask the following questions: (1) Who created the site? (2) Is the purpose and intention of the site clear? (3) Is the information accurate and current? (4) Is the site well-designed and stable?

Developing and Maintaining a List of Sources for Research/Practice/Education

Essential Computerized Resources

The purpose of the information retrieved from these information resources is to enable nurses to answer specific questions that relate to research, practice, and/or education. For example:

   

    1. A staff nurse needs to find information to share with his or her colleagues on oral care and the prevention of pneumonia

   2. A nursing student has to finish a term paper and needs to find five nursing research studies on caring for a Hispanic patient with a myocardial infarction.

   3. A nurse manager needs to find research studies and anecdotal material showing the best way to prevent patient falls in his or her health facility.

Bibliographic Retrieval Systems    Resources essential in answering this type of question again include bibliographic databases as well as various Web sites. Once a resource has been selected, the nurse breaks down his or her needs into a search statements such as, "I need information on oral care and prevention of pneumonia." The information on this topic would best be found in a bibliographic database. On such database, the best method of searching is to do a subject search using a controlled vocabulary.

SEARCH STRATEGIES   One of the most important aspects of searching the literature is formulating the exact strategy to obtain the information from a resource, whether from a bibliographic retrieval system or a Web site.

There are steps in planning the search strategy.

   1. Plan the search strategy ahead of time.

   2. Break down the search topic into components.

   3. Check for terms in a subject heading list, if available. If the concept is new and there are no subject headings, a text word or key word search is necessary.

   4. Select "operators," which are words used to connect different or synonymous components of the search. The "and" operator, for example, makes the search narrower or more specific as the results of the search for two different terms will only result in records that include both terms as subject headings.

   5. Run the search. For the search on oral care and pneumonia, select the option "explode" for the subject headings oral hygiene and mouth care.

   6. View the results.

Practice Guidelines and Position Statements   Organization-specific practice guidelines, position statements, and standards of practice can often be accessed and obtained form the Web site of an individual's professional organization. These are extremely useful documents that present information on the scope of practice, qualifications, and education among other important details. Cinahl Information Systems currently includes nurse practice acts as one of its publication types in the CINAHL database. These appear in full text and can be read online or printed.

Continuing Education and Computer-Assisted Learning   Many nurses do nit have time or money to attend conferences and workshops to keep abreast of the latest information in their specialties or to complete the necessary units or credits for continuing education (CE) for relicensure or recertification. The sites are easy to access, and there is no travel time or great expense involved.

As mentioned at the beginning of this chapter, nurses use computers for many purposes. Computer-assisted instruction (CAI), computer-assisted learning (CAL) and interactive videodisc (IVD) provide easy learning experiences.

Supportive Computerized Resources

Assist in practice, research, and education contain all types of health information including drug and treatment information, anatomy, and physiology. Specific products such as the Merck Manual of Diagnosis and Therapy  or the Physician's Desk Reference available as PDRhealth are also available on the World Wide Web. The Visible Human Project includes complete, anatomically detailed, 3D representations of the male and female human bodies.

Collaborating and Networking Regarding Issues of Professional Practice

Nurses frequently gather information from their personal networks; either at the worksite or at professional meetings. The increased availability of computers makes contact with other professionals much easier, resulting in networking and collaboration possibilities heretofore impossible. Information retrieved by this method enables nurses to learn from their colleagues' experiences. When considering with whom to network, the specialty of the person should be evaluated along with experience, the material they have published in their field, and the research undertaken by the institution with which they are affiliated. Most of this information is not published and would be unavailable through traditional information resources.

Computerized resources for collaboration and networking vary in several technical details.

Essential Computerized Resources

Electronic Mail and Listservs   An important fundamental computerized resource for collaboration and networking is e-mail, which is at the core of almost any electronic communication. E-mail allows one-to-one communication between individuals and can provide immediate response to practice-related questions.

A second essential computerized resource for collaboration is an electronic discussion group or "listserv." Listservs allow individuals to subscribe free of charge and to read and respond to messages via e-mail. Some listservs have a closed membership for a specific group, and some are moderated. In a moderated group, an individual or group of individuals reads the messages prior to distribution to the group.

Supportive Computerized Resources

Electronic Bulletin Boards, Forums, Newsgroups, and Chat Rooms   Bulletin Boards, Forums, Newsgroups, and Chat Rooms  are examples of supportive computerized resources. Similar to a traditional bulletin board, the electronic version has an administrator who sends the discussion to various Web sites, where nurses visit to read and participate in the discussion. An individual posts a message concerning a topic for others to read and respond to. Newsgroup operate in much the same way but have a tendency to be less focused. all of these resources are interactive but on a delayed basis. An individual may respond to a message immediately or wait several days. Chat rooms, on the other hand, are interactive on "real time." Conversations in chat rooms can be compared to telephone conversations; without the benefit of sound.

Each of these methods of collaboration and networking provides an option or nurses to contact and build relationships with other professionals concerning issues important to them.