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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