Health libraries review最新文献

This article summarizes a research project carried out with the nursing staff of South Buckinghamshire NHS Trust. A 'community profile' looked at nurses' use of library and information services for patient care purposes and found that only a small portion of all categories of qualified staff were library users. A postal questionnaire was used to investigate why nurses sought information, what they used it for, where they obtained it from and how valuable they perceived it to be. The results shown that personal and departmental collections were used quite frequently and the information was widely disseminated by the nurses to patients and their families, to colleagues and to students. The overall message from the survey was that the information obtained is valued highly and is used for various important purposes in health care delivery, such as educating patients and their families and revising treatment plans. However, nurses have difficulty in accessing libraries, which are judged to contain the most accurate, reliable and up-to-date information. The data from the community profile and questionnaire were further analysed using soft systems methodology, in order to identify problems in the traditional model of information delivery to nurses via conventional library and information service. These were then investigated further and a series of recommendations for action drawn up.

One of the North Thames' pioneering consortia, the Inner London Consortium (ILC) is a complex body which includes NHS Trusts with teaching hospital university connections, community-based Trusts and general hospital acute Trusts. Within the consortium there are 12,000 trained nurses, midwives, health visitors and other professional staff working in the professions allied to medicine (PAMs), all of whom require access to and provision of appropriate library information services. In 1994, taking into account experiences elsewhere in the Region and nationally, it became clear that library issues were complex and would become acute with the move of nursing libraries from ILC Trust sites over a very short timescale. A report on the issues commissioned by the Consortium recommended that a library project, which built on existing NHS Trust PGMDE funded library resources and moved these to a multidisciplinary base to serve the consortium membership, be implemented. The objective of providing access to library information services for nurses and PAMs was achieved. Successes that emerged from the implementation included: The registration in Trust libraries of almost 12 000 new members within the initial 6-month monitoring period. The development of service level agreements and standards for the delivery of services to these new user groups. This paper describes the processes behind these significant and complex changes.

The aims of the EVINCE research project included examination of the impact of information on the clinical knowledge and practice of nurses, midwives and health visitors. EVINCE (Establishing the Value of Information to Nursing Continuing Education) was funded by the British Library R&D Department for 1 year, from 1 November 1995 to 31 October 1996. The methods employed (based on those used in the Value project) included a critical incident type study to establish patterns of information need and use among a random sample of nursing professionals. The nature of the impact of information obtained on present and future competencies was assessed from a survey of the searches and requests presented to library and information services. Nurses, midwives and health visitors did value the information (96% of respondents agreed that there was, or would be an effect on future practice through enhanced competence in one or more areas). The impact findings can be used to guide a more precise assessment of information needs.

This paper reports on a research project which examined the potential of the Internet, and other networked information resources, to improve access to information for trained nurses working in remote areas. This paper provides a review of current literature in the field. It describes the research carried out, presents a summary of the research findings and discusses the implications of these findings. The paper concludes that the Internet and networked resources do have considerable potential to improve access to information for nurses working in remote and rural areas. However, information skills, along with professional guidance, are also required.

The practice of evidence-based health care requires that information on methodology be identified from databases such as MEDLINE. Up until this year there have been no designated medical subject headings (MeSH) for evidence-based health care. 'EVIDENCE-BASED MEDICINE' appears as a MeSH term from 1997. The absence of designated MeSH for this concept prior to 1997 provides a challenge to the searcher. This paper describes the creation of a MEDLINE search strategy to retrieve articles on the methods of evidence-based health care published prior to the introduction of the new term, where an optimal combination of free-text and MeSH terms is required to identify relevant material. The study examines both free-text and subject heading searching and attempts an optimal balance of sensitivity and specificity. It begins by examining separate free-text and subject heading searches. Sensitivity of the subject heading search was 33% and specificity 80%, while the free-text search produced a sensitivity of 50% and a specificity of 67%. The final strategy, combining both approaches, was more successful with sensitivity reaching between 82 and 90% and specificity 83%. It is therefore possible to devise a search strategy to retrieve articles on the methods of evidence-based health care with relatively successful rates of sensitivity and specificity. The limitations of MEDLINE, however, necessitate the use of additional approaches in identifying articles on the methods of evidence-based health care.

Patients' rights to information in the UK are based on a mixture of statute (including legislation on access to medical records) and case law (principally revolving around the issue of informed consent). These rights are set out in the Patient's Charter, which is itself a mixture of rights based on legislation and those enforced by management practice. Failure to provide adequate information to a patient could expose a medical practitioner to action for negligence or battery. Negligent information-giving could also expose consumer health information services to damages, for which the best defence is a high standard of professional competence and adequate professional indemnity insurance. Sharing information about the risks and benefits of treatment to enable truly informed decision making and consent by the patient is a key element of an ethical relationship between care giver and consumer--the therapeutic partnership.