Barriers and benefits associated with nurses information seeking related to patient education needs on clinical nursing units

Developing a Tool for Assessing the Process of Seeking Health Information: Online Think-Aloud Method

Nursing students can access massive amounts of online health data to drive cutting-edge evidence-based practice in clinical placement, to bridge the theory-practice gap. This activity requires investigation to identify the strategies nursing students apply to evaluate online health information. Online Think-Aloud sessions enabled 14 participants to express their cognitive processes in navigating various educational resources, including online journals and databases, and determining the reliability of sources, indicating their strategies for information-seeking, which helped to create this scoring system. Easy access and user convenience were clearly the instrumental factors in this behavior, which has troubling implications for the lack of use of higher-quality resources (e.g., from peer-reviewed academic journals). The identified challenges encountered during resource access included limited skills in the critical evaluation of information credibility and reliability, signaling a requirement for improved information literacy skills. Participants acknowledged the importance of evidence-based, high-quality information, but faced numerous barriers, such as restricted access to professional and specialty databases, and a lack of academic skills training. This paper develops and critiques a Performative Tool for assessing the process of seeking health information using an online Think-Aloud method, and explores factors and strategies contributing to evidence-based health information access and utilization in clinical practice, aiming to provide insight into individuals' information-seeking behaviors in online health contexts.

Nurses' Perceptions of Intensive Care Unit Orientation Patient Education Pamphlet

Background

Critical illness is a stressful time for patients and their support networks. Although patient-directed educational material to improve the understanding of critical illness exists, both patients and staff members are often unaware of these resources or how to find them.

Objectives

We aimed to evaluate the impact of the implementation of the American Thoracic Society's (ATS) "Managing the Intensive Care Unity (ICU) Experience: A Proactive Guide for Patients and Families", an ICU orientation pamphlet, on nurses' perceptions of the availability and effectiveness of patient and family educational resources.

Methods

In a safety-net urban institution, we surveyed medical ICU (MICU) nurses in February 2021 regarding their perceptions of the availability of patient and family educational materials and the time and quality of communication with families of critically ill patients. We then introduced the MICU nurses to the ATS ICU orientation pamphlet to complement patient and family education. Quick response (QR) codes were created, linking to the online versions of the ICU pamphlet, and made available in waiting rooms. Printed copies of the pamphlet were provided to families in the ICU introductory packet upon patient MICU admission. We informed nurses regarding the pamphlet content, website, and QR codes. A postintervention survey was administered 11 months after the initial survey. Changes between pre and postintervention responses were analyzed for significant differences. Debriefing sessions with the MICU nurses were conducted, and subsequent discussions identified opportunities to improve the available educational resources.

Results

At baseline, 28 of 67 (42%) MICU nurses responded to the survey. Although all nurses provided verbal education to patients and families, only 18% reported knowing about and using additional resources to supplement this education. The postintervention survey was completed by 39% of nurses; 39% of them reported using additional materials to supplement patient and family education. Reported awareness of the ATS ICU pamphlet increased from 4% before implementation to 23% after implementation (P = 0.04). MICU nurses offered suggestions to improve the pamphlet, which thematically fell into three categories: 1) opportunities to alter the ICU pamphlet, 2) opportunities to provide the pamphlet in varied formats, and 3) opportunities to add additional education topics.

Conclusions

Informing nurses about the ICU pamphlet improved the acceptance and use of the materials, but it was still not accepted by many nurses. Barriers to ICU nurses using patient education resources should be explored to facilitate quality materials reaching patients and complementing patient communication. QR codes may have offered a way to disseminate educational materials to patients and families in a manner not previously considered. The process of evaluating the ICU pamphlet for our institution led to a broader discussion of additional needs for patient and family educational materials for our patient population. We encourage institutions to evaluate the sufficiency of their patient and family educational materials for similar local benefits.

Factors influencing the information behaviour of doctors and nurses in South Africa's Eastern Cape, Mpumalanga, Limpopo and Northern Cape provinces: a survey study protocol

INTRODUCTION

Information is a prerequisite for quality healthcare service. Health professionals play a key role in the health system as they jointly have the responsibility of looking after patients everyday. Failure to use evidence in medicine may lead to medical errors such as incorrect diagnosis and/or mismanagement. Health professionals with access to quality health information can improve health services. This study focuses on the information behaviour of doctors and nurses whose role involves direct patient care.

METHODS AND ANALYSIS

This study will employ a quantitative approach using a cross-sectional survey design. Simple random sampling will be used to identify the provinces and hospitals. Stratified random sampling will be used to select doctors and nurses to whom a validated questionnaire will be administered. The study will use a structured self-administered questionnaire. Data collection will be carried out at Nelson Mandela Academic Hospital, Witbank Hospital, Pietersburg Hospital and Robert Mangaliso Hospital, respectively. Questionnaires are distributed to health professionals in one of two ways. First, by emailing an editable Microsoft word document (questionnaire) to the health professionals to complete and send back. Second, by sharing with the health professionals through WhatsApp or email, an online version of the questionnaire that has been created on Google Forms. Data collection process is scheduled to commence on 14 March 2022 and is expected to end on the 15 September 2022.

ETHICS AND DISSEMINATION

Ethical approval was obtained from the University of the Witwatersrand Human Research Ethics Committee (reference: M211013) and Walter Sisulu University Human Research Ethics and Biosafety Committee (reference: 099/2021). Permission to access the health facilities was approved by the Provincial Health Research Committees of the Eastern Cape, Limpopo, Mpumalanga and Northern Cape. Finally, results will be shared with all key stakeholders, including hospital management, clinical staff, through public presentation and direct engagements with stakeholders.

Evidence-based practice and its associated factors among point-of-care nurses working at the teaching and specialized hospitals of Northwest Ethiopia: A concurrent study

Evidence-based practice (EBP) is the application of the best scientific evidence for clinical decision-making in professional patient care. In Ethiopia, the majority of nursing care is based on experience, tradition, intuition, common sense, and untested hypotheses. Evidence-based clinical practice has the potential to increase the quality of healthcare services while also lowering costs and increasing clinical outcomes. An institutional-based concurrent study design method of quantitative and qualitative research was conducted from Feb. 30 to Apr. 20, 2020. Systematic random sampling and purposive sampling techniques were used to select the study participants for the quantitative and qualitative analyses, respectively. To collect quantitative data, a pretested, structured, and self-administered questionnaire was used, and to collect qualitative data, an in-depth interview guided by questions was used. EBP was found to be significantly associated with educational level (AOR = 2.15, CI (1.15–4.02)), administrative support for EBP (AOR = 1.89, CI (1.22–2.91)), attitude toward EBP (AOR = 1.80, CI (1.24–2.62)), and preference of available information sources (AOR: 2.32, CI (1.58–3.39). The four main themes that emerged from the conventional content data analysis were the advantages of EBP application, barriers to EBP implementation, enabling factors for EBP, and evidence sharing. According to the findings of this study, only a few nurses used EBP at a high level. The implementation of EBP was positively associated with educational level, attitude toward EBP, administrative support, and the availability of information resources, as confirmed by the qualitative study. There must be an intervention program to facilitate the implementation of evidence in nursing practice by stakeholders to improve and increase the efficacy of practicing EBP.

Information retrieval as a part of evidence-based practice: Retrieval skills, behavior and needs among nurses at a large university hospital

Nurses are required to apply research-based knowledge in order to perform evidence-based practice. A survey was conducted to identify nurses’ information-retrieval skills, behavior and needs and replies were received from 1301 nurses. The most used electronic resources for retrieval of healthcare information were the local intra-net and Google, while bibliographic databases were used to a lesser extent. Half of the respondents indicated that they were accustomed to search databases and an equal number indicated lack of time and that information retrieval was not requested by their colleagues. The majority assessed their own information-retrieval skills as good while one third lacked knowledge and described information retrieval as difficult. Significant differences in competences and use of bibliographic databases were found between nurses who had graduated before and after an educational reform in 2011. Further measures, including collaborations between librarians and nurse management, must be developed to support information literacy and evidence-based practice among nurses.

Effectiveness of a computerised system of patient education in clinical practice: a longitudinal nested cohort study

INTRODUCTION

Developing electronic health record information systems is an international trend for promoting the integration of health information and enhancing the quality of medical services. Patient education is a frequent intervention in nursing care, and recording the amount and quality of patient education have become essential in the nursing record. The aims of this study are (1): to develop a high-quality Patient Education Assessment and Description Record System (PEADRS) in the electronic medical record (2); to examine the effectiveness of the PEADRS on documentation and nurses' satisfaction (3); to facilitate communication and cooperation between professionals.

METHODS AND ANALYSIS

A quasi-experimental design and random sampling will be used. The participants are nurses who are involved in patient education by using traditional record or the PEADRS at a medical centre. A prospective longitudinal nested cohort study will be conducted to compare the effectiveness of the PEADRS, including (1): the length of nursing documentation (2); satisfaction with using the PEADRS; and (3) the benefit to professional cooperation.

ETHICS AND DISSEMINATION

Patient privacy will be protected according to Electronic Medical Record Management Practices of the hospital. This study develops a patient education digital record system, which would profit the quality of clinical practice in health education. The results will be published in peer-reviewed journals and will be presented at scientific conferences.

E-health tools in oncology nursing: Perceptions of nurses and contributions to patient care and advanced practice

As oncology nurses confront a rapidly evolving field with increased workplace pressure, the integration of evidence-based connected health platforms within practice presents promise. This study explores nurses' perceptions regarding the utility of e-health tools, with a focus on the Oncology Interactive Navigator (OIN^TM), as a potential contributor to their practice and interactions with patients. Focus groups with oncology nurses were conducted at two time points: prior to exposure to the OIN^TM (T1, n=8) and four weeks post unrestricted tool access (T2, n=7). Using qualitative constant comparison analysis, three themes emerged: (1) Key factors driving e-health use are multidimensional and evolving; (2) Dual role of e-health in meeting patient needs and supporting practice; (3) E-health as a catalyst for professional development and networking. E-health is appealing to oncology nurses, as it serves to advance practice and support patient care. Future research should explore best practices for optimal clinical implementation among all stakeholders involved.

Online Resources to Support Clinical Practice

Evidence-based practice requires access to practice guidelines, research articles, and other resources; however, home healthcare clinicians can face barriers when seeking health information. The purpose of this article is to provide home care clinicians with: a) free resources available on the internet, b) suggestions for searching and evaluating health information found on the internet, and c) opportunities for free continuing education for home healthcare clinicians.

Barriers to using electronic evidence based literature in nursing practice: a systematised review

BACKGROUND

Nurses' use of electronic literature has remained limited.

OBJECTIVES

The aim of this study was to identify barriers concerning application of electronic literature on evidence based practice in nursing.

METHODS

Six bibliographic databases were searched using the following keywords: challenges, barriers, obstacles, evidence based practice, EBP, information seeking, online databases, electronic literature, bibliographic databases and nurs*. Results were filtered to peer reviewed empirical studies, written in English or Persian and published from 2010 to 2017. Studies were selected based on specified inclusion criteria, and quality of the included studies was assessed. The approved articles (n = 21) were extracted and synthesised.

DISCUSSION

There are different types of barriers in using electronic evidence based literature in nursing demonstrating the issue as a multi-faceted problem. Not having enough time to conduct a search was the first major barrier noted by almost 81% (n = 17) of the reviewed studies followed by lack of knowledge on searching skills (66%; n = 14) and access requirements (38%; n = 8).

CONCLUSIONS

There appears to be an important role for hospital management in providing nurses with enough time and access to online information while at work and also for health care librarians together with nursing leaders in providing the required training on using electronic evidence based literature.

Insulin knowledge and practice: a survey of district nurses in Northern Ireland

Insulin is one of the top ten high-alert medications worldwide. Approximately 30% of people with diabetes in the UK use injectable therapies, most commonly insulin, to manage their condition. With an increasing number of people with diabetes being managed within the community, district nurses play an important role in the safe and effective use of insulin. This study surveyed a convenience sample of 164 district nurses working within one Health and Social Care Trust in Northern Ireland to ascertain their knowledge and practice regarding insulin. Study response rate was 38% (n=63). It was found that district nurses' knowledge and practice relating to insulin therapy was lacking as indicated by a total mean score of 53.1%. Total knowledge scores were slightly higher (58%) than total practice scores (46%). Nevertheless, 79.4% of district nurses felt secure and 6.3% felt very secure in managing diabetes. Deficits in district nurses' knowledge and practice were identified in areas relating to insulin action, dosage, storage, injection site technique and rotation, hypoglycaemic/hyperglycaemic management, pharmacological action and prescription format. These deficits highlight the need for workplacebased learning and development programmes, incorporating real time, point of care interventions, to enhance and maintain district nurses' insulin knowledge and practice.

Ensuring Quality in Online Palliative Care Resources

Evidence and information is an integral part of the processes enabling clinical and service delivery within health. It is used by health professionals in clinical practice and in developing their professional knowledge, by policy makers in decision making, and is sought by health consumers to help them manage their health needs and assess their options. Increasingly, this evidence and information is being disseminated and sought through online channels. The internet is fundamentally changing how health information is being distributed and accessed. Clinicians, patients, community members, and decision makers have an unprecedented capacity to find online information about palliative care and end-of-life care. However, it is clear that not all individuals have the skills to be able to find and assess the quality of the resources they need. There are also many issues in creating online resources that are current, relevant and authoritative for use by health professionals and by health consumers. This paper explores the processes and structures used in creating a major national palliative care knowledge resource, the CareSearch website, to meet the needs of health professionals and of patients and their families and carers.

How Do I Find the Evidence? Find Your Librarian-Stat!

Clinical nurses often struggle with a lack of time and proficiency when it comes to finding and reviewing research. Knowing where to start, and discerning which search terms will retrieve the best results, can be arduous. As expert searchers, medical librarians have the skills and knowledge to make significant contributions to the clinical team, helping nurses navigate information resources and research from start to finish. When there is not direct access to a librarian, the toolbox of resources outlined in the article can save nurses' time and effort when they require quality, evidence-based information.

Diabetes knowledge of nurses in different countries: An integrative review

OBJECTIVE

The aim of this study was to identify, critically appraise and synthesise evidence of nurses' knowledge of diabetes and identify factors that function as barriers to nurses' acquisition of diabetes knowledge.

DESIGN

An integrative review

METHODS

A systematic search was conducted for English-language, peer reviewed publications of any research design via CINAHL, Medline, EMBASE, and Education Research Complete databases from 2004 to 2014. Of 374 articles retrieved, after removal of duplicates and quality appraisal, 25 studies were included in the review and synthesised based on study characteristics, design and findings.

FINDINGS

Studies originated from developed and developing countries and applied a variety of research designs and tools to assess nurses' knowledge of diabetes. Assessed aspects of diabetes care included knowledge of diabetes medications (12 studies), nutrition (7), blood glucose monitoring (7), diabetes complications (6), and pathology, symptoms and diabetes management (9). Factors/barriers affecting nurses' acquisition of diabetes knowledge were identified (11). Overall, findings indicated wide-spread serious and sustained deficiencies in nurses' knowledge of diabetes and diabetes care.

CONCLUSION

With nurses demonstrating significant and long-standing knowledge deficits in many aspects of diabetes care, strategies are urgently required to overcome the identified barriers to knowledge acquisition.

Information seeking and retrieval skills of nurses: Nurses readiness for evidence based practice in hospitals of a medical university in Iran

BACKGROUND

With the explosion of medical information, and emergence of evidence-based practice (EBP) in healthcare system, searching, retrieving and selecting information for clinical decision-making are becoming required skills for nurses.

AIMS

The aims of this study were to examine the use of different medical information resources by nurses and their information searching and retrieving skills in the context of EBP.

METHOD

A descriptive, cross-sectional study was conducted in four teaching hospitals in Iran. Data were collected from 182 nurses using a questionnaire in 2014.

RESULTS

The nurses indicated that they use more human and printed resources than electronic resources to seek information (mean=2.83, SD=1.5; mean=2.77, SD=1.07; and mean=2.13, SD=0.88, respectively). To search online resources, the nurses use quick/basic search features more frequently (mean=2.45, SD=1.15) than other search features such as advanced search, index browsing and MeSH term searching. (1.74≤mean≤2.30, SD=1.01). At least 80% of the nurses were not aware of the purpose or function of search operators such as Boolean and proximity operators. In response to the question measuring skills of the nurses in developing an effective search statement by using Boolean operators, only 20% of them selected the more appropriate statement, using some synonyms of the concepts in a given subject.

CONCLUSION

The study showed that the information seeking and retrieval skills of the nurses were poor and there were clear deficits in the use of updated information resources. To compensate their EBP incompetency, nurses may resort to human resources. In order to use the latest up to date evidence independently, nurses need to improve their information literacy. To reach this goal, clinical librarians, health information specialists, nursing faculties, and clinical nurse educators and mentors can play key roles by providing educational programs. Providing access to online resources in clinical wards can also encourage nurses to learn and use these resources.

Nurses’ and midwives’ information behaviour: a review of literature from 1998 to 2014

Purpose

– This paper aims to provide an overview of recent literature on nurses’ and midwives’ information behaviour, with a particular focus on sources used and barriers encountered.

Design/methodology/approach

– Comprehensive searching was undertaken and an analysis of the appropriate literature carried out.

Findings

– Practitioners within the nursing profession have a marked preference for interactive and human sources of information. They habitually associate information seeking with professional development rather than with clinical practice. Lack of time is the most frequently reported problem; also, they frequently lack confidence in searching and appraising the professional literature and in applying research in practice. Cultural factors may inhibit information seeking in the workplace, and access to appropriate information technology may be limited.

Practical implications

– As a group, nurses and midwives present significant challenges to health library and information professionals seeking to design services to meet their needs. A perceived lack of access to information resources may be associated with pervasive information literacy skill deficits, with the inability to undertake critical appraisal of material that is retrieved, or with the lack of a workplace culture that is supportive of information seeking. To reach nurses and midwives, more than diligent marketing is required; library and information professionals need to work closely with the holders of nursing and midwifery research, practice development and educational roles within their institutions on “embedded”, specific information initiatives.

Originality/value

– An overview of recent work is presented on the information behaviour of nurses and midwives within developed economies, focusing particularly on the UK. It may be of interest and value to health librarians and to nursing and midwifery educators in facilitating evidence-based practice.

Primary health-care nurses and Internet health information-seeking: Access, barriers and quality checks

Online information is a critical resource for evidence-based practice and patient education. This study aimed to establish New Zealand nurses' access and evaluation of online health information in the primary care context using a postal questionnaire survey; there were 630 respondents from a random sample of 931 nurses. The majority of respondents were satisfied with work access to online information (84.5%, n = 501) and searched for online information at least several times a week (57.5%, n = 343). The major barrier to online information seeking was insufficient time, but 68 respondents had no work online information access. The level of nursing qualification was significantly correlated with computer confidence and information quality checking. A range of information evaluation approaches was used. Most nurses in study accessed and evaluated Internet information in contrast to the findings of earlier studies, but there were barriers preventing universal integration into practice.

Quality of care for patients with traction in shahid beheshti hospital in 2012

Background

With increasing incidence of traumatic fractures, the use of orthopedic intervention such as traction has increased. Inappropriate traction care may cause substantial morbidity and delay the patient rehabilitation.

Objectives

This study was conducted to evaluate the quality of care for patients with traction in the orthopedic unit of Kashan's Shahid Beheshti Hospital, Kashan, Iran.

Patients and Methods

This observational study was conducted on 100 patients with traumatic fractures of hip and femur bones who were admitted to Kashan Shahid-Beheshti Hospital during the first 6 months of 2012, and for whom skeletal or skin traction was performed. Data were collected using a checklist including questions about the personal characteristics and 23 items related to care for patients with tractions. These items were in three domains including caring while establishing traction, recording care and patient’s education. Descriptive statistics were calculated and data were analyzed using the independent sample t-test and Pearson correlation coefficient.

Results

The mean age of patients was 51.16 ± 23.28 years and 66% of them were male. In total, 47% of the patients were treated by skin traction and 53% by skeletal traction. The overall mean score of quality of care was 10.20 ± 2.64. Quality of establishing traction was good in 55% of patients, but the quality of care was poor in the domains of recording care (88%) and patient education (96%). Total mean of quality of care was significantly different between male and female patients (P < 0.02).

Conclusions

The quality of care of patients with traction was not optimal. Therefore it is necessary to improve measures in this area.

Nurses' attitude to patient education barriers in educational hospitals of Urmia University of Medical Sciences

BACKGROUND

The purpose of this study was to explore nurses' attitudes to the barriers of patient education as a right for getting information based on work situation of nurses, educational facilities in hospitals, and patients' situation.

MATERIALS AND METHODS

The study was conducted using a cross-sectional design. The populations consisted of 240 nurses affiliated in the Educational Hospitals. The data were gathered by a questionnaire. Demographic variables and three domains were studied. Twenty questions were about their working situation, 4 questions about hospital educating facilities, and 12 questions were about patients' situation in hospital. The type and frequency of education barriers were evaluated, and variables associated with reporting an obstacle were analyzed.

FINDINGS

In our questionnaire, we used a Likert scale for determining severity of three domains as the barriers of patient education that ranged from 0 to 4. Generally, it was obvious that educational condition in our hospitals was not good and most of the nurses believed that patient education is not their duties, facilities in hospitals are not sufficient and shortness of time is the most important cause of insufficiency of patient education.

CONCLUSIONS

The interactions of patient, physician and systemic factors have implications for the implementation of patient education. The failure of adequate patient education may be attributed to the lack of patient adherence, the failure of nurses' knowledge and skill level or the insufficient funding and organization of necessary programs in the current health care system.