Friday, February 13, 2009
Module 2 Question 3: Indices
I found the electronic index the easiest to use in terms of researching a clinical question. I frequently review guidelines but it is difficult to find a definitive clinical answer without reading the supporting data. I do not have the same level of confidence in a clinical guideline as I do in a review of the literature. Guidelines are situation and specialty specific. A guideline from Europe may not be accepted in the U.S. A guideline from internal medicine may not have the same recommendations as a guideline from endocrinology. Web search engines are entertaining and may retreive more information on alternative therapies than PubMed but I think their use is limited in evidence based practice. I may do a web engine search to develop a search strategy and learn more about a topic but I would always go back to PubMed or another appropriate electronic database for actual research. All resources are useful for information retrieval but the researcher has the responsibility to determine the quality of the research needed. I read texts and journal articles in print as alternative methods of developing a research strategy. Texts and journal articles onpoint have references that I may not be able to find online.
Module 2 Question 2: Endnote
Endnote has features that allow me to create groups for my different research topics. I like that I was able to create a master endnote library. I also liked being able to separate my articles into specific groups based on issues. I was able to create an account for PubMed and then import the references into a group I formed. I was able to sort and revise my references in endnote and export a revised list into another file I could attach to my email. I was able to sort my references by date, text available, author and so on. I also enjoyed cite while you write and used it for a paper for another class last week. I changed my settings to APA 5th and was able to format my paper and references appropriately.
Module 2 Question1: Clinical Problem
The clinical problem I selected was based ona recent patient interaction. A 38 year old with Type II Diabetes and hypercholesterolemia recently lost his job as an engineer in Silicon Valley and could no longer afford his prescription medications and pay his mortgage. The pharmacist was attempting to find over the counter options for 25% of his pprescription cost. I wanted to reasearch and see how effective the following are for hypercholesterolemia: omega 3 fish oil, niacin and/or green tea. I wanted to review randomized clinical trials due to the fact that I wanted to advise a patient. I tried the Cochrane Librabry without success. I returned to PubMed and retrieved many articles for niacin, some for fish oil and one for green tea. PubMed was easy to search using the MeSH database and it was easy to track the search history. I don't think alot of research has been done on fish oil and green tea. The search in PubMed was not time consuming but it would be difficult to use routinely in a clinical setting. I found that it was important to take the time to plan the search and also to revisit the search strategy. I also needed to read articles in order to develop a more efficient search strategy. This would be difficult to do at work.
Tuesday, February 10, 2009
Blog entries for module 1
My name is Ann E. LaPolla and I am currently in the acute care DNP program. I am currently living in the Bay Area and started a new job. Time will tell whether or not I will be able to complete my program at the U of have to transfer to another school. Currently I am commuting between SF and SLC, however the pace of my job is picking up so I will mostly spend more time in SF than SLC. I have found knowledge about information management not only crucial in graduate school but essential at work. My new position requires managing databases, intrepting and communicating results. I need to access information from regulatory agencies daily and incorporate information into new management models. The hospital where I currently work in CA does not have any computer charting. It is extremely frustrationg to collect data from paper. I find it interesting that most hospital in the Bay Area are so far behind Utah in terms of computerized anything. Lots of duplicate and triplicate charting in these hospitals. Lots of room for errors. Going from computerized charting and medication administration systems in Utah has made me realize how dangerous paper charting really is.
The hospital where I work has nothing on the computer except lab and radiology results. The amount of paper charting the nurses must do is horrendous. The charting is in no way coordinated. Everyone tries to access the chart at the same time and tempers grow short. The is a long delay between orders being taken off by the unit clerk, pharmacy releasing or bringing the med to the ICU and the nurse finally administering it. There are no checks in the medication administration process. I see alot of med errors that could be prevented by computerized medication administration.
My new position is Director of Quality, Risk Management and Performance Improvement and there is alot of work that needs to be done to bring the facility where I am working into compliance. Currently, the physician and nursing cultures of the hospital do not support evidenced based practice. The staff is unaware of patient safety goals. There is no internet access at the hospital for clinical staff so they are unable to research meds, protocols and questions. Nursing documentation is not standardized from unit to unit and rarely do the staff look at the previous nursing notes. I believe that access to information is crucial for quality patient care. As an attorney, I see many areas of miscommunication, near misses and actual patient harm. One of my goals is to research a cost effective way to introduce computerized systems into the hospital.
The hospital where I work has nothing on the computer except lab and radiology results. The amount of paper charting the nurses must do is horrendous. The charting is in no way coordinated. Everyone tries to access the chart at the same time and tempers grow short. The is a long delay between orders being taken off by the unit clerk, pharmacy releasing or bringing the med to the ICU and the nurse finally administering it. There are no checks in the medication administration process. I see alot of med errors that could be prevented by computerized medication administration.
My new position is Director of Quality, Risk Management and Performance Improvement and there is alot of work that needs to be done to bring the facility where I am working into compliance. Currently, the physician and nursing cultures of the hospital do not support evidenced based practice. The staff is unaware of patient safety goals. There is no internet access at the hospital for clinical staff so they are unable to research meds, protocols and questions. Nursing documentation is not standardized from unit to unit and rarely do the staff look at the previous nursing notes. I believe that access to information is crucial for quality patient care. As an attorney, I see many areas of miscommunication, near misses and actual patient harm. One of my goals is to research a cost effective way to introduce computerized systems into the hospital.
Subscribe to:
Posts (Atom)