Medical Librarians & the Magnet Journey

Midday at the OasisMarch 20, 2013

Adele Dobry, Nursing Informationist, UCLA Biomedical Library Lisa Marks, Director, Providence Saint Joseph Medical Center,

Burbank

Introduction

History of Magnet

Forces of Magnetism

The Clinical Practice Council (CPC) at UCLA

Librarian Role in Supporting Evidence-Based Practice

Overview

Provide instruction and research support to:

◦ Department of Nursing ◦ School of Nursing◦ Office of Animal Research and Oversight ◦ Ecology and Evolutionary Biology ◦ various other life science departments

Adele Dobry, Nursing Informationist, Louise M. Darling Biomedical Library, UCLA

Nursing shortage of 1970s and 1980s

◦ Why were some hospitals able to attract and keep nurses while others were scrambling to fill positions (Schwartz & Iobst, 2008)?

◦ 1983: American Academy of Nursing (AAN): Task Force on Nursing Practice in Hospitals• Performed a study to recognize “environments that attract and

retain well-qualified nurses who promote quality patient, resident and client care” (ANCC, 2013).

Brief History of Magnet Program

41 of 163 institutions “possessed qualities that enabled greater capacity to attract and retain nurses, and were therefore described as “magnet” hospitals” (ANCC, 2013).

These distinguishing qualities are known as “Forces of Magnetism.”

1990: The American Nurses Credentialing Center (ANCC) and Magnet Hospital Recognition Program for Excellence in Nursing Services were created. ◦ The ANCC is a subsidiary of the American Nurses Association

(ANA) (ANCC, 2013).

Study Results

1. Quality of Nursing Leadership2. Organizational Structure3. Management Style4. Personnel Policies and Programs5. Professional Models of Care6. Quality of Care7. Quality Improvement8. Consultation and Resources9. Autonomy10.Community and the Health Care Organization

Forces of Magnetism

11. Nurses as Teachers12. Image of Nursing13. Interdisciplinary Relationships14. Professional Development

(ANCC, 2013)

Forces of Magnetism continued

New Model of ANCC Magnet Recognition Program©

(ANCC, 2013)

Model Components & Forces of Magnetism

(ANCC, 2013)

2005: UCLA Medical Center designated as a Magnet Hospital (UCLA Health System, 2010)

2010: UCLA Medical Center re-designated as a Magnet Hospital (UCLA Health System, 2010)

The structure that the Clinical Practice Council (CPC) provides supports the indicators of nursing excellence which Magnet recognizes.

Clinical Practice Council, UCLA

“Historically, hospital nursing policy and procedure committees have focused mainly on the process of policy review, with limited reliance on research and evidence-based literature to guide changes in practice documents and with minimal involvement of staff nurses” (Becker et al., 2012).

CPC Filled a Research Gap

From the article “Clinical Nurse Specialists Shaping Policies and Procedures Via an Evidence-Based Clinical Practice Council”:◦ 1. Foster exemplary patient care through the development,

review, and dissemination of clinical nursing policies, procedures, and institutional guidelines of care.

◦ 2. Ensure that practice documents are aligned with the latest research and evidence.

◦ 3. Provide a forum that stimulates innovative thinking among frontline clinicians regarding integrating evidence into current practices.

◦ 4. Provide a mechanism for dissemination and feedback regarding new practices among frontline clinicians (Becker et al., 2012).

Clinical Practice Council Goals

3 major subgroups◦ Critical Care- Emergency◦ Intermediate Care- Medical Surgical◦ Pediatrics, Neonate, and Perinatal

◦ Doctorally prepared director of research and EBP serves as the chair of CPC

◦ Each subgroup is chaired by 1 or 2 CNSs◦ Each subgroup has 10-15 nurses (Becker et al., 2012)

CPC Structure

CPC members meet monthly for 4 hours to work as a group in the following areas, from Becker article:◦ 1. retrieval, critique, and synthesis of evidence-based

literature◦ 2. interpretation and evaluation of current evidence◦ 3. review and revision of policies and other practice

documents◦ 4. performance as a member of a nursing team within council

structures◦ 5. dissemination of EBP changes◦ 6. clinical role modeling and leadership skills (Becker et al.,

2012)

CPC Meetings

Attend monthly CPC meetings to assist subgroups with research.

Provide research instruction sessions at the Library, local summits, meetings, and at units.

Provide individual research consultations. Be available via phone and email. Attend and present at, if possible, at local Evidence-

Based nursing conferences and/or the ANCC National Magnet Conference.

Librarian Role

1. introduction/overview

◦ What would you like to learn?◦ What tools or resources have you used to do research in the

past?

◦ Go over Biomedical Library website and Nursing Research Guide

◦ How to find and request books

Outline of Library Research Session

Publication Process

The Peer Review Process

Evidence Grading Schemes

Pick an example topic based on one of the nurses selected topics for research, if possible

“Diagram” the topic on the board◦ Synonyms◦ Boolean operators

◦ Try the PICOT Search Strategy worksheet

Search Strategy Overview

PubMed◦ Simple search◦ Filters◦ Search details◦ Send to◦ Access full text (request articles when needed)◦ MeSH◦ Advanced◦ Clinical Queries◦ Save Search◦ My NCBI

Database Time!

CINAHL◦ Smaller database focused on nursing◦ Use synonyms in search◦ Go over limiters and subsets◦ Emphasize usage of “apply related words” and “also search within

the full text of the articles” expanders to find more results as necessary

◦ Refine results◦ Citation mapping◦ Subject: Major Heading (use to refine search)◦ Tools: email article, copy and paste citation◦ CINAHL Headings◦ EBSCO account

More Databases

Cochrane Review◦ Systematic reviews

National Guideline Clearinghouse◦ Browse and compare guidelines

Web of Science◦ Citation mapping◦ EndNote Web

Databases Continued

Personal searching time with the librarian

Questions

Remind nurses of consultations-make an appointment to meet with the librarian

Hand out assessment forms

Conclusion of Research Class

Now you know:

◦ Why Magnet started

◦ What the Magnet Model is made up of

◦ An example of an evidence-based practice program

◦ How the Librarian supports nurses in this program

◦ Outline of key concepts to cover when teaching

wrap-up

American Nurses Credentialing Center. (2013). Program Overview. Retrieved from http://www.nursecredentialing.org/Magnet/ProgramOverviewBecker, E., Dee, V., Gawlinski, A., Kirkpatrick, T., Lawanson- Nichols, M., Lee, B., . . . Zanotti, J. (2012). Clinical nurse specialists shaping policies and procedures via an evidence- based clinical practice council. Clinical Nurse Specialist, 26, 74-86. doi: 10.1097/NUR.0b013e3182467292Sherwill-Navarro, Pamela, & Roth, Karen L. (2007). Magnet hospitals/magnetic libraries-the hospital medical library: a resource for achieving magnet status. Journal of Hospital Librarianship, 7(3), 21-31. Retrieved from http://www.tandfonline.com/loi/whos/Schwartz, Linda Matula, & Iobst, Barbara J. (2008). Magnet again! Librarian's role in research collaboration to maintain Magnet status. Journal of Hospital Librarianship, 8(1), 72-81. Retrieved from http://www.tandfonline.com/loi/whos/UCLA Health System. (2010). UCLA awarded redesignation as a national Magnet hospital. Retrieved from http://www.uclahealth.org/body.cfm?id=426

References