Chapter 10
The Internet: A Road to
Evidence-Based Practice
Information and Health Literacy
• Information literacy
– Awareness of need for information
– Ability to find it
– Ability to analyze its validity and relevance
– Ability to interpret it for use
• Health literacy
– Subset of information literacy
Healthcare Professional Information and
Health Literacy
• Necessary for lifelong learning
• Need:
– Domain knowledge
– Clinical experience
– Functional understanding of search skills
Advantages for Healthcare Professional
Information and Health Literacy
• Improved quality of care (first step in any research study); justify, question, and improve patient care
• New knowledge, design of solutions, implementation and evaluation methods
• Empowerment of healthcare consumer for partnership in care
Question
• Is the following statement True or False?
Answer
• False
Critical Thinking
• Supported by information literacy; does not exist unless used
• Two components
– Skill sets to process and generate information
– Intellectual commitment to use those skills to guide behavior
• Vital part: asking questions, knowing when more
information is needed, developing and applying a plan to acquire information, and using plan to generate
knowledge
Knowledge Generation
• Integration of published literature with aggregated data from computerized clinical information systems
knowledge
• Two parts
– Knowledge developed from turning nursing data into information and interpreting it to make new meaning
Knowledge Dissemination Activities
• Manuscript (via word processing)
• Drawings, presentation or poster presentation
• Spreadsheets to create graphs
• Databases to query, aggregate data, and create reports
• Web documents
• Statistical software to analyze quantitative data
• E-mail for collaborating and sharing nursing knowledge
Healthcare Consumer Information and
Health Literacy
• Important for discharge planning and patient education
• Educational materials written at no higher than a fifth-grade level
• Include nonwritten materials into patient education.
• Readability (testing via Flesch Reading Ease and Flesch-Kincaid Grade Level tests)
Question
• Is the following statement True or False?
Answer
• False
Information Technology Skills
• Necessary to support application of information literacy
• Three kinds of knowledge necessary
– Current skills: use of up-to-date computer applications
– Foundational concepts: understanding underlying principles of computers, networks, and information
– Intellectual abilities: ability to apply information
technology for problem solving; abstract thinking and ability to manipulate information for new
Discovery and Evaluation of Health
Information on the Internet
• Need for a systematic, analytical review process
• Essential information for validation
– Source
– Funding
– Validity and quality
Nursing Knowledge on the Internet
• Web sites related to
– Laws, rules, and regulations related to nursing practice
– Nursing care
– Healthcare agencies and nursing education programs
– Government-sponsored and not-for-profit health and disease specialty organizations
– Nursing professional organizations
– Continuing education resource
Sites for Laws, Rules, and Regulations
• The National Council of State Boards of Nursing (NCSBN) https://www.ncsbn.org/index.htm: links to all U.S. state boards of nursing; information about the National Council Licensure Examination (NCLEX)
• Joint Commission: http://www.jointcommission.org/
• Centers for Medicare and Medicaid (CMS) http://www.cms.hhs.gov/
Government and Not-for-Profit Health and
Disease Specialty Organizations
• National Institutes of Health (NIH) http://www.nih.gov
• Centers for Disease Control and Prevention (CDC) http://www.cdc.gov/
• CDC Wonder http://wonder.cdc.gov/
Question
• Is the following statement True or False?
Answer
• True
Scholarly Journals and Journal Articles
• Free online journals
– Online Journal of Issues in Nursing (OJIN)
– Online Journal of Nursing Informatics (OJNI)
– BMC Nursing
– Free medical journals
– BioMed Central
Scholarly Journals and Journal Articles
(Cont.)
• Factors affecting online journals
– Perception that content quality is less than that of print journals
– Writing for publication may present a dilemma.
– Lack of awareness by nurses that journals exist
Scholarly Journals and Journal Articles
(Cont.)
• Web presence for print journal
– Full-text digital versions available with personal subscription or small fee for nonsubscribers
• Articles from search engines
– Medscape®: full-text articles, free
Scholarly Articles versus Ezine,
Newspaper, or Web Site
• Scholarly article
– Written by qualified nurse with subject area expertise
– Subject to complex peer-review process
• Ezines and newspapers
– Written by reporters, not necessarily nurses or person with expertise in nursing
– Example: ADVANCE for Nurses
• Web sites
– Not required to be authored by qualified nurse
Professional Organizations
• Each organization has Web site of general information for public and password-protected information for members.
– ANA
– Sigma Theta Tau International (STTI)
Question
• Is the following statement True or False?
Answer
• False
• Rationale: Ezine articles are written by reporters, who may or may not be nurses or persons with expertise in nursing. Scholarly articles undergo a peer-review
Clinical Practice and Informatics
• Evidence-based nursing
• Star Model of Knowledge Transformation©
– Cyclical process of moving knowledge from original research into patient care
– Evidence summary translation into practice guidelines + clinical expertise set of
recommendations for best practice implementation into practice evaluation via patient outcomes,
Online Evidence-Based Resources
• Abundance of information
• Variable in quality
• Comprehensive Web sites found in libraries and educational evidence-based practice centers
