Module 3: Electronic Index, Guideline Index, Search Engine

I was able to use an electronic index (PubMed), a guideline index (National Guideline Clearinghouse web site), and a web search engine (Google) to research diabetic amputations. I found that these three techniques have some similarities and differences, and some strengths and weaknesses. The electronic index is unique in that it provides articles about all of the information available about a given topic (unlike the guideline index which just offers practice guidelines). It would be useful in writing a resarch paper. However, if I were at work and trying to discover the best way to perform a certain procedure, the guideline index would be the most convenient. I would have less information through which to filter. The web search engine is useful in that it is available from any computer that has the internet, unlike the electronic index, which is only available in some libraries. It provides a lot of information about a given topic, and a search can be narrowed as in the other two indices. However, the sources of the information should be researched to make sure the information they contain is valid. An added benefit of the web search engines is that a lot of the information is written in language that would be understood by patients; they could therefore be printed out and given to patients for educational material.
All three information sources were useful for my information retrieval. Their usefulness simply depends on the reason that I am conducting the search. I preferred PubMed for my own learning purposes, simply because I find that research articles can be critiqued for their validity. However, if I wanted to provide educational material for my patients, I might use a web search engine. If I wanted to determine if my floor uses the most up-to-date practices, I would look at the national guideline clearinghouse. An alternative research method would be to look at textbooks or books about certain topics (the "old-fashioned" way), by using a library index. Because I want to find different types of information in different situations, context-relevant information retrieval would definitely be useful.

Module 3: Reference Management Software

I chose to use Endnote as my reference management software. Although it was a struggle for me to access it (I was able to find it on the computers in the Health Sciences Library), it seems that this software would be useful in referencing works. It includes the option of creating your own libraries of articles, organized by topics. I could create libraries on a variety of topics, and I could organize the articles by publication year or alphabetically. I could search online for articles through endnote. Also, articles and references can be directly imported from a variety of electronic indexes (including PubMed) to my library. By clicking on the articles within my library, I could access the abstracts of these articles, which would be useful in remembering what their findings are. This would be especially useful as my library expands. This program can be used to reference the articles in a research paper, and it includes styles of referencing text (such as APA) depending on my needs. If I include articles in my research paper, I would be able to keep my references organized with footnotes or endnotes. A librarian even told me that I could e-mail my library references to someone else, and that if they had Endnote, they would be able to access the article abstracts in the same way that I can. Although it was somewhat hard for me to figure the program out, I feel that it would become user-friendly as I used it more.

Module 3: Electronic Index

I chose to research diabetic amputations, which I see a lot in my practice. I looked for prevention and treatments on PubMed. After completing the tutorial, I found that there are a lot of options that can help with research. For example, after doing my search using keywords, I was able to create (and save) a clipboard that included only the articles that I thought would be of interest. Also, there was an option of viewing the articles' abstracts online, and I was even able to create a clipboard of articles that included full text online. This would be a definite time saver. There is also the option of having the National Library of Medicine (the information source) e-mail me any new articles that are published. This would be a great way to keep abreast of new developments so that I could continue to use evidence-based practice. I felt that the search was very efficient; it did not take long to find articles once I had chosen and narrowed my topic. The only barrier that I can think of in using this index in daily practice is that I would need to have access to a computer that has access to PubMed. The computers on campus (which are the ones that I use) all have it, so this currently would not be a barrier to me.

Module 2- Structured Terminologies

Honestly, as a registered nurse working on my floor, I was unaware of structured terminologies. However, I have done some research and found out that they are, in fact, used. An RN case manager and a billing employee told me that the physicians who visit patients on the floor use the ICD-9 coding system, which ensures that their patients' insurance will be charged. Also, the case manager told me that they use a system called Interqual, which has a list of diagnoses and criteria that are applied to patients so that their insurance will process their claim. I also talked with an admissions employee, who said that when patients are admitted to the hospital, they (or a family member) fill out a form that includes all of the necessary data that the hospital requires (such as demographics, phone number, employment, an emergency number, etc.). Although the employee did not know of a name for this information, it is possible that this may be part of the nursing minimum data set. As far as structured terminologies that I use in my nursing practice, I use the NANDA terminology for nursing diagnoses. These nursing diagnoses are sometimes listed on the patients' cardex, and the nurses perform interventions based on these nursing diagnoses. I do not know of any place that they can be found in the new computer system that we have been using.
Structured clinical data can be useful in providing quality patient care because it promotes communication among the people who work for a specific patient. All of the care providers know something about the patient's background (such as with the minimum data set). Also, if all of the data is in structured terminologies, all providers "speak the same language" and can provide treatment while keeping in mind the various diagnoses and treatments the patient is experiencing.