Module 2, Question 3

I think each index/search engine has it's place. The guideline index would definitely be most useful to practitioners. It is also a good index because others have done all the research for you to come up with the current guidelines. It is also very specific. When I put in my search terms in the guideline index, I only got 2 items, and they were very specific. The other two methods were not as specific.

As a future instructor, I think the electronic indexes will be very useful. Since I won't have patients sitting right in front of me, waiting for me to make decisions on their care, I won't necessarily need the fast, specific information that is provided with the guidelines index. I will however, need access to the guidelines to teach my students the latest in about them, but I will also use the other indexes as well. The Google search was almost silly. So many items come up with Google, it's overwhelming. The other problem with the Google search, is that the first citations to come up are not ususally "scholarly" items. They seem to be aimed at the lay public. I tended to find things like support groups as opposed to legitimate research items. However, to the lay person, this is probably a good research tool to simply find out general information in order to speak somewhat intelligently to their provider. We just have to teach our patients which are reliable sources to turn to. In a previous class, someone suggested only recommending websites that end in "edu" or "org." I think that is good advice.

Module 2, Question 2

This past week, I have been learning to use EndNote. It does have some cool features. First of all, you are basically creating your own database of only the things that interest you. It's like your own mini PubMed that only contains the things you want. Secondly, it allows you to create groups that you can sort your items into and organize them that way. I could make as many and as detailed groups as I wanted.

The software also allows you to search within the database, itself. You could search by topic or author, for example. And say you wanted to send an article by a particular author to a collegue, you would just search for it, retrieve it and then send it. That's assuming the citation you found has a full text article associated with it. EndNote also allows you to find which citations have full text available, which is also a nice feature.

Module 2, Question 1

The clinical issue I wanted to look up was incompetent cervix. Since I am teaching nursing student, I tend to use the CINAHL and ERIC databases, but I wanted more practice with Pubmed. I am a L/D nurse and have personal experience with this particular topic, so I thought it would be a good one to search on Pubmed. I also wanted to find out about the identification of the problem, since it seems that to be diagnosed, a woman has to go through at least 1-2 losses. I was wondering if there were any new ways of identifying the condition before a woman has to experience a loss.

So, at first, I tried the keywords, "incompetent cervix, treatment and identification." I got zero findings with that, so I took out the word "identification." I also added some limits and with that, I got 55 items. The search wasn't very time consuming at all. I think Pubmed makes it easy, but you just have to know how to use Boolean terms and also know what the common MeSH headings are. But even that isn't too tricky, because each citaion has a list of MeSH headings that were used for it, and if you just start using those words in your searches, it makes it a lot easier. For me, as a future instructor, I don't think there will be barriers to using this, I would just have to have access to a computer, which I'm sure I will. But maybe for practitioners, this wouldn't be the best way because you get too many items back, and it does take time to go through them.

Module 1, Question 2

IT is affecting me in two different ways. The first is in my clinical practice setting, which is in labor and delivery. The second is in the teaching field. And, of course, there will be an overlap of the two.

We, in L/D are very lucky to have the ability to chart on "the strip." For those not familiar, we run a strip of the baby's heart rate and the mom's contractions. It's like charting on an EKG strip. About a year and a half ago, we switched charting systems. We used to have a great, user-friendly system that was all-inclusive for our needs. We still have a strip system, but it has very limited capabilities. We now have 5 (that I can think of) different and separate systems that we have to know in order to handle all the potential info on our patients. This includes knowing all the different acronyms that the systems go by and having that many different passwords just to get into them. Our readings mentioned that in order for info systems to work, they have to be "intuitive." I think that's why our unit has had such a hard time transitioning from our old system to the new ones: because we went from an intuitive system to a non-intuitive one. We went from a system that made perfect sense to us, as L/D nurses to one that doesn't.

I think patient care is affected in a negative way due to these changes because there is too much time wasted on double charting, for example. I think the time wasted in fiddling with these inefficient systems takes away from patient care. Also, our old system provided us a way to easily track all admissions on each patient. Our current system makes this much more difficult.

I think IT can improve patient outcomes by decreasing mistakes and sharing info between providers, but on our unit, I think the technology that our company chose is making our lives harder.

As far as teaching nursing goes, I have one word: WIMBA.

OK, I don't just have one word concerning teaching nursing. We now have the capability of showing students moving fetal heart rate tracings from our computers, in the classroom, for them to study and analyze. Pretty cool.

Module1, Question 1

Introduce myself: OK, my name is Rieneke (pronounced Renika) and I am a grad student in the Teaching Nursing program. I am going full-time and am currently in my second semester of 4. I have been a labor and delivery nurse for 11 years and my ultimate goal is to teach undergrads maternity nursing. I love teaching and I love L/D, so I think it's great that I can combine the two.

As far as knowing about information management, I decided it's important for everyone, not just grad-level nurses to know about it. Like our readings mentioned, there is so much information generated in the health care system, alone, that improving technology is the only way to realistically handle it all. On the unit where I currently work, we have a few nurses that have been around for about 30 years, and the majority of them are AD RN's. They too, have had to adjust to the technology as it has advanced. We recently changed computer charting systems, which was a difficult adjustment, even to the computer-savvy nurses, let alone to the ones that are not. My point to all this is that everyone, from AD nurses to grad nurses need to be familiar with the changing technology and information management.

For me, personally, in my upcoming role, knowledge of info management is hugely important. Education is quickly drifting from "traditional, in-the-classroom" to "asynchronous, on-line". In order to participate in this new style of teaching, I will have to be familiar with all the technology it entails.

Just for fun!

Being that I am in the Teaching Nursing program, I thought this was kind of funny. I also thought the instructors might appreciate it. As if tenure just falls into your lap. And once you get it, all your problems are solved! p.s. This is not my post for module 1.