Information literacy as the foundation for evidence-based practice in graduate nursing education: a curriculum-integrated approach.

As part of a system-wide initiative to advance evidence-based practice among clinicians, graduate students, and educators, the New York University Division of Nursing embarked on a curricular initiative to integrate components of information literacy in all core courses of the master's program. Increasing competency in information literacy is the foundation for evidence-based practice and provides nursing professionals with the skills to be literate consumers of information in an electronic environment. Competency in information literacy includes an understanding of the architecture of information and the scholarly process; the ability to navigate among a variety of print and electronic tools to effectively access, search, and critically evaluate appropriate resources; synthesize accumulated information into an existing body of knowledge; communicate research results clearly and effectively; and appreciate the social issues and ethical concerns related to the provision, dissemination, and sharing of information. In collaboration with the New York University Division of Libraries' Health Sciences Librarian, instructional modules in information literacy relevant to each of the 5 core nursing master's courses were developed, complemented by a Web-based tutorial: http://library.nyu.edu/research/health/tutorial. The Web site is multifaceted, with fundamentals for the beginner, as well as more complex content for the advanced user. Course assignments were designed to promote specific competencies in information literacy and strategies for evaluating the strength of the evidence found. A survey of information literacy competencies, which assessed students' knowledge, misconceptions, and use of electronic information resources, was administered when students entered the program and at 1-year intervals thereafter.     

The Australian experience of nurses' preparedness for evidence-based practice

Aim  This study aimed to determine current knowledge and attitudes towards evidence-based practice (EBP) among pre- and post-registration nurses in New South Wales (NSW), Australia.
Background  Educational and clinical strategies for EBP in nursing assume a readiness to interpret and integrate evidence into clinical care despite continued reports of low levels of understanding and skill in this area.
Method  Perceptions of EBP were examined through a self-complete, anonymous postal survey distributed to 677 (post-registration) clinical nurses and to 1134 final year (pre-registration) nursing students during 2002 and 2003.
Results  A completed survey was returned by 126 post-registration and 257 final year nursing students (combined 21% response rate). Both pre- and post-registration nurses had a welcoming attitude towards EBP. Pre-registration nurses expressed more confidence in their EBP skills but self-rated knowledge and skill were low to moderate in both groups.
Conclusion  Nurses in Australia are clearly supportive of EBP but it is incorrect to assume that even recent graduates have a level of knowledge and skill that is sufficient to permit direct engagement in evidence implementation.
Implications for nursing management  Among a range of clinical supports, nurse managers and leaders can contribute to evidence-based health care by understanding the EBP knowledge and skills of their workforce and demanding a more practical approach in nursing education towards evidence-based guidelines and summaries appropriate to the clinical context.     

Computer literacy study: report of qualitative findings.

Computer literacy and information literacy are critical to the future of nursing. The very nature of health care is being transformed in response to environmental drivers such as the demands for cost-effective delivery of high quality services and enhanced patient safety. Facilitating the quality transformation depends on strategic changes such as implementing evidence-based practice (), promoting outcome research (), initiating interdisciplinary care coordination [Zwarenstein, M., Bryant, W. (2004). Interventions to promote collaboration between nurses and doctors. The Cochrane Library(I)], and implementing electronic health records (). Information management serves as a central premise of each of these strategies and is an essential tool to facilitate change. This report of the analysis of qualitative data from a national online survey of baccalaureate nursing education programs describes the current level of integration of the computer literacy and information literacy skills and competencies of nursing faculty, clinicians, and students in the United States. The outcomes of the study are important to guide curriculum development in meeting the changing health care environmental demands for quality, cost-effectiveness, and safety.     

Computer competencies in a BSN program

Beginning nurses need informatics skills to work efficiently in an environment that increasingly relies on information technology to promote patient safety. In addition, a federal order mandates that all Americans have an electronic medical record by 2014. Nursing programs must integrate informatics content into their curricula to prepare nurses to use information technology. This article describes a baccalaureate (BSN) curriculum evaluation of nursing informatics content. Results can inform faculty about strategies that can strengthen informatics competencies. A research-based tool, based on the informatics competence work of Staggers, Gassert, and Curran, was developed to evaluate course syllabi. Although evidence of learning experiences related to computer skills was present, students were not routinely exposed to computerized systems. No syllabi included evidence that addressed informatics knowledge competencies. We conclude that students received limited informatics exposure and may not be adequately prepared to use information technology. Recommendations for increasing nursing informatics experiences within a BSN curriculum are offered.     

Efficacy of integrating information literacy education into a women's health course on information literacy for RN-BSN students

Information literacy, essential to evidences-based nursing, can promote nurses' capability for life-long learning. Nursing education should strive to employ information literacy education in nursing curricula to improve information literacy abilities among nursing students. This study explored the effectiveness of information literacy education by comparing information literacy skills among a group of RN-BSN (Registered Nurse to Bachelors of Science in Nursing) students who received information literacy education with a group that did not. This quasi-experimental study was conducted during a women's health issues course taught between March and June 2004. Content was presented to the 32 RN-BSN students enrolled in this course, which also taught skills on searching and screening, integrating, analyzing, applying, and presenting information. At the beginning and end of the program, 75 RN-BSN student self-evaluated on a 10 point Likert scale their attained skills in searching and screening, integrating, analyzing, applying, and presenting information. Results identified no significant differences between the experimental (n = 32) and control groups (n = 43) in terms of age, marital status, job title, work unit, years of work experience, and information literacy skills as measured at the beginning of the semester. At the end of the semester during which content was taught, the information literacy of the experimental group in all categories, with the exception of information presentation, was significantly improved as compared to that of the control group. Results were especially significant in terms of integrating, analyzing, and applying skill categories. It is hoped that in the future nursing students will apply enhanced information literacy to address and resolve patients' health problems in clinical settings.     

Nursing students and health literacy: The effect of region and programme level

Low levels of health literacy have been associated with poor health outcomes. If an organisation does not have a health literate workforce, it cannot be expected to create a healthcare service that supports the development of health literacy among its users.The aim of this cross-sectional study was to determine the health literacy profiles of undergraduate student nurses over year groups and between regions. The collaborative study employed an anonymous online survey using the Health Literacy Questionnaire which investigated the health literacy profiles of 845 undergraduate student nurses from eight universities in four regions from mid-2014 to early 2016 with co-investigators in each of the universities. Results show specific significant changes in health literacy profiles as a function of year level across the four regions; for example, in the Ability to find good health information. Different regions have different health literacy profiles; however, all could be improved. The results from this study provide specific direction to educators on what student health literacy may look like upon graduation as well as challenge current assumptions. Graduating nurse professionals have a role in mediating and sponsoring a health literate health system as well as being part of supporting patients’ health literacy.     

The missing link: information literacy and evidence-based practice as a new challenge for nurse educators

The evolution of nursing as a profession requires the development of evidence-based practice based on outcomes and the ability by nurses to access and evaluate professional literature, both in print and on the Internet. To educate nurses to apply current research outcomes to nursing practice, an information literacy program was designed and implemented for first-semester associate degree nursing students in conjunction with a foundations in nursing course. The effectiveness of the program was evaluated using a 22-item questionnaire, both prior to the course and immediately after. A control group, students who did not receive the intervention, was also tested at both time points. Data analysis revealed that the information literacy program had both a positive effect on students' literacy skills and a negative effect on their attitudes toward the need for using these skills in nursing practice.     

Improving nurse computer proficiency with a tri‐focal educational intervention

Use of the electronic health record is expanding rapidly. Nurses are primary users of this technology and more than half rate their own computer skills to be below average. Nurses at this ambulatory genitourinary oncology practice recognized a need to improve information technology (IT) skills in the nursing team. An assessment was undertaken of nurses working in the unit by means of a confidential survey. The survey questioned nurses' ability to perform unit‐specific tasks as well as offering a free text component to identify further educational needs. Survey responses identified a need to improve computer proficiency. A nurse‐led, unit‐specific, educational intervention was developed to address this need and improve nurses IT skills. Unit‐specific competencies were identified as well as basic computer skills. The intervention was targeted at adult learners and addressed different styles of learning. A PowerPoint presentation was developed utilizing a step‐by‐step pictorial and written instruction to guide the nurse to complete the intended task. This was presented in small groups to allow visual and auditory learning. The PowerPoint presentation was also e‐mailed to each staff member for reference and personal learning. Finally, multiple opportunities for hands on learning were offered in small groups or one‐on‐one to allow kinesthetic learning to take place. Post‐survey results demonstrated an increase in unit‐specific competencies and improved overall confidence in IT skills. This was a small group of nurses N = 53, pre‐survey responses (N = 32) and post‐survey responses (N = 14) were low but within expected norms for surveys. A unit‐specific peer led intervention can improve IT skills in nurses and open a dialogue about computer skills     

Health literacy as the missing link in the provision of immigrant health care: A qualitative study of Southeast Asian immigrant women in Taiwan

ObjectivesLanguage and communication barrier are main contributors to poor health outcomes and improper use of health care among immigrants. The purpose of this study was to explore and understand specific language and communication problems experiences by Southeast Asian immigrant women in Taiwan.DesignThis qualitative study used focus groups and in-depth interviews to uncover the experiences of immigrant women regarding their access to and utilization of health care in Taiwan.ParticipantsEight focus groups were conducted with 62 Southeast Asian immigrant women and 23 individual in-depth interviews with a wide range of stakeholders who had diverse background and intimate knowledge of immigrant-relating health care issues were performed.ResultsDirected content analysis was applied and identified four major themes concerning conditions that influenced immigrant women's use of health information and services: (1) gaining access to health information, (2) navigating in health care delivery system, (3) interactions during health care encounters, and (4) capability of using health information and services. Findings from this study suggest that, without basic language and literate skills, the majority of immigrant women had inadequate health literacy to manage health information and navigate the Taiwan health care system. Interpersonal communication gap between immigrant women and health care providers exists because of lack of health literacy in addition al language and cultural barriers.ConclusionWith limited language and health literacy skills, immigrant women face numerous challenges in navigating the health care system, interacting with health care providers, and gaining access to proper health care. Future efforts are necessary to enhance individual's health literacy and establish health literate environment.     

The education and training needs of qualified mental health nurses working in acute adult mental health services

This paper presents findings from a research study that investigated the education and training needs of qualified mental health nurses who work in acute adult mental health services in the UK. The study aimed to address a key knowledge 'gap' highlighted by recent Department of Health reports () that suggest that little is known regarding the education and training expectations, priorities and needs of mental health nurses who work in acute adult mental health services. This study aimed to identify (i) what type of post-registration education and training mental health nurses working in acute settings need; (ii) how the nurses want education and training to be delivered; and (iii) what qualifications and accreditation the nurses want to receive? The research consisted of two methods: focus groups and a questionnaire survey. This paper reports on the findings from the questionnaire survey. The results of the survey demonstrate that there is a real need for post-registration education and training for this group of nurses; to equip them with the relevant knowledge and skills to nurse people in the acute phase of their mental illness in acute inpatient settings.     

A qualitative study of charge nurse competencies.

Little information exists regarding competencies required to function as a charge nurse. This qualitative study identified charge nurse competencies. Data sources were interviews (N = 42) with charge nurses, head nurses, staff nurses, and supervisory personnel. A total of 54 competencies were identified in four categories: clinical/technical, critical thinking, organizational and human relations skills. The charge nurses who were interviewed primarily came from medical-surgical and intensive care units. The competencies derived from their interviews reflect leadership and management skills that medical-surgical nurses need to function as effective charge nurses.     

Health education: an important role for school nurses.

Health education is an important, yet challenging and time-consuming, nursing intervention. It is one of the most important tools school nurses have in teaching students, families, and staff about health. To be effective health educators, nurses need skills in planning and implementing attractive and effective programs to students. They also need to develop skills in evaluating the effectiveness of their efforts to emphasize the impact school nursing can have on the health of children. This editorial highlights the school nurse's role in health education in schools and gives a brief overview of the health education process. Health education provides many opportunities for school nurses to reach out in new and creative ways to students in their quest to promote health and success in the school environment.     

Nurses and Internet health information: a questionnaire survey

AIM: This paper is a report of a study to identify the extent of postgraduate nursing students' information literacy skills in relation to electronic media and health information and barriers to accessing this information. BACKGROUND: The Internet is a key source of information for a significant group of patients. However, there is evidence of quality issues with some Internet health information sites. Nurses need to be aware of the range and quality of online health information so as to assist patients and families to locate and evaluate relevant and current information. METHOD: A questionnaire designed to collect quantitative and qualitative data was posted to a convenience sample of all students enrolled in a postgraduate nursing programme in December 2005. The response rate was 55.1% or 123 responses. RESULTS: Most respondents had Internet access at home and work and believed that access to online health information resources had improved their practice. However, some had difficulties in accessing computers at work and insufficient time to search for online health information. Concern was expressed about the quality of online information, but the majority of respondents did not assess patient use. Frequent users of online resources were more likely to assess patient use. CONCLUSION: The development of nursing competencies in accessing and using online resources is a key precursor to supporting patients and families' use of the medium. Access to Internet resources at work, along with training and time for searching, is necessary for the development of skills enabling effective use of information technology.     

The Henry street consortium population-based competencies for educating public health nursing students

The Henry Street Consortium, a collaboration of nurse educators from universities and colleges and public health nurses (PHNs) from government, school, and community agencies, developed 11 population-based competencies for educating nursing students and the novice PHN. Although many organizations have developed competency lists for experts, the Consortium developed a set of competencies that clearly define expectations for the beginning PHN. The competencies are utilized by both education and practice. They guide nurse educators and PHNs in the creation of learning experiences that develop population-based knowledge and skills for baccalaureate nursing students. Public health nursing leaders use the competencies to frame their expectations and orientations for nurses who are new to public health nursing. This paper explains the meaning of each of the 11 population-based competencies and provides examples of student projects that demonstrate competency development. Strategies are suggested for nurse educators and PHNs to promote effective population-based student projects in public health agencies.     

Promoting health literacy: a nursing imperative

It is imperative that nursing responds to the call of creating a health literate society by taking an active role in health literacy research, education, and promotion. Nurses have a professional and ethical obligation to communicate in a clear, purposeful way that addresses the unique information needs of each patient. Evidence-based strategies that promote health literacy must be incorporated in every patient's plan of care and become part of the routine practice of nursing. The goal of all patient interactions should be to empower the patient to obtain, understand, and act on information that is needed for optimal health. This article explores the concept of health literacy and its relationship to patient education and communication. Practical strategies that the nurse can use to assess, communicate with, and evaluate comprehension in patients with low literacy skills are provided.     

Health literacy knowledge and experiences of associate degree nursing students: A pedagogical study

Health literacy is recognized as a major health problem in the United States. Preparing nurses to address the challenges of low health literacy in clinical settings is crucial because of their role in patient education. This study was a cross-sectional one designed to assess the health literacy knowledge and experiences of 391 associate-degree nursing students. Results indicate that participants had knowledge about health literacy; however, they could benefit from additional educational opportunities that would reinforce that knowledge and skills in health literacy.     

The journey to becoming a graduate nurse: a study of the lived experience of part-time post-registration students

Following a period of dissatisfaction with the current provision of continuing professional education (CPE) in nursing, the ENB Higher Award/ BSc (Hons) Professional Practice was developed. This phenomenological study investigated the lived experience of nine students on this course, exploring the impact of a part-time modular post-registration degree on their personal and professional lives. Taped unstructured interviews were used to collect data. The analytical process revealed that their experiences could be symbolised as a journey consisting of four key themes: the traveller, the guide, the journey, and journey’s end. Areas such as motivation, the impact of education on individuals, and linking theory to practice were found to be part of a complex web of variables influenced by the individual, their workplace, managers and colleagues, and personal tutor. The personal and professional changes experienced were often stressful and they utilised many support networks, including their tutor, family and work colleagues, to gain success. However, some failed to have any recognition of their new skills and knowledge. Recommendations included further research into the value and function of post-registration degrees, the learning environment for post-registration nurses, and links between CPE and the quality of patient care.     

Statistics: a painless injection.

This paper springs from experience in the teaching of research methodology and statistics to a wide variety of post-registration health professionals attending courses in higher education (Community Psychiatric Nurses, Occupational Health Nurses, Health Visitors etc.). The paper has two main aims: 1. To describe and comment upon the nature of the learning problems perceived by nurses who are required to confront research methodology and/or statistical methods as components of their chosen post-registration course. 2. To describe a teaching approach and a teaching schema which the writer has found to be successful in promoting knowledge, skills, and--above all--confidence in the handling of methodology/statistics related material by such students.     

A replicable model of a health literacy curriculum for a third-year clerkship

Contrary to recommendations from national medical organizations, medical school education often fails to train students to interact effectively with patients with limited health literacy. The objectives of a new health literacy curriculum in a family medicine clerkship were to increase students' knowledge of health literacy and develop comfort with specific communication skills. Instructional strategies included lectures, practice with standardized patients (SPs), and a facilitated discussion board. At the end of the first year of the curriculum, there was a statistically significant increase in students' knowledge of health literacy. During the final testing with SPs, students achieved high scores for health literacy related communication skills. The curriculum is replicable at other universities and was an effective and efficient way for medical students to learn about health literacy and to acquire valuable skills to improve their patients' understanding of health information.