Occupational Therapy 5903

1. Occupational Therapy 5903 Sandra A. Martin, M.L.I.S. Instructor of Library Services Health Sciences Resource Coordinator John Vaughan Library Room 305B marti004@nsuok.edu – 918-444-3263

2. Knowledge is the Enemy of DiseaseSir Muir Gray • Existing Knowledge Can Prevent • Waste & Errors • Poor Patient Experience • Adoption of low value interventions • Failure to adopt high value interventions

3. Sandra Martin Provides…. • Instruction • Research Assistance • Small Group Consulting • Database Searches • Collection Development (Selection of print and online books, audiovisuals, journals and databases) • Assistance with any health-related information need • Office Hours: Tuesday 10 am to 4 pm – Tahlequah • By Appointment: NSU Muskogee

5. Bookmark this Page: http://library.nsuok.edu/collegesh/healthpr/ot/index.html

6. From the NSU Libraries Home Page

7. From the Health Professions Page, Click on Occupational Therapy

8. Remote Access • Enter NT-NSU user id and password to access the library’s electronic resources • Contact your instructor if you have problems with your user id or password • Contact Sandra to report other technical problems or for search assistance

9. Technical Issues • Check your browser • Internet Explorer does not work with our online resources • Use Firefox or Chrome • Check your Internet Carrier • Satellite Systems are frequently erratic or go down entirely during inclement weather • Wireless Hotspot • You need at least 3G • If you can login with your NSUuserid and password (the one assigned for your NSU email) and you have checked the above, “email” Sandra with a brief description of your problem

10. Interlibrary Loan/Document Delivery Services Delivery of journal articles, books, and other items not owned by the library Delivery of books, audiovisuals, and journal articles in the library’s print collection Journal articles delivered electronically if possible ILL Requests Click on Interlibrary Loan link from OT Web Page Complete and submit the online registration form Complete the online request form Provide complete information about the journal article or book that you need. Indicate your status as a graduate student and include your contact information If you have questions or need assistance, contact: Donna Graham – x3243 – grahamdg@nsuok.edu

11. Learning Objectives • To provide a mechanism for students to access the most current occupational therapy and health related information • To familiarize students with specific information resources and services to support the occupational therapy curriculum • To familiarize OT students with evidence-based health care and lifelong learning skills

12. Overview of Online Resources • Research and Clinical Databases • e-Journals • e-Books • Consumer Health • Evidence-Based Summaries

13. Journal Article Databases • Ovid MEDLINE, CINAHL Plus w/Full Text, and Mosby’s Nursing Consult are most frequently used resources to find journal articles on OT topics. • Search this section when you need articles on subjects, e.g., stroke, hand splinting, pressure ulcer • Databases in this section provide links to full text journal articles and other resources • You must start at the library’s OT web page to access our subscribed full text

14. Databases – Ovid MEDLINE • Premier biomedical database from the National Library of Medicine • Provides journal articles from 1946 to present in medicine, nursing, health care system, and allied health care practice, education, and research • Hints: • Search the Daily Update, and In-Processsegments simultaneously with desired range of years • Search keywords along with subject headings

15. Use MEDLINE to locate • Articles that report results of primary (original) studies • Conclusions supported by data and reproducible methodology • Ovid MEDLINE contains full text of many OT and rehabilitation journals

16. Databases - CINAHL Plus w/Full Text • CINAHL stands for Cumulative Index to Nursing and Allied Health Literature • Core research tool that contains full text of hundreds of nursing and allied health journals • Use “CINAHL Headings” to search topics for best results, e.g., search “pediatric occupational therapy” for occupational therapy with children • Use CINAHL to locate overviews and articles in related allied health care fields

17. Databases – Mosby’s Nursing Consult • All in one resource provides full text of e-Journals, e-Books, images, and other documents • Unique features include full text from pre-searches of popular health topics (top picks), full text monographs of all FDA approved drugs, and peer-reviewed patient education materials • Widely used in major hospitals and medical centers

18. Native American Health Care • National Library of Medicine – provides free access to American Indian Health database • Native Health Databases – contains citations and abstracts of documents pertaining to the health care of North American indigenous peoples

19. Tracking Down the Full Text • If your database search does not provide a link to full text of a relevant article: • Print a list of the citations • Click on the Library e-Journals link on the Library’s OT web page • Enter the title of the journal in the search box • Click on the database that contains the year you need

20. OT Journals • Click on the individual OT journal title from the OT web page • Open the year, volume, and issue you need

21. Consumer Health Resources • Current, authoritative, peer-reviewed, and evidence-based resources • MEDLINEPlus – the National Institutes of Health’s web site for patients and families • Joanna Briggs Database - provides full text consumer information sheets • Mosby’s Nursing Consult - includes patient education handouts produced by Elsevier

22. Getting Started: Match Resource to Information Need • What is the question? • How will information be used?

23. Background vs. Foreground Questions • Asking questions about your proposed topic helps to clarify your knowledge gap • Clarifying type of question helps to determine which sources are most likely to have the answers you need

24. Proposed Research Projects • Evaluate the effectiveness of fatigue management programs for patients with multiple sclerosis • Use of virtual reality therapies in rehabilitation of stroke patients

25. Background Questions • Generally ask who, what, why, where or how about a single concept

26. Background Questions • What are methods of reducing fatigue in patients with multiple sclerosis? • What are newer approaches to rehabilitation therapy for stroke patients that are based on motor learning?

29. Answers to Background Questions • Resources: • MEDLINE • CINAHL Plus w/Full Text • Mosby’s Nursing Consult • Books – print and online

30. Information Retrieval to conduct Research • Comprehensive in scope and time • All levels of resources • Current and Retrospective • Background and Foreground Information

31. Foreground Questions • Usually compare two or more concepts – theories, drugs, treatments, tests, harms or benefits of two approaches

32. Answers to Foreground Questions • Require precise information about complex issues • Sources should provide current, original clinical research data • Start with Evidence-based summaries

33. New Tools Target High-Quality Studies • Increase ease of accessing and understanding information • Preprocessed (preappraised) tools - practical resources that facilitate ready access to high-quality research • Pre-appraised – tools that have undergone a filtering process to include only those studies that are regularly updated and of higher quality

34. Critically Appraised (Evidence-Based) Summaries • DynaMed • First Consult • Joanna Briggs Institute

35. Information Retrieval for Evidence Based Health Care • Using research findings versus conducting research • Retrieving and evaluating information that has direct application to specific patient care problems • Selecting resources that are current, valid and available at point-of-care • Developing search strategies that are feasible within time constraints of clinical practice

36. “Evidence-based medicine is the integration of best research evidence with clinical expertise and patient values” Sackett DL, Rosenberg WMC, Gray JAM, Haynes RB, Richardson WS: Evidence based medicine: what it is and what it isn’t. BMJ 1996;312:71-2. Patient Concerns Best research evidence Clinical Expertise EBM What is EBM?

37. EBM Process – 5 Steps • ASK: Convert need for information into answerable question • ACQUIRE: Find best evidence to answer the question • APPRAISE: Critically appraise evidence for validity, impact, and applicability • APPLY: Integrate evidence with clinical expertise and patient values • ASSESS: Evaluate own effectiveness

38. Information Retrieval to Answer Clinical Questions Requires New Skills • Clinical question formulation • Search and retrieval of best evidence • Critical appraisal of study methods

39. Is All Evidence Created Equal? • Small portion of medical literature is immediately useful to answer clinical questions • Understanding “wedge or pyramid of evidence” is helpful in finding highest level of evidence • High levels of evidence may not exist for all questions due to nature of medical problems and research limitations

40. As you move up the pyramid the amount of available literature decreases, but it increases in its relevance to the clinical setting. Source:  Sackett, D.L., Richardson, W.S., Rosenberg, W.M.C., & Haynes, R.B. (1996). Evidence-Based Medicine: How to practice and teach EBM. London: Churchill-Livingstone.

42. Highest Level of Evidence - CriticallyAppraised Content Evidence Based Summaries First Consult, DynaMed, Joanna Briggs Institute Joanna Briggs, Mosby’s Nursing Consult, OT Seeker, PEDro, ACP Journal Club, DARE Joanna Briggs, Cochrane Database of Systematic Reviews MEDLINE, CINAHL Plus w/Full Text SOURCE: Haynes, R. B. (2001). Of studies, syntheses, synopses, and systems: the “4S” evolution of services for finding current best evidence. Evidence-Based Medicine, 6 (2), 36-38. Retrieved 2-07-07 from http://ebm.bmj.com/cgi/reprint/6/2/36

43. Summaries • FirstConsult • Includes summaries of systematic reviews of primary research, high-quality research papers from MEDLINE and evidence-based practice guidelines • Included studies are evaluated for clinical relevance and scientific validity • Recommendations labeled with Levels of Evidence • Detailed narrative format and lengthy overviews

44. DynaMed • Summaries for more than 3,000 topics • Monitors >500 medical journals and systematic review databases • Updated daily • Each article evaluated for clinical relevance and scientific validity • Recommendations labeled with Levels of Evidence

45. Joanna Briggs Institute (JBI) • an international, not-for-profit research organization at the University of Adelaide • collaborates internationally with over 70 entities to promote synthesis and transfer of evidence • contributes to improving health care outcomes by supporting evidence-based practice

46. JBI Database • Evidence Summaries – literature reviews that summarize existing literature on common health care problems • Evidence-Based Recommended Practices – procedures that recommend practice on clinical topics • Best Practice Information Sheets – guidelines produced for practicing health care professionals • Systematic Reviews – comprehensive reviews of international research literature • Consumer Information Sheets – summaries designed for patients, clients, and care providers • Updated weekly, access through Ovid

48. Life-Long Learning • Selecting and searching online databases is challenging • Information is ever changing • Contact Sandra (email preferred)

49. If you need Help, contact Sandra

50. Occupational Therapy 5903 Sandra A. Martin, M.L.I.S. Instructor of Library Services Health Sciences Resource Coordinator John Vaughan Library Room 305B marti004@nsuok.edu – 918-444-3263