Information overload: Cybrarians contribute to use of evidence-based practice

Forgot your password? I probably answer yes to this question about once a week. I have multiple email and voicemail accounts and various profiles at sites like Amazon, Barnes & Noble and Facebook–all requiring different passwords. At work, I’ve been instructed to keep passwords secret, not to write them down and to create ones that are pretty impossible for me to remember to ensure security. It’s a lot of information to retain, and I obviously need some help.

I know I’m not alone in this. Otherwise the “Forgot your password” prompt wouldn’t have been invented. And if there are legions of us needing help managing menial information like passwords, imagine the kind of assistance needed to keep track of vital information like healthcare best practices and evidence-based practice.

For those  unfamiliar with evidence-based practice, or EBP as we nurses call it, here’s quick explanation. EBP has really taken off in the nursing profession over the past five years as hospitals strive to improve patient outcomes and patient safety, save money, and push for for Magnet designation. It involves applying research and data to direct patient care in the hopes of improving outcomes. EBP is not theoretical, it is practical. It allows nurses to take research and use it at the bedside.

The University of Minnesota library has an EBP tutorial that explains the five steps involved in EBP:

Step 1: Formulating a well-built question

Step 2: Identifying articles and other evidence-based resources that answer the question

Step 3: Critically appraising the evidence to assess its validity

Step 4: Applying the evidence

Step 5: Re-evaluating the application of evidence and areas for improvement

It sounds pretty simple but nurses are often intimidated by the process since most graduated nursing school (myself included) before EBP was part of the curriculum. Most daunting are step 2 and step 3. Nurses are not quite sure how to start their literature search, are overhwhelmed by the amount of research available and at a loss on how to evaluate its validity.

During these steps, a medical librarian can be a nurse’s best friend. I’ve spoken with Lisa Sams, RN, of Clinical Linakages, a consulting group  assisting hospitals with EBP implementation, about this in the past. She thinks  it’s unrealistic to expect staff nurses to be experts at literature searches and reviews, and that medical librarians are invaluable assets during those steps.

Melissa Cole, RN, Senior Consultant at Healthcare Transformation Resources,  said medical librarians can be even more valuable when they leave the stacks and join the healthcare team at the bedside. Cole said Lorri Zipperer , of Zipperer Project Management, coined the word “cybrarians,” to describe medical librarians who use technology to find, evaluate and share information with the clinical team.

“There’s so much information out  there,” said Cole. “Clinicans can’t be expected to hold it all in their brains.”

Cole and LSU Clinical Medical Librarian Julie Esparza, are co-writing a book chapter on using cybrarians at the bedside.

“The cybrarian rounds with a laptop and has access to something other than WebMd,” explained Cole.

They can pull up evidence-based information right at the patient’s bedside and share it with the clinical team. In the past, it’s taken 17 years for research to make it “from the bench to the bedside.” But with a cybrarian in the mix, that information can instantly be brought to the beside. Cole said cybrarians can help translate and evaluate the research available and share this with the clinical team.

“They take information and turn it into knowledge,” she said.

Cybrarians can help the clinical team standardize practice and improve patient care.

Will the practice of cybrarians at the bedside take off? With the push for EBP and standardization of care, I think it’s a strategy worth looking at.

How do you think cybrarians could affect bedside practice? I’d love to hear your thoughts.

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Jennifer Thew, RN, MSJ

Jennifer Thew, RN, MSJ, is a registered nurse and journalist who has covered healthcare issues and how they relate to the nursing profession. She began her nursing career as a neuroscience nurse at Rush University Medical Center in Chicago and then transitioned to journalism after receiving a degree from Roosevelt University in Chicago. She has edited and written numerous articles on a wide range of nursing and healthcare topics like Accountable Care Organizations, evidence-based practice and telehealth.

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  • Jennifer Thew

    Thanks for the clarification Lorri!