YSN Library July 3 - July 7

Here is the schedule for when I will be at YSN for this week.
Questions, comments, concerns? .... please email me
janene.batten@yale.edu

Monday 7/3
Call the Medical Libray for assistance - 737-4065

Tuesday 7/4
University Holiday

Wednesday 7/5
See me in Medical Library for assistance - 737-2964
Class 7:00 - 8:00 PowerPoint Basics

Thursday 7/6
See me in Medical Library for assistance - 737-2964

Friday 7/7
8:30 - 5:00

Complete list of classes

Electronic healthcare records and privacy

In JAMA this week there is an interesting commentary on President Bush's request for the adoption of interconnected healthcare records within the next 10 years and the implications that has for possible violation of privacy. The commentary explains the laws surrounding health information portability. There is also discussion about the complexity of compelled authorizations for the disclosure of healthcare records, and creating contextual access criteria which would ensure limits to the scope of disclosure.

To read the full article:
Rothstein MA & Talbott MK (2006) Compelled Disclosure of Health Information: Protecting Against the Greatest Potential Threat to Privacy JAMA. 295 pp.2882-2885

Collaborative strategies to enhance research and EBP

Whether the goal is to generate new knowledge through basic research or to effectively use existing knowledge in evidence-based clinical practice, collaborative exchange between service and academia is essential. The authors describe 2 successful strategies that have been mutually beneficial to a clinical agency and a school of nursing in fostering research and evidence-based practice. These strategies can be used by other institutions as they strive to meet standards for excellence in academia and service.

To read the full article:
Engelke MK, Marshburn DM.(2006) Collaborative strategies to enhance research and evidence-based practice. J Nurs Adm. 2006 Mar;36(3):131-5.

New Stroke Guidelines

New stroke prevention guidelines focus on individual patient risks. The stroke prevention guidelines released by the American Heart Association and the American Stroke Association advise physicians to adopt a "patient-oriented approach to stroke prevention," marking a departure from previously published guidelines that advocated a population-based approach. The guidelines, which are published in the June issue of Stroke, were based on an analysis of clinical trials conducted between 2001 and January 2005.

To see the complete guideline:
Sacco RL, et al. (2006) Guidelines for prevention of stroke in patients with ischemic stroke or
transient ischemic attack: a statement for healthcare professionals from the American Heart Association/American Stroke Association Council on Stroke: co-sponsored by the Council on Cardiovascular Radiology and Intervention: the American Academy of Neurology affirms the value of this guideline. Stroke. 2006 Feb;37(2):577-617

Nurse leaders serve greater good by making decisions based on ethics

Writing in the January-March 2006 Nursing Administration Quarterly, Kathleen Sanford, current president of the American Organization of Nurse Executives, offers tips to help nurse executives make ethical management decisions. The author asserts that just as nurses face ethical issues in patient care, nurse administrators face complex ethical dilemmas in management. In striving to make the best decisions for their hospitals and staff, nurse executives must champion the “principles of right, moral, and good conduct.” To this end, nurse executives should consider the impact of decisions on all stakeholders, identify which decision best serves the common good, and evaluate the results of each decision to improve future decisions.

To read the full article:
Sanford K. (2006) The ethical leader. Nurs Adm Q. 30(1):5-10.

YSN Library June 26 - June 30

Here is the schedule for when I will be at YSN for this week.
Questions, comments, concerns? .... please email me
janene.batten@yale.edu

Monday 6/26
8:30 - 5:00

Tuesday 6/27
See me in Medical Library for assistance - 737-2964


Wednesday 6/28
9:30 - 4:00
Class 7:00 - 8:00 RefWorks Basics

Thursday 6/29
See me in Medical Library for assistance - 737-2964
Class 4:00 - 5:00 Endnote Advanced

Friday 6/30
12:00 - 5:00

Complete list of classes

Case study: Trust in times of clinical catastrophy

When caring for children who become suddenly and catastrophically ill, clinicians must simultaneously attend to a complex and rapidly evolving medical situation, as well as to the equally challenging demands of establishing compassionate relationships with family members and communicating well with colleagues.

An 18-month-old toddler was brought to the hospital with severe head injury after being struck by a car. Over a period of hours, her condition evolved from prognostic uncertainty to the diagnosis of brain death and considerations of organ donation. Against this medical backdrop, the clinicians successfully established a trusting relationship with family members by careful attention to their emotional, informational, and care needs as they absorbed the devastating prognosis, took in the results of the brain death examination, and considered the option of organ donation.

This case illustrates the importance of interdisciplinary communication, the vital role of social workers and other psychosocial providers with expertise in working with families, and the critical significance of mutual care and support for the clinicians who accompany families through these tragic life events.

To read the full article:
Truog RD, Christ G, Browning DM, Meyer EC. (2006) Sudden traumatic death in children: "we did everything, but your child didn't survive". JAMA. 2006 Jun 14;295(22):2646-54.

Google's Book Blog

Google has added a new tool in its quest to convince people that scanning millions of books in university libraries is beneficial and perfectly legal. The company started a blog devoted to the Google Book Search project.

One of the latest entries highlights the complete works of Shakespeare, all of which can be read in their entirety through Google. “The modern-day printing press brought his plays to people all around the world, unleashing countless performances and sparking astonishing creativity,” the blog item reads. “This summer we’re working to make Shakespeare even more accessible with our website.”

On a “News & Views” page of the blog, Google addresses lawsuits that have been filed seeking to stop it from scanning copyrighted library books. “So why has such a universally useful tool become so controversial? Because some in the publishing community question whether any third party should be able to copy and index copyrighted works so that users can search through them, even if all a user sees is the bibliographic information and a few snippets of text, and even if the result is to make those books widely discoverable online and help the authors and publishers sell more of them.”

As far as we know, the publishing groups opposing Google have not set up similar blogs making their case. A Google search (what else?) does pull up a press release by the Association of American Publishers on the issue:
“While authors and publishers know how useful Google’s search engine can be and think the Print Library could be an excellent resource, the bottom line is that under its current plan Google is seeking to make millions of dollars by freeloading on the talent and property of authors and publishers.” (http://chronicle.com/wiredcampus/index.php?id=1345)

Healthcare spending: US vs. OECDs

In 2003, the United States had fewer practicing physicians,practicing nurses, and acute care bed days per capita than the median country in the Organization for Economic Cooperation and Development (OECD). Nevertheless, U.S. health spending per capita was almost two and a half times the per capita health spending of the median OECD country. One proposal for both lowering health spending and improving quality is the adoption of health information technology (HIT). The United States lags as much as a dozen years behind other industrialized countries in HIT adoption—countries where national governments have played major roles in establishing the rule, and health insurers have paid most of the costs.

To read the full article:

Anderson, G.F., Frogner, B.K., Johns, R.A., and Reinhardt, U.E. (2006). Health care spending and use of information technology in OECD countries. Health Affairs 25(3): 819-831

Mumps Outbreaks

May 18, 2006 MMWR Dispatch update
CDC and state and local health departments continue to investigate an outbreak of mumps that began in Iowa in December 2005 (1) and involved at least 10 additional states as of May 2, 2006. This report summarizes preliminary data reported to CDC from these 11 states and provides recommendations to prevent and control mumps during an outbreak.

The CDC Web site provides a collection of resources for healthcare professionals regarding the recent multistate mumps outbreak. The CDC has also released clinical guidance for the control and elimination of mumps.

YSN Library June 19 - June 23

Here is the schedule for when I will be at YSN for this week.
Questions, comments, concerns? .... please email me
janene.batten@yale.edu

Monday 6/19
8:30 - 3:30

Tuesday 6/20
See me in Medical Library for assistance - 737-2964
Class 3:00 - 4:00 EndNote Basics

Wednesday 6/21
2:00 - 5:00
Class 7:00 - 8:00 PowerPoint Basics

Thursday 6/22
See me in Medical Library for assistance - 737-2964

Friday 6/23
Call the Medical Reference Desk for assistance - 737-4065

Complete list of classes

IOM: New reports on Emergency Medicine

Following a two-year investigation, the Institute of Medicine (IOM) yesterday issued three reports concluding that “the nation’s emergency medical system…is overburdened, underfunded, and highly fragmented.”

Emergency Care for Children: Growing Pains

Emergency Medical Services At the Crossroads

Hospital-Based Emergency Care: At the Breaking Point

According to the IOM, demand for emergency services has surged over the last several years, rising to 114 million ED visits in 2003 from only 90 million visits in 1993, while the number of inpatient hospital beds declined by 198,000 during the same period as hospitals shifted toward more outpatient care. According to the reports, hospital EDs are currently overwhelmed by day-to-day emergencies, with more than 500,000 ambulances being diverted from overcrowded EDs in 2003. Furthermore, the IOM warns that the nation’s EDs are ill-equipped to handle a sharp influx of patients in the event of a terrorist attack, natural disaster, or pandemic flu.

As a result, the group is urging Congress to establish a pool of $50 million that will be spent to reimburse hospitals for emergency care provided to poor and uninsured patients. The reports also recommend that Congress take steps to ensure that hospitals and emergency medical workers receive a greater portion of the nation’s disaster-preparedness funding. In addition, the IOM calls on JCAHO to develop “strong guidelines” aimed at reducing ambulance diversions and overcrowding in EDs, and an ED physician and panel member adds that in the absence of systemwide reform, individual hospitals can take steps to improve ED efficiency and preparedness.

Medical error listed in Wikipedia

Wikipedia has recently created an entry on medical error.

For those of you that have never visited Wikipedia it's worth the look. Wikipedia's definition of itself is it "is a multilingual Web-based free-content encyclopedia. It exists as a wiki, a website that allows visitors to edit its content; the word Wikipedia itself is a portmanteau of wiki and encyclopedia. Wikipedia is written collaboratively by volunteers, allowing articles to be changed by anyone with access to the website."

So my disclimer for anything that you read on a Wiki is to recognise that it may not be authoritative, and is subject to change by anyone at anytime.

What is cool about it though is that it is the future of collaboration and communication. Many organisations and people are investigating the use of wikis as a means of communication. "Like many simple concepts, "open editing" has some profound and subtle effects on Wiki usage. Allowing everyday users to create and edit any page in a Web site is exciting in that it encourages democratic use of the Web and promotes content composition by nontechnical users. ... The first ever wiki site was created for the Portland Pattern Repository in 1995." (http://wiki.org/wiki.cgi?WhatIsWiki).

Here are some other examples:

• wikinews
• readerwiki
• Clincial Informatics Wiki
• in healthcare - Quality through Knowledge
• in healthcare -The RHIO wiki

And I am sure there are many more out there.

And finally word of warning about using and trusting what is written in Wikipedia.
Professor raises Wikipedia awareness

Hurricane preparedness: it's the season

To assist in the relief and recovery efforts in the aftermath of Hurricanes Katrina and Rita, the National Guideline Clearinghouse™ (NGC) provides this list of clinical practice recommendations, tools and resources, public health measures, and other sources of information.


Resources include:

• AIDSInfo Web site
• American Red Cross
• Centers for Disease Control and Prevention (CDC)
• CDC's Hurricane-Related Information for Health Care Professionals
• Environmental Protection Agency (EPA)
• Federal Emergency Management Agency (FEMA)
• U.S. Department of Health and Human Services

Also see the Centers for Disease Control site Key Facts on Hurricane Readiness, and a handout tin PDF that can be quickly printed off.

State of the World's Mothers 2006

From the Save the Children website:

For most children in the developing world, the most dangerous day of their lives is the day they are born, according to new research by Save the Children.

The State of the World’s Mothers 2006 report reveals that of more than 10 million children under the age of 5 who die each year in the developing world, about 1 in 5 - an estimated 2 million babies - die within the first 24 hours of life.

An additional 1 million babies die during days 2 through 7 and a total of 4 million babies die during the first month.

Save the Children stresses that simple, affordable techniques, such as immunising women against tetanus and providing a skilled attendant at birth, could reduce these deaths by 70 percent.

“The first hours, days and weeks of a baby’s life are critical yet, only a tiny minority of babies in poor countries receive proper heath care during this highly vulnerable period,” said Save the Children Chief Executive Jasmine Whitbread. “The most simple health measures such as that we take for granted can mean the difference between life and death.”

Most newborn deaths are the result of preventable causes such as infections, complications at birth and low birth weight. Newborn deaths are one of the world’s most neglected heath problems. While there has been significant progress in reducing deaths among children under age 5 over the past decade, there has been little progress in reducing mortality rates for babies during the first month of life. Newborn deaths are so common in many parts of the developing world that parents put off naming their babies until they are a week to 3 months old.

The report recommends:

• Increased investment to help girls and young women in poor countries have greater access to education, nutrition and modern contraceptives.
• Provision of low-cost, low-tech solutions to mothers and babies that save lives during pregnancy, at birth and immediately after birth. These measures include tetanus immunizations, skilled attendant at childbirth, prompt treatment of newborn infections and education about proper hygiene, warmth and breastfeeding for infants.
• Improved access to good quality health care to mothers after childbirth.

In addition to its special focus on newborns and mothers, the report includes Save the Children’s seventh annual Mothers’ Index that identifies the best—and worst—countries to be mother and child through a comprehensive look at their well-being in 125 countries. For the seventh year in a row, Scandinavian countries dominate the top tier of the rankings with Sweden taking first place. The United States and United Kingdom tie for 10th place. Niger is in last place.

Read the State of the World's Mothers 2006

NIH Consumer Magazine

NIH MedlinePlus Magazine is a new quarterly guide for patients and their families. It brings the latest and most authoritative medical and healthcare information from the National Institutes of Health (NIH) as featured online on the MedlinePlus website.

Table of contents for the Summer 2006 issue include:

• clinical trials: a crucial key to human health research
  
• Lance Armstrong shares his battle with cancer
• detecting and managing high blood pressure
• the challenges of living with Parkinson's disease
• this is the season of the itch
  

This colorful, informative, and authoritative magazine is designed to engage consumers in the health care process.

YSN Library June 12 - June 16

Here is the schedule for when I will be at YSN for this week.
Questions, comments, concerns? .... please email me
janene.batten@yale.edu

Monday 6/12
See me in Medical Library for assistance - 737-2964
Class 3:00 - 4:00 EndNote Basics

Tuesday 6/13
See me in Medical Library for assistance - 737-2964
Class 5:00 - 6:00 RSS and Blogs
Class 3:00 - 4:00 RefWorks Basics

Wednesday 6/14
1:30 - 3:30

Thursday 6/15
See me in Medical Library for assistance - 737-2964

Friday 6/16
8:30 - 5:00

Complete list of classes

Ways to Manage Calories Away from Home

The FDA has found that Americans spend about 46 percent of their food budget on items prepared away from home and take in about 32 percent of their calories from such foods. "Away-from-home" foods are those that are prepared and purchased out of the home.

In the recent report Keystone Forum on Away-From-Home Foods -- Final Report the FDA offers recommendations to improve the ability of consumers to manage calorie intake from foods prepared and bought away from home. The document is part of FDA efforts to help reduce overweight/obesity, poor nutrition, and physical inactivity.

For more information about the report you can read:

background information

FDA's Plan to Tackle U.S. Obesity

Questions & Answers

Press release

YSN Library June 5 - June 9

Here is the schedule for when I will be at YSN for this week.
Questions, comments, concerns? .... please email me
janene.batten@yale.edu

Monday 6/5
See me in Medical Library for assistance - 737-2964

Tuesday 6/6
See me in Medical Library for assistance - 737-2964

Wednesday 6/7
1:30 - 3:30

Thursday 6/8
See me in Medical Library for assistance - 737-2964

Friday 6/9
8:30 - 5:00

Complete list of classes

Nurses from abroad to fill nursing shortage

A recent article in the New York Times, and a follow up editorial, spark interest over the prospect of where to find nurses to fill the positions open in the current nursing shortage.

Read the article:
Dugger, C.W. & Conde C.H. (2006) U.S. Plan to Lure Nurses May Hurt Poor Nations New York Times (Late Edition (East Coast)). New York, N.Y.: May 24, 2006. p. A.1

Read the editorial:
For Want of a Nurse; [Editorial] New York Times (Late Edition (East Coast)). New York, N.Y.: May 27, 2006. p. A.12