Background: Evidence-based practice is the ideal in clinical practice. Finding and accessing needed evidence in an appropriate time is crucial. According to van Dijk, Hooft and Wieringa-de Waard (vanDijk N, Hooft L, Wiegeringa-de Waard M. “What are the barriers to residents’ practicing evidence-based medicine? A systematic review.” Acad Med. 2010 Jul;85(7):1163-70) lack of time and skills in searching for needed information are the major barriers to residents’ practice of evidence-based medicine. We surveyed comparable hospital libraries in Colorado and Missouri to determine what role library provided information played in patient management diagnosis, clinical decisions and treatment.
Methods: Four hospitals were surveyed and results were analyzed using using model-based methods to evaluate differences among the respondent groups – physicians, residents, physician assistants, nurse practitioners, nurses, and non-clinical staff – while including an effect for differences among hospitals. Our survey was intended and designed to elicit perceptions, and made no attempt to link results to patient care outcomes.
Results: Respondents totaled 328, including 203 physicians, 11 residents, 11 physician assistants, 12 nurse practitioners, 60 nurses, and 31 “other” participants. Confidence intervals indicated few differences when respondent groups were combined, although more physicians/residents than nurses answered that they used health sciences library resources for patient care, changing a patient management decision, or confirming a patient management decision. Among all respondents, large proportions (> 0.70) answered that the library influenced patient care, changed or confirmed management decisions, and influenced therapy; smaller proportions (0.21-0.62) answered that library information influenced patient length of stay, advice, tests, and clinical diagnosis.
Conclusion: The health care professionals we surveyed indicated that library resources were influential in many aspects of patient care. In particular, our data suggest that health care professionals’ library resources may be influential in both changing and confirming patient management decisions. Expanding the role of information resources and libraries in evaluating patient safety is warranted. .
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