how to use the resources of the telelibrary project effectively jane a. pellegrino, msls, ahip...

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How to Use the Resources of the Telelibrary Project Effectively Jane A. Pellegrino, MSLS, AHIP Department Head, Library Services Naval Medical Center Portsmouth

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Page 1: How to Use the Resources of the Telelibrary Project Effectively Jane A. Pellegrino, MSLS, AHIP Department Head, Library Services Naval Medical Center Portsmouth

How to Use the Resources of the Telelibrary Project Effectively

Jane A. Pellegrino, MSLS, AHIP

Department Head, Library Services

Naval Medical Center Portsmouth

Page 2: How to Use the Resources of the Telelibrary Project Effectively Jane A. Pellegrino, MSLS, AHIP Department Head, Library Services Naval Medical Center Portsmouth

Why do health professional look for clinical information?

• To stay current with new relevant medical developments

• To find answers to patient-specific clinical questions

Page 3: How to Use the Resources of the Telelibrary Project Effectively Jane A. Pellegrino, MSLS, AHIP Department Head, Library Services Naval Medical Center Portsmouth

When you need information, where do YOU start?

Page 4: How to Use the Resources of the Telelibrary Project Effectively Jane A. Pellegrino, MSLS, AHIP Department Head, Library Services Naval Medical Center Portsmouth

Where does Google Fit In?

Google http://www.google.com

• Great locating tool for specific information

• Rarely scholarly, not a substitute for library reference databases

• Unstable

Google Scholar http://scholar.google.com

• Searches peer-reviewed papers, books, theses, etc.

• Leads to fee-based online full-text websites

Page 5: How to Use the Resources of the Telelibrary Project Effectively Jane A. Pellegrino, MSLS, AHIP Department Head, Library Services Naval Medical Center Portsmouth

Objectives

• Look beyond Google• Formulate a clinical question• Select appropriate resources to answer

a clinical question• Search PubMed or CINAHL to find the answer to

a clinical question• Find online full-text available through the

Telelibrary

Page 6: How to Use the Resources of the Telelibrary Project Effectively Jane A. Pellegrino, MSLS, AHIP Department Head, Library Services Naval Medical Center Portsmouth

Clinical Questions

• What patients are at greatest risk for RSV infections?

• What are the current guidelines for treating acute otitis media?

• Does clonidine pose a risk to the fetus in a hypertensive patient?

• What are the diagnostic criteria for Lyme disease?

• Should healthy patients over 65 years of age receive pneumococcal vaccine and does immunization reduce hospitalization for pneumonia?

Page 7: How to Use the Resources of the Telelibrary Project Effectively Jane A. Pellegrino, MSLS, AHIP Department Head, Library Services Naval Medical Center Portsmouth

Where do I begin?

• Formulate the question– Identify key concepts– PICO (patient, intervention, comparison, outcome)

• Choose a likely source of the information– Is it an overview of a subject found in a textbook or

other full-text reference?– Is it a set of specific drug facts?– Is there a guideline on the clinical question?– Is it the latest journal article?

Page 8: How to Use the Resources of the Telelibrary Project Effectively Jane A. Pellegrino, MSLS, AHIP Department Head, Library Services Naval Medical Center Portsmouth

Formulate a good, answerable clinical question

Identify key concepts

Question ConceptsWhat patients are at greatest risk for RSV infections?

RSV, repiratory syncytial virus, risk

What are the current guidelines for treating acute otitis media?

otitis media, acute illness, therapy, drug therapy, guidelines

Does clonidine pose a risk to the fetus in a hypertensive patient?

clonidine, pregnancy complications, fetal, hypertension therapy

Page 9: How to Use the Resources of the Telelibrary Project Effectively Jane A. Pellegrino, MSLS, AHIP Department Head, Library Services Naval Medical Center Portsmouth

Choosing the right tool

• To stay current with new relevant medical developments

– American Family Physician, Journal of Family Practice, JAMA, New England Journal of Medicine

– MD Consult– Stat!Ref

• ACP Medicine, ACS Surgery– eMedicine (CME)– Journals in online full-text

Page 10: How to Use the Resources of the Telelibrary Project Effectively Jane A. Pellegrino, MSLS, AHIP Department Head, Library Services Naval Medical Center Portsmouth

Choosing the right tool

• To find answers to patient-specific clinical questions– UpToDate– MD Consult– eMedicine– eBooks

• Stat!Ref - ACP Medicine, ACS Surgery• Books @ Ovid

– Practice Guidelines and Systematic Reviews

Page 11: How to Use the Resources of the Telelibrary Project Effectively Jane A. Pellegrino, MSLS, AHIP Department Head, Library Services Naval Medical Center Portsmouth

https://tlib.med.navy.mil CAC required

Links are also available at Navy Medicine Online

https://nmo.med.navy.mil

Page 12: How to Use the Resources of the Telelibrary Project Effectively Jane A. Pellegrino, MSLS, AHIP Department Head, Library Services Naval Medical Center Portsmouth

http://www.med.navy.mil/sites/nmcp/Library/Pages/Telelibrary.aspx

Page 13: How to Use the Resources of the Telelibrary Project Effectively Jane A. Pellegrino, MSLS, AHIP Department Head, Library Services Naval Medical Center Portsmouth

Question #1 – Brief Clinically Related Question

Try UpToDate

What patients are at greatest risk for RSV infections?

Page 14: How to Use the Resources of the Telelibrary Project Effectively Jane A. Pellegrino, MSLS, AHIP Department Head, Library Services Naval Medical Center Portsmouth

UpToDate

Page 15: How to Use the Resources of the Telelibrary Project Effectively Jane A. Pellegrino, MSLS, AHIP Department Head, Library Services Naval Medical Center Portsmouth

RSV - UpToDate

Page 16: How to Use the Resources of the Telelibrary Project Effectively Jane A. Pellegrino, MSLS, AHIP Department Head, Library Services Naval Medical Center Portsmouth

Risk of RSV - UpToDate

Page 17: How to Use the Resources of the Telelibrary Project Effectively Jane A. Pellegrino, MSLS, AHIP Department Head, Library Services Naval Medical Center Portsmouth

Question #2 – Discussion of Current Management

Try UpToDate

What are the current guidelines for treating acute otitis media?

Page 18: How to Use the Resources of the Telelibrary Project Effectively Jane A. Pellegrino, MSLS, AHIP Department Head, Library Services Naval Medical Center Portsmouth

UpToDate

Page 19: How to Use the Resources of the Telelibrary Project Effectively Jane A. Pellegrino, MSLS, AHIP Department Head, Library Services Naval Medical Center Portsmouth

Acute Otitis Media - UpToDate

Page 20: How to Use the Resources of the Telelibrary Project Effectively Jane A. Pellegrino, MSLS, AHIP Department Head, Library Services Naval Medical Center Portsmouth

Question #3 – Question on the Safety of a Drug

Try MicroMedex

Does clonidine being taken by a hypertensive mother pose a risk to the fetus?

Page 21: How to Use the Resources of the Telelibrary Project Effectively Jane A. Pellegrino, MSLS, AHIP Department Head, Library Services Naval Medical Center Portsmouth

http://www.med.navy.mil/sites/nmcp/Library/Pages/Telelibrary.aspx

Page 22: How to Use the Resources of the Telelibrary Project Effectively Jane A. Pellegrino, MSLS, AHIP Department Head, Library Services Naval Medical Center Portsmouth

Choose MicroMedex

Page 23: How to Use the Resources of the Telelibrary Project Effectively Jane A. Pellegrino, MSLS, AHIP Department Head, Library Services Naval Medical Center Portsmouth

MicroMedex

Page 24: How to Use the Resources of the Telelibrary Project Effectively Jane A. Pellegrino, MSLS, AHIP Department Head, Library Services Naval Medical Center Portsmouth

MicroMedex

Page 25: How to Use the Resources of the Telelibrary Project Effectively Jane A. Pellegrino, MSLS, AHIP Department Head, Library Services Naval Medical Center Portsmouth

Question #4 – Looking for an overview?

Try eBooks: MD Consult or Stat!Ref

What are the diagnostic criteria for Lyme disease?

Page 26: How to Use the Resources of the Telelibrary Project Effectively Jane A. Pellegrino, MSLS, AHIP Department Head, Library Services Naval Medical Center Portsmouth

Choose MD Consult or a specific ebook textbooks at the click of a mouse

Page 27: How to Use the Resources of the Telelibrary Project Effectively Jane A. Pellegrino, MSLS, AHIP Department Head, Library Services Naval Medical Center Portsmouth

MD Consult

Page 28: How to Use the Resources of the Telelibrary Project Effectively Jane A. Pellegrino, MSLS, AHIP Department Head, Library Services Naval Medical Center Portsmouth

MD Consult ~ Information for the Provider

Page 29: How to Use the Resources of the Telelibrary Project Effectively Jane A. Pellegrino, MSLS, AHIP Department Head, Library Services Naval Medical Center Portsmouth

MD Consult ~ Information for the Patient

Page 30: How to Use the Resources of the Telelibrary Project Effectively Jane A. Pellegrino, MSLS, AHIP Department Head, Library Services Naval Medical Center Portsmouth

Question #5 – Looking for a guideline?

Try ACP PIER at Stat!Ref or the National Guideline Clearinghouse

Should healthy patients over 65 years of age receive pneumococcal vaccine and does immunization reduce hospitalization for

pneumonia?

Page 31: How to Use the Resources of the Telelibrary Project Effectively Jane A. Pellegrino, MSLS, AHIP Department Head, Library Services Naval Medical Center Portsmouth

Evidence-based resource

Page 32: How to Use the Resources of the Telelibrary Project Effectively Jane A. Pellegrino, MSLS, AHIP Department Head, Library Services Naval Medical Center Portsmouth

ACP PIER from Stat!Ref

ACP PIER

EBM Resources

Page 33: How to Use the Resources of the Telelibrary Project Effectively Jane A. Pellegrino, MSLS, AHIP Department Head, Library Services Naval Medical Center Portsmouth

ACP PIER from Stat!RefEBM Resources

Page 34: How to Use the Resources of the Telelibrary Project Effectively Jane A. Pellegrino, MSLS, AHIP Department Head, Library Services Naval Medical Center Portsmouth

National Guideline Clearinghouse

http://www.guideline.gov

Page 35: How to Use the Resources of the Telelibrary Project Effectively Jane A. Pellegrino, MSLS, AHIP Department Head, Library Services Naval Medical Center Portsmouth

Vaccine Recommendations

EBM Resources

Answer to the first part of the question

Page 36: How to Use the Resources of the Telelibrary Project Effectively Jane A. Pellegrino, MSLS, AHIP Department Head, Library Services Naval Medical Center Portsmouth

When the textbooks or guidelines do not answer the specific question

Use PubMed with LinkOut or CINAHL to look for journal articles

Should healthy patients over 65 years of age receive pneumococcal vaccine and does immunization

reduce hospitalization for pneumonia?

Search the journal literature to answer the second part of the question

Page 37: How to Use the Resources of the Telelibrary Project Effectively Jane A. Pellegrino, MSLS, AHIP Department Head, Library Services Naval Medical Center Portsmouth

Journal Searching ~ beyond Google

MEDLINE (complete MEDLINE indexes 6000 journals) PubMed Ovid Online

Ovid Online (MEDLINE, PsycINFO) CINAHL with Fulltext Evidence-Based Healthcare Database

Cochrane Library (at Ovid)

Page 38: How to Use the Resources of the Telelibrary Project Effectively Jane A. Pellegrino, MSLS, AHIP Department Head, Library Services Naval Medical Center Portsmouth

Using MEDLINE or CINAHLto find articles on a specific subject

Page 40: How to Use the Resources of the Telelibrary Project Effectively Jane A. Pellegrino, MSLS, AHIP Department Head, Library Services Naval Medical Center Portsmouth

Reviewing the resultsMedline

Fulltext @ Telelibrary

Fulltext @ NEJM

Fulltext @ Ovid

Page 41: How to Use the Resources of the Telelibrary Project Effectively Jane A. Pellegrino, MSLS, AHIP Department Head, Library Services Naval Medical Center Portsmouth

Using PubMed with LinkOut for journal article searching

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?myncbishare=navy&holdings=usntelib

Page 42: How to Use the Resources of the Telelibrary Project Effectively Jane A. Pellegrino, MSLS, AHIP Department Head, Library Services Naval Medical Center Portsmouth

PubMed enter keywords in query box, separate concepts

Use AND or OR to combine concepts

Page 43: How to Use the Resources of the Telelibrary Project Effectively Jane A. Pellegrino, MSLS, AHIP Department Head, Library Services Naval Medical Center Portsmouth

Results Screen

Combine terms using AND or OR; use * to truncate words pneumococcal vaccin* AND hospitalization

160 citations

PubMed

Page 44: How to Use the Resources of the Telelibrary Project Effectively Jane A. Pellegrino, MSLS, AHIP Department Head, Library Services Naval Medical Center Portsmouth

Medical Subject Headings - MeSH

PubMed

Page 45: How to Use the Resources of the Telelibrary Project Effectively Jane A. Pellegrino, MSLS, AHIP Department Head, Library Services Naval Medical Center Portsmouth

Using MeSH to formulate a search

Select term and send it to the search box; restrict search to major topic headings; choose subheadings

PubMed

Adding a term

Page 46: How to Use the Resources of the Telelibrary Project Effectively Jane A. Pellegrino, MSLS, AHIP Department Head, Library Services Naval Medical Center Portsmouth

Choose a second MeSH term

Search StrategyExecute Search

Choose another MeSH heading, send it to the search box, and execute the search

PubMed

Page 47: How to Use the Resources of the Telelibrary Project Effectively Jane A. Pellegrino, MSLS, AHIP Department Head, Library Services Naval Medical Center Portsmouth

Reviewing the results

35 citations

All articles

PubMed

Full text @Telelibrary

Page 48: How to Use the Resources of the Telelibrary Project Effectively Jane A. Pellegrino, MSLS, AHIP Department Head, Library Services Naval Medical Center Portsmouth

Using Limits Limit by date, language, age group…

Select limits

PubMed

Page 49: How to Use the Resources of the Telelibrary Project Effectively Jane A. Pellegrino, MSLS, AHIP Department Head, Library Services Naval Medical Center Portsmouth

Reviewing the limited results Limited by age, language, and journal subsetAll articles

PubMed

Page 50: How to Use the Resources of the Telelibrary Project Effectively Jane A. Pellegrino, MSLS, AHIP Department Head, Library Services Naval Medical Center Portsmouth

Saving the results to the Clipboard

PubMed

Page 51: How to Use the Resources of the Telelibrary Project Effectively Jane A. Pellegrino, MSLS, AHIP Department Head, Library Services Naval Medical Center Portsmouth

Linking to the full-textArticles available through Telelibrary

PubMed

Abstract View

Page 52: How to Use the Resources of the Telelibrary Project Effectively Jane A. Pellegrino, MSLS, AHIP Department Head, Library Services Naval Medical Center Portsmouth

ProQuest Fulltext through LinkOut

Page 53: How to Use the Resources of the Telelibrary Project Effectively Jane A. Pellegrino, MSLS, AHIP Department Head, Library Services Naval Medical Center Portsmouth

Use PubMed features that make life easier – Try My NCBI

• Customize PubMed with My NCBI• Have search updates sent directly to your mailbox

PubMed

Page 54: How to Use the Resources of the Telelibrary Project Effectively Jane A. Pellegrino, MSLS, AHIP Department Head, Library Services Naval Medical Center Portsmouth

CINAHL with Fulltext – Basic Search

CINAHL

Page 55: How to Use the Resources of the Telelibrary Project Effectively Jane A. Pellegrino, MSLS, AHIP Department Head, Library Services Naval Medical Center Portsmouth

CINAHL fulltext results

CINAHL

Page 56: How to Use the Resources of the Telelibrary Project Effectively Jane A. Pellegrino, MSLS, AHIP Department Head, Library Services Naval Medical Center Portsmouth

CINAHL with Fulltext

Limits screen

CINAHL

Page 57: How to Use the Resources of the Telelibrary Project Effectively Jane A. Pellegrino, MSLS, AHIP Department Head, Library Services Naval Medical Center Portsmouth

EBSCO CINAHL Fulltext

CINAHL

Page 58: How to Use the Resources of the Telelibrary Project Effectively Jane A. Pellegrino, MSLS, AHIP Department Head, Library Services Naval Medical Center Portsmouth

Sources of Telelibrary online fulltext

• Journals @ Ovid

• MD Consult

• EBSCO CINAHL with Fulltext

• Free online fulltext

PubMed LinkOut from the Telelibrary links them together.

Page 59: How to Use the Resources of the Telelibrary Project Effectively Jane A. Pellegrino, MSLS, AHIP Department Head, Library Services Naval Medical Center Portsmouth

Finding Answers to Clinical Questions

Point of Care Resources UpToDate MD Consult– ACP PIER, ACP Medicine (Stat!Ref)– eMedicine

Online books E-book list on Telelibrary Toolkit

Journal Articles and Systematic Reviews PubMed with LinkOut CINAHL Evidence-Based Health Care databases (Ovid)

Web Resources National Guidelines Clearinghouse HSAT CDC

Page 60: How to Use the Resources of the Telelibrary Project Effectively Jane A. Pellegrino, MSLS, AHIP Department Head, Library Services Naval Medical Center Portsmouth

Questions?Ask a Librarian

• Call Library Services, Naval Medical Center Portsmouth– (757) 953-5384

• Send e-mail message to – [email protected]