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Changing practice

 

How the web portal NHS Evidence will help nurses to make informed decisions

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Exploring how nurses can make the most of the newly launched online portal NHS Evidence, and its relevance to daily clinical practice

 

 

Author

Katie Perryman Ford, RGN, is implementation adviser for NICE and former practice development nurse at University College London Hospitals Foundation Trust.

Abstract

Perryman Ford, K. (2009) How the web portal NHS Evidence will help nurses to make informed decisions. Nursing Times; 105: 36, early online publication..

NHS Evidence, launched in April 2009, is an internet based-service which aims to help those working in health and social care to access the latest clinical and non-clinical evidence and best practice, to make informed decisions.
This article outlines how nurses can make best use of the service and explains its key features. From October, one of these is helping users to identify the best evidence by awarding an accreditation mark to the most reliable sources of guidance.
Keywords: NHS Evidence, Guidance, Information, Online access

  • This article has been double-blind peer-reviewed.

 

Practice points

NHS Evidence has significant positive benefits for nurses as it:

  • Provides quick access to evidence-based information;
  • Saves time in sourcing relevant, up to date materials for writing assignments; provides teaching aids such as presentations, posters and leaflets; and helps nurses keep their PREP (post-registration education and practice) file up to date.

From October it will:

  • Give added confidence in the information available via an accreditation system;
  • Allow users to personalise the homepage and save searches;
  • Provide a regular personalised alert system through RSS feeds for new evidence relevant to nurses.

 

Introduction

NHS Evidence is an internet-based service for everyone working in health and social care to help them make informed decisions about treatments and resources, by providing easy and rapid access to the best clinical and non-clinical evidence and best-practice information.

Until now, finding relevant and reliable information has been complex and time-consuming, which has been problematic, particularly for specialist nurses and those involved in training and policymaking.

NHS Evidence makes researching a wide range of issues significantly easier, including patient care, commissioning and service management. It also quality assesses the organisations that produce guidance and recommendations for practice.

It is as easy to use as popular search engines such as Google, but can be used with the confidence that it will only return relevant results from credible sources.

Changing practice in assessing information

Most nurses come into the profession with the motivation to provide excellent care, both medically and compassionately. However, the demands of the job sometimes make it feel like an impossible task. Healthcare is changing rapidly and, with the volume of medical research substantially increasing, trying to keep up to date with all the latest developments can feel overwhelming.

After a 12-hour shift on a busy ward, probably the last thing any nurse wants to do is read a medical paper, which may or may not be relevant to their daily work.

However, while keeping up to date is challenging, it is also necessary if we are to deliver the highest possible care.

For the majority of healthcare professionals who do not have time to review all relevant new publications, a facility to help highlight important new information is essential.  

NHS Evidence will provide a regular alert system through RSS feeds and put this in context for users, due to be launched in the next major update of the service in October. The context is important because new evidence is much more likely to add weight to the existing evidence base, rather than challenge or overturn current practice.

NHS Evidence highlights significant new information on a monthly basis, in context, via an electronic bulletin, Eyes on Evidence - to which subscription is free via the portal, and annually through annual evidence updates in key topic areas. This work is supported by 34 specialist collections which make up the NHS Evidence Health Information Resources, available via the portal. The collections filter the huge quantity of published research, identify relevant sources of information and review new publications.

How it works

In many ways NHS Evidence is a one stop shop for all the best and most up to date information on health and social care. However, most of the content is not stored on the site and in this sense it is much more than just a new website.

The search engine directs users to information from a range of different sources, split into six interest areas: clinical research; commissioning; drugs and technologies; public health; social care; and education and learning tools.

It is designed to look simple and user-friendly like other popular search engines. However, because of its specialist nature it has an added degree of complexity to ensure users get the most out of it.

NHS Evidence has a vast number of features. One of its main advances on other search engines is in the way it rapidly filters results, allowing users to refine them further, using a navigation menu, into various topic areas, such as clinical or drugs and technologies. Results can be displayed by relevance or date of publication and shared easily via email.

As with all new technology, learning a few simple techniques can greatly improve the benefits, both in terms of speed and in more refined, specialist searching. The NHS Evidence ‘Introductory Guide to Searching’ can be found on the site under the drop-down menus ‘About Us’ and ‘Search Tips’. For tips on filtering a search, see Box 1.

Instilling user confidence

One of the core benefits of NHS Evidence is the development of the first evidence accreditation scheme, due to be launched in October. It will help instill user confidence in the value and integrity of information by accrediting the sources.

It is not the information itself that is assessed but the processes used to develop it. It is therefore the organisations which produce information that are accredited. NHS Evidence will award an accreditation mark to guidance producers which show compliance with a defined set of criteria that reflect the processes used to develop their products. These criteria are based on international standards for guideline development produced by the AGREE Collaboration (appraisal of guidelines and research evaluation). An accredited organisation that produces lots of information of different types – for example, guidelines on different topics as well as clinical summaries – can add the accreditation mark to all its guidance.

Users, in turn, see this mark when they search for information through NHS Evidence, with accredited providers listed at the top of search results and flagged up with the accreditation mark.

Only selected sources available through NHS Evidence which meet the criteria will be accredited. However, it is hoped the process will improve the quality of information available to healthcare professionals and, in time, more groups are expected to achieve these standards.

Clinical implementation

As nursing continues to change, most nurses will find information on NHS Evidence that will benefit aspects of their working life significantly.

Currently most nurses stay updated either by attending or running training sessions. NHS Evidence can help with producing training materials because those organising a session can quickly search for and find the latest information, including whether NICE has already provided guidance on the topic.

This kind of information is also invaluable to specialist nurses – for example, in areas such as diabetes, where much new guidance is being produced. Rather than clinical leads trying to raise awareness of new guidance and putting together a presentation for staff, information is already available through NHS Evidence in a user-friendly form.

In a similar way NHS Evidence can also benefit those working on policy development. When using other search engines such as Google, it is difficult to determine what information is relevant and what is out of date.

As a result of having to sort and sift through what could be unreliable and outdated information, many policymakers tend to rely on resources from other hospital websites or from their own experience. Using NHS Evidence now means policymakers do not have to start from scratch in compiling and assessing information. It will also mean greater consistency across the country in terms of best practice, while still allowing scope to tailor policy documents to an organisation’s specific needs.

Future challenges

NHS Evidence has been launched in a world where online access to information is increasingly popular. 

Google is one of the most popular sources of information, alongside numerous other websites and browsers. NHS Evidence is designed to be equally fast in providing results, but also to add value through other aspects of its service – by formally accrediting sources of information, highlighting significant new information and identifying information most relevant to the UK.

The service is also supporting a range of activities designed to encourage changes in practice – as well as providing ready access to information through the online portal. It seeks to promote the use of evidence across healthcare.

From October NHS Evidence will allow users to personalise the online portal to facilitate specific updating mechanisms and to tailor searches to make them more effective. To ensure the service remains useful in a rapidly changing online world, regular feedback from users will be gathered for review and continuous improvement.

While NHS Direct and NHS Choices will remain the first point of contact for the public, NHS Evidence is available to anyone with access to the internet.

Conclusion

NHS Evidence is a new and developing service that has been designed to help make it easier to keep up to date with the latest developments in clinical and non-clinical evidence and best practice.

There are already several features that can directly benefit all nurses, particularly those working in specialist fields or involved in training and policy development. As the service moves forward, the applications for its use will increase.

By making it quicker and easier to stay updated, NHS Evidence is much more than an academic exercise. It is not about taking the care out of caring – simple humanity and care will always remain the cornerstone of what clinicians do. It simply means that when nurses do need information, their task is made much easier - they will know where to look and be able to rely on the quality of information provided.

 

Background

NHS Evidence, which launched in April this year, was developed in response to Lord Darzi’s NHS next stage review (Department of Health, 2008)

Lord Darzi made clear that if quality was to become the organising principle for the NHS, then its staff must have a way to access the best information needed to deliver the highest quality care.

The service is provided by NICE, and offers access to a range of information types, including primary research literature, practical implementation tools, guidelines and policy documents.

 

Box 1. Filtering a search

Searches can be as general or specific as users make them.

Nurses can refine a search using filters:

  • Areas of interest, for example, clinical, public health, social care and commissioning;
  • Types of information such as drug information, policies and guidelines;
  • Clinical query, for example, diagnosis and symptoms;
  • Sources such as the Department of Health and Patient and Public Involvement Collection (www.library.nhs.uk/PPI);
  • Medicines and devices, for example, heparin, aspirin and prednisolone.

 

 

 

  • 3 Comments

Readers' comments (3)

  • Whilst the article does an excellent job of promoting NHS Evidence to nurses it fails to acknowledge that the support nurses can receive from their library services is a major factor. As a Health Librarian I am always trying to support staff to access the best evidence and the constant lack of recognition of our profession is extremely annoying. The article is also a bit misleading by not mentioning the fact that many of the resources are only accessible through Athens authentication so when you try to follow these recommendations you will come up against barriers and who will they turn to to help them - yes their librarian. So please a little acknowledgment would be nice.

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  • I'll echo those comments.

    NHS Evidence is a fairly nifty tool but it is only one of the tools available. If you need to find journal articles to support your research or learning then it is likely not going to do the job. Sometimes you need a screw driver not a hammer (all be it that hitting screws with a hammer can be interesting and kind of work).

    Some times the best thing to do is to ask an expert. You can find your nearest health librarian at http://www.hlisd.org (includes services in the NHS and beyond).

    Generally we are a fairly cheerful bunch - ask nicely and we will be very cheerful!

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  • NHS Evidence, oft trumpeted as the be all and end all of evidence gathering, is very much a work in progress and to date does not have the functionality or flexibility of other search resources. It is extremely limited by not allowing for individual results to be stored or allowing for detailed searching to take place. NICE has driven a coach and horses through tried and tested practices and seemingly totally pushed experienced and skilled health librarians out of the picture. At present I think this article has more spin than Alistair Campbell could ever produce.

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