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CHAPTER 24 INTERNET TOOLS FOR ADVANCED NURSING PRACTICE BASIC AND ADVANCED INTERNET SEARCH METHODS Strategies in Internet

et Search Methods Name precisely the information being sought. Use a search string (one or more search terms) rather than a single word to increase the preciseness of a search. Enhance search strings by Boolean or natural language methods. Use the Boolean terms: AND, OR, or NOT. AND is used when search terms or strings need to be added together. OR is used when equivalent terms or synonyms are used to capture the information required. METASEARCH represents a process similar to parallel, federated, broadcast, or cross database searches. Two metasearch providers: 1. NLM Gateway (http://gateway.nlm.nih.gov/gw/Cmd) 2. Ithaki (http://www.ithaki.net/indexu.htm) INTERNET-AVAILABLE CLINICAL PRACTICE TOOLS - This structured approach to clinical information database development is clinically useful, helps clinicians organize their own knowledge databases, and facilitates ready access to needed information. Y ASSESSMENT -refers to the systematic collection of data needed to arrive at one or more diagnoses. -includes forms, miscellaneous screening tools, risk assessment instrument, and information of the manifestation of signs and symptoms. http://www.hospitalsoup.com/public/nursingassess2001.pdf - example of a comprehensive nursing assess form. http://www.niaaa.nih.gov resource information on alcoholism http://www.state.vt.us/health/abuse.htm - domestic abuse assessment tool http://www.ctclearinghouse.org/ - multiple assessment and screening hyperlinks

GOVERNMENT DOMAINS: www.fda.gov Food and drug Administration www.pubmed.gov NLM Pubmed database EDUCATIONAL DOMAINS: http://medicine.iupui.edu/flockhart.htm - P450 Drug Interaction table http://nhlbisupport.com/bmi/bmicalc.htm - body mass index calculator http://www.yourcancerrisk.harvard.edu cancer risk tools http://hin.nhlbi.nih.gov/atpiii/calculator.asp?usertype=prof coronary heart disease risk calculator

http://www.umm.edu/healthcalculators/ - health risk calculators for 24 health conditions. NLM MEDLINE Y DIAGNOSIS -from the Greek word, Dia means through and gnosis means knowledge. -is dependent on the knowledge base of the person diagnosing. New Threats to Health include mass trauma, biologic and biochemical warfare agents, and emerging infectious diseases. Mass Trauma Preparedness and Response mass trauma hyperlinks, featured on the CDC Emergency Preparedness and Response webpages include coping with a traumatic event, a primer for clinicians on dealing with explosions and blast injuries; fact sheets for injuries and mass trauma; possible research studies; and rapid assessment of injuries. Bioterrorism Agents/Diseases the CDC Emergency Preparedness and Response webpages present information on approximately 30 diseases. Photographic images and/or video presentations facilitate clinical decision making related to infectious agents that may be used for bioterrorism purposes. Chemical Agents the CDC Emergency Preparedness and Response webpages hyperlink information to more than 70 chemical agents. Recent Outbreaks and Incidents the Emergency Preparedness and Response page also includes information on outbreaks, e.g., severe acute respiratory syndrome (SARS), West Nile Virus, monkey pox, and mad cow disease; this site also includes information on incidents, e.g., wild fires, winter storms and power outages. Bioterrorism Information Available through Academic Health Science Centers http://www.bioterrorism.uab.edu/ - bioterrorism education http://www.gmu.edu/centers/biodfense/ - biodefense http://bioterrorism.slu.edu/ - Bioterrorism and Emerging Infections http://www.upmc-biosecurity.org/ - Biosecurity

DISEASE DIAGNOSIS http://www.cms.hhs.gov/medlearn/icd9code.asp - International Classification of Disease www.cdc.gov disease directories http://cancer-web.ncl.ac.uk/omd - online medical dictionary http://noah-health.org A-Z index of health information of uncommon illnesses. http://www.cdc.gov/genomics/default.htm - information on genomics and disease prevention. HUMAN RESPONSE TO ILLNESS/HEALTH DIAGNOSES http://www.aorn.org/research/pnds.htm - perioperative nursing data set

Nanda.org listing nursing diagnoses http://www.nlinks.org/research_main.phtml - evidence-based nursing diagnoses

METHODS OF CONTRIBUTING TO TERMINOLOGY REVISION AND DEVELOPMENT http://nlinks.org/cac_introduction.phtml - network for Language in Nursing Knowledge System

THE INTERNATIONAL CLASSIFICATION OF FUNCTONING, DISABILITY, AND HEALTH (ICF) - standardized nursing diagnosis terminologies do not encompass the entire field. As a result, subsets from the ICD are used, especially in the provision of primary care services by advanced practice nurses. Another terminology of interest to nursing practice is the ICF. - consist of four domains: body functions, body structures, activity and participation, and environmental factors. -I CF may assist nursing terminology developers in generating revised and new diagnose. It may also serve as a tool facilitating collaboration among leaders in the field of nursing diagnosis classifications. - Kearney and Pryor (22004) found it to be a useful conceptual framework for practice, education, and research. - Lehman (2003) concluded that it provides a useful framework in researching health conditions, body structures and function, activity and participation, and environmental influences on patients with idiopathic intracranial hypertension. http://www3.who.int/icf/onlinebrowser/icf.cfm - ICF browser

Y TREATMENT -the term treatment is used here in lieu of interventions and nursing actions, because it expresses more precisely the broad clinical management focus of this section. NURSING TREATMENT www.sabacare.com Home Health Care Classification http://www.nursing.uiwo.edu/centers/cncce/nic/index.htm - Nursing Intervention Classification http://www.aorn.org.research/pnds.htm - Perioperative nursing data set CALCULATORS http://www.martindalecenter.com/Calculators1B_4_Nut.html Martindales Calculators Online Part I:Nutrition -

http://www.manuelsweb.com/nrs_calculators.htm - Nursing Calculators for Drug Administration http://www_users.med.cornell.edu/-spon/picu/calc/medcalc.htm Medical calculators

DRUG MANAGEMENT www.dea.gov Drug Enforcement Agency http://www.fda.gov/medwatch/safety/vaers1.pdf - Vaccine Event Reporting System www.nida.nih.gov National Institute on Drug Abuse www.medscape.com Medscape www.rxlist.com Rxlist

Adverse

EVIDENCE-BASED PRACTICE GUIDELINES http://www.cdc.gov/std/treatment - Sexually Transmitted Diseases Treatment www.ngc.gov National Guidelines Clearinghouse http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm - Diagnosis and Management for Asthma http://www.nhbli.nih.gov/guidelines/cholesterol/index.htm - evaluation and treatment of high blood cholesterol in adults http://www.nhbli.nih.gov/guidelines/hypertension/index.htm - High blood pressure Guidelines PRACTICE AND TREATMENT GUIDELINES: PROFESSIONAL ORGANIZATION SITES -many of the professional association or societies include clinical practice guidelines or recommendations. http://www.diabetes.org/fot-health-professionals-and-scientists/cpr.jsp American Diabetes Association http://www.diabetes.org/for-health-professionals-and-scientists/cpr.jsp American cancer Society Guidelines for Screening, Surveillance, and Early Detection of Adenomatous Polyps and Colorectal Cancer http://www.aafp.org/x132.xml - American Academy of Family Physicians Y OUTCOMES -outcomes measurement is a tradition within nursing practice. -categories of patient outcomes: Patient safety Nursing outcomes Nursing home and home healthcare setting outcomes Health plan outcomes Short form health survey PATIENT SAFETY http://www.webmm.ahrq.gov presentation and discussion of medical errors.

http://www.ihi.org/ihi - Institute for Healthcare Improvement

NURSING OUTCOMES http://www.nursing.uiowa.edu/centers/cncce - Information of NOC NURSING HOME AND HOME HEALTHCARE SETTING OUTCOMES -related to nursing outcomes are those measures that evaluate the quality of care within nursing homes and home healthcare setting. www.cms.hhs.gov Centers for Medicare and Medicaid OASIS (outcomes assessment information set measures are used to evaluate quality within home healthcare settings. HEALTH PLAN OUTCOMES http://www.ncqa.org/Programs/HEIDIS/index.htm - HEDIS ( health plan employer data and information set OFFICE TOOLS: Online Healthcare Record Audit and Patient Satisfaction Forms -First, both the quality of the health care record and patient satisfaction reflect upon the quality of the care provided, a healthcare outcome. -Second, patient satisfaction variables provide clinicians with criteria to evaluate their own performance and that of the office in which they are practicing. http://www.geomedics.com/downloads/pss4.rtf - Patient Satisfaction Form

SHORT FORM HEALTH SURVEY http://www.outcomes-trust.org Medical Outcomes Trust http://www.sf-36.org - SF-36.org OUTCOMES MEASUREMENT: INTERNET-AVAILABLE BIOSTATISTICAL AND ANALYTICAL TOOLS http://www.cdc.gov/hiv/software/ez-text.htm Qualitative data creation, management and analysis software http://www.cdc.gov/hiv/software/answr/howto.htm - Qualitative database software http://www.cdc.gov/epiinfo/ - Epidemiologic analysis software

eCLINICALOG ( http://www.eclinicalog.org ) , A Web-Based Clinical Encounter Database - Part of an educational strategy, initially designed to build data entry, analysis, and synthesis skills in nurse practitioner students. - Started out as a paper and pencil format - First version was a spiral-bound, legal-sized, two-page grid of boxes that student filled in.

Second, addressed issues of retrievability, familiarity, availability, student acceptance, curricular congruence and contribution to the discipline Consist of three categories: Patient Program Demographic Guides students through an informatics skill building and refinement process and assists professional development.