SEARCH

SEARCH BY CITATION

Abstract

  1. Top of page
  2. Abstract
  3. Introduction
  4. Background
  5. Aims and objectives
  6. Methods
  7. Literature review
  8. Service Innovation
  9. Discussion
  10. Conclusion
  11. Acknowledgements
  12. Key Messages
  13. References

Background:  Decades of hospital restructuring in Canada resulted in significant reductions of nursing leadership positions and altered a nursing infrastructure important for guiding patient care. The importance of acquiring nursing leadership skills to address the negative effects of restructuring is advocated by Canadian nursing bodies.

Objectives:  To describe a service innovation for a nursing community. The librarians of the University of Manitoba Health Sciences Libraries (UMHSL) created an online nursing leadership literature centre to support a leadership programme launched by the Nursing Leadership Council (NLC) of the Winnipeg Regional Health Authority. The article will contribute to the body of literature about health library services for nurses.

Methods:  The creation of the service is described. A literature search was undertaken to determine what services have been implemented by librarians for nursing leadership programmes, as well as to review the literature with regard to contributions made by librarians for nursing communities.

Results:  The literature service, comprised of 19 webliographies based on the NLC's leadership topics, is available on the UMHSL website. A webliography, by definition, is a list of electronic works relating to a particular topic. The NLC created its own website that provides nurses with a means to identify, enhance and evaluate leadership competencies, and which is linked to the UMHSL website.

Conclusion:  The contributions of the UMHSL librarians to this project support the goals of instilling leadership skills in nurses, encouraging evidence-based nursing practice, and transforming a practice environment to meet the ultimate goal of effective patient care.


Introduction

  1. Top of page
  2. Abstract
  3. Introduction
  4. Background
  5. Aims and objectives
  6. Methods
  7. Literature review
  8. Service Innovation
  9. Discussion
  10. Conclusion
  11. Acknowledgements
  12. Key Messages
  13. References

The librarians at the University of Manitoba Health Sciences Libraries (UMHSL) have partnered with the Nursing Leadership Council (NLC) of the Winnipeg Regional Health Authority, an administrative body overseeing hospitals and long-term care centres in the city of Winnipeg, to provide ongoing resource support for the NLC's leadership development programme. The NLC has implemented a framework and built a website that provides nurses with a means to identify, assess, enhance and evaluate nursing leadership competencies.1 The NLC's leadership website is linked to the UMHSL Website, which hosts the literature centre component of the leadership programme. It was developed by a team of librarians under the aegis of the NLC. This nurse leader–librarian partnership aims to:

  • support the development of a nursing culture that is aware of, informed by, and applies current best evidence to practice;
  • support efforts to ameliorate a nursing leadership deficit and expertise gap that arose as a result of funding decrements and hospital restructuring.

The Winnipeg Regional Health Authority (WRHA) has an affiliation agreement with the University of Manitoba to obtain access to library resources and services for the Health Sciences Centre, the city's largest teaching hospital, five community hospitals, two long-term care centres, the WRHA corporate office, personal care homes, and community health access centres. UMHSL librarians support WRHA staff through a variety of services that include library education programmes, literature searching and delivery, individual and departmental training, participation on clinical committees, involvement in curricula, and publication of two library newsletters. WRHA nurses are one of the libraries’ largest client groups, and thus the librarians create unique services for them.

Background

  1. Top of page
  2. Abstract
  3. Introduction
  4. Background
  5. Aims and objectives
  6. Methods
  7. Literature review
  8. Service Innovation
  9. Discussion
  10. Conclusion
  11. Acknowledgements
  12. Key Messages
  13. References

The conditions under which nurses work have become the focus of Canadian governments and healthcare leaders since the beginning of the 21st century. Regulated nurses make up approximately a third of the entire healthcare workforce, and the care that they provide affects patient outcomes. Throughout the 1990s, Canada's healthcare system was subjected to rigorous cost containment policies and various restructuring schemes. This had affected the stability of nursing work environments.

Canadian governments, who fund and manage Canada's universal healthcare system, and nursing leadership bodies have undertaken in-depth analyses of nursing work environments. The Canadian Nursing Advisory Committee, alarmed by findings that indicate high rates of burnout, heavy workloads, excessive overtime, and low morale, sets forth a number of recommendations to improve the working conditions of nurses in order that patient care objectives can be effectively met.2 The report of the Commission on the Future of Health Care in Canada states that nurses’ work environments are marked by persistent low morale, which contributes to their leaving the profession, and that hospital and healthcare restructuring across Canada in the 1990s had a direct impact on their workload and the competencies that they were expected to develop.3

In addition to the challenges of minimizing stressful work environments, nursing leadership bodies are dealing with an ongoing nursing deficit. Restructuring in Canada resulted in a significant reduction of nursing positions, many of these in a managerial capacity. This had not only altered the nursing infrastructure, whereby inexperienced nurses were deprived of an experienced colleague, but it also created workload burdens. This contributed to an exodus of nurses from the profession. As demonstrated in some studies, the nursing expertise gap that has arisen has consequences for patient care.4,5 Hiring more nurses, an endeavour to which many Canadian governments are now committed, will not immediately address the incommutable loss of nursing expertise.

Nurses who experience negative effects of restructuring, but who work under supportive leaders experience less stress than those who work under non-supportive leaders. The quality of front-line care attests to this relationship.6,7 Leadership development programmes are a means to address some of the problems besetting work environments. The nursing literature emphasizes the importance of nurse leaders who possess a wide range of skills. An analysis of leadership programmes underway across Canada, the UK, USA, and internationally, for example, enumerates 10 core competencies that nurse leaders should acquire: change, caring, leading self, leading others, policies/politics, managing, teambuilding, project managing, communicating, and visioning.8

The WRHA NLC's leadership programme addresses these competencies. It is adapted from a certificate programme offered by the Dorothy Wiley Nursing Leadership Institute in Canada. The NLC's framework, launched April 2007, is an online programme, the first of its kind in Canada. Nurses work through an eleven-step programme that includes a tutorial, a method for assessing current leadership skills, development of a self-tailored learning plan, and a means by which to evaluate progress. Nurses acquire leadership behaviours in five stages arranged on a continuum of novice to expert. The online literature component of the programme, hosted on the UMHSL Website, provides an organized structure for evidence about nursing leadership.

Aims and objectives

  1. Top of page
  2. Abstract
  3. Introduction
  4. Background
  5. Aims and objectives
  6. Methods
  7. Literature review
  8. Service Innovation
  9. Discussion
  10. Conclusion
  11. Acknowledgements
  12. Key Messages
  13. References

The aim of this article is to describe a service innovation for a nursing community. The UMHSL created an online nursing leadership literature centre to support the objectives of a Nursing Leadership Council. The article will also contribute to the body of literature about health library services for nurses.

Methods

  1. Top of page
  2. Abstract
  3. Introduction
  4. Background
  5. Aims and objectives
  6. Methods
  7. Literature review
  8. Service Innovation
  9. Discussion
  10. Conclusion
  11. Acknowledgements
  12. Key Messages
  13. References

The author carried out a literature search in both library and information science databases and health databases to determine whether other health libraries have created online literature services for nursing clientele, as well as to determine what types of health library services are being offered to nurses and other healthcare clients. The author then describes the two main phases of the UMHSL literature project, the first of which entailed a series of meetings and working sessions between UMHSL librarians and the NLC, and the second of which entailed the creation of the online literature centre.

Literature review

  1. Top of page
  2. Abstract
  3. Introduction
  4. Background
  5. Aims and objectives
  6. Methods
  7. Literature review
  8. Service Innovation
  9. Discussion
  10. Conclusion
  11. Acknowledgements
  12. Key Messages
  13. References

The author searched library and information science and health databases such as Library Literature & Information Science, Library, Information Science & Technology Abstracts, PubMed, Cumulative Index of Nursing & Allied Health Literature (CINAHL), EMBASE, and the Cochrane Library. A combination of truncated keywords and/or subject headings such as ‘virtual’, ‘web’, ‘online’, ‘outreach’, ‘librarians’, ‘nurses’, ‘medical’, ‘health personnel’, ‘libraries/medical’, ‘libraries/health sciences’, and ‘Websites’ were used. Hand searching the reference lists of articles perceived as relevant provided additional sources. Only English language articles dated 2000 forward are cited in the review, as two systematic reviews on the services provided by health libraries collectively cover the period 1974–2001.9,10

As far as the author of this article could discover, the provision of an online literature centre for a nursing leadership programme is unique among Canadian health sciences libraries. No evidence of this type of service in commonwealth and American health libraries was retrieved by the literature search. Health libraries are, however, offering online services to nurses or nursing students to support various objectives, and will be discussed below.

The majority of the literature retrieved on health library services focuses on two main areas: (i) descriptive and/or evaluative articles about services that have been created primarily in response to local client's point-of-need requests, and (ii) studies that focus on evaluating services to determine what effect they have had on clients’ information use or to introduce a methodology for measuring them.

A select number of studies that describe the variety of health library services pose questions about librarian role consistency. Sargeant and Harrison conducted a review of clinical librarianship practice in the UK by undertaking content analysis of job advertisements and interviewing clinical librarians.11,12 They determined that the services offered are dictated by clients’ local needs, and imply that this poses a measure of difficulty to the establishment of a national clinical librarian profile, which they believe is important for promoting librarian services to the National Health Service. Ward also conducted a survey of clinical librarianship practice in the UK to define the current use of the term ‘clinical librarian’ and to determine whether a standard definition against which to measure the effectiveness of the services offered can be created. Like Sargeant and Harrison, she found that there are ‘typical’ duties carried out by librarians, such as meeting with clinical staff on wards, conducting literature searches, teaching, preparing current awareness alerts, and preparing digests or summaries of literature search results, but that the variability of clinician needs militates against a unitary description of the clinical librarian role.13 She recommends that evaluation of services is necessary to prove the value of libraries.

Articles that describe and/or evaluate a particular health library service demonstrate that they are viewed positively whether the services were created from clients’ point-of-need requests or librarian initiated. These include a programme of scheduled health facility or hospital ward visits to promote evidence-based practice, facilitating research endeavours or providing database training,14–16 providing a virtual reference service for undergraduate nursing students to improve information retrieval skills,17 and participating on clinical practice committees to promote the transfer of evidence-based research into practice.18 Promotion of library services such as library classes about online health resources and a web page built especially for clinical nurses was found to result in nurses’ willingness to use them.19 Active promotion of library services, something that various authors have recommended,12,16 is as necessary to establish the presence and value of health librarians as that of responding to clients’ requests.

Articles discussing online library services for practicing nurses are few. The librarians at the UMHSL provide webliographies on various health topics that have been requested by select groups of nurses to support their annual continuing competency profile.20 A librarian-nursing faculty partnership implemented an online library tutorial for registered nurses who had returned to school to earn a bachelor of science nursing degree. Librarians created five online modules on the library's Website to improve library information literacy competencies.21 Another librarian–nursing faculty partnership created an online tutorial for graduate nursing students to reinforce information literacy skills covered in the curricula.22 Formal evaluation of these services indicated that they met clients’ needs.

The literature indicates that no all-encompassing benchmark for evaluating health library services exists. A comprehensive bibliography on measuring the value of library services that is included in a recent publication reveals a wide variety of approaches to measurement, the majority of which focus on the use of information by particular client groups. Because this emulates evidence-based healthcare research on particular populations, the author suggests that this would be a feasible area for future development.23 Another study posits that a benchmark could be created by aligning a library's services with the organizational goals of a hospital or an academic health centre, and offers a method by which to do so.24,25 The authors of a survey on the effectiveness of outreach services concluded that American health librarians are providing these services with little or no evaluation of their effectiveness. Despite the fact that the US National Library of Medicine emphasizes evaluation for refining and focusing services, 36% of health libraries do not do so. The authors also discovered that libraries possess no formal definition of outreach service, and that this poses problems for creating a standard evaluation method.26

Recent studies that report on the outcomes of evaluated services indicate notable improvement in healthcare clients’ ability to find and use information. The outcome of an evaluation of outreach service offered to Wirral Hospital NHS Trust demonstrated that the value of the service lies in its point-of-need response to primary care staff and its ability to improve their information skills.27 An evaluation of a library class for neonatal intensive care unit nurses indicated improvement in the nurses’ facility with library resources, and also indicated a need for restructuring the content, duration and objectives of the service.28 Before creating a service whereby a librarian would establish a regular presence on a nursing ward, nursing faculty and a librarian at one NHS teaching hospital undertook a survey to determine whether such a service would be feasible. Feedback was positive because it was thought that it would encourage nurses to adopt an evidence-based approach to care.29

The review of health library services reveals that there are a wide range of services being offered to clinical staff and affiliated faculty. Many of the services created are responses to local point-of-need requests. This accounts for the difficulty in describing the ambit of the health librarian role. Despite there being a lack of evaluation of the impact of many services with regard to client use, due in part perhaps to the lack of a standard method or benchmark by which to measure them, the services offered to healthcare clients are perceived as ‘valuable’. Forming partnerships with clinical groups enhances the value of the health librarian role. The case presented below exemplifies how health librarian participation assists in meeting a nursing community's leadership development objectives.

Service Innovation

  1. Top of page
  2. Abstract
  3. Introduction
  4. Background
  5. Aims and objectives
  6. Methods
  7. Literature review
  8. Service Innovation
  9. Discussion
  10. Conclusion
  11. Acknowledgements
  12. Key Messages
  13. References

Project phase I: acquisition of nursing leadership literature

The WRHA Nursing Leadership Council is composed of Chief Nursing Officers (CNOs) of four Winnipeg hospitals and a Director of Nursing Education at the Health Sciences Centre, Winnipeg's largest teaching hospital. In August 2006, the NLC approached the UMHSL librarians for help in completing the final phase of their nursing leadership development programme—obtaining literature on nursing leadership and making it accessible online. A librarian volunteered to coordinate the literature searching activity. She met with a member of the Council to discuss the framework's structure, criteria, scope, and time frame for completion.

At the outset, the NLC requested only journal literature, but as borne out by early searches, many topics were better suited to information contained in books (print or electronic) or in practice guidelines located on Websites. The coordinator discussed with the NLC the applicability of other types of literature for certain topics. Where possible, material published in Canadian contexts was searched and selected, but nursing leadership resources from commonwealth countries and from the USA were included, as these could be extrapolated to a Canadian nursing context. The NLC requested only full-text online articles that contained an abstract and that had been published in the past 5 years.

The coordinator assembled literature search volunteers among whom she divided the leadership topics, and identified potential resources. The primary databases used were PubMed, CINAHL, ProQuest: ABI/Inform, Academic Search Elite, EMBASE, and the Cochrane Library. Librarians also searched NetLibrary, a large e-book database, and the Libraries’ catalogue for books and videos. Web searching was restricted to reputable Websites, which included the National Guideline Clearinghouse, the Canadian Institute for Health Information, and provincial nursing association Websites.

At the outset of the project, neither the NLC nor the librarians had envisaged how best to present the literature in an online format. The RefWorks database, a bibliographic management database licensed by the University, was eventually selected because it would permit nurses to access online materials from various WRHA locations across Winnipeg, it contains a commentary feature, which the NLC had requested, and it contains embedded links to full-text material. The coordinator created a shared account into which all search results were transferred. The literature search results were presented to the NLC in early September accompanied by a training session about the RefWorks database.

The UMHSL obtained full-text material for all of the literature results and delivered it to the NLC. The nursing literature indicates that nurses require a substantial amount of time to read, synthesize, and select information, which is difficult to carry out while on ward duty.30 With this in mind, the NLC decided that it would take responsibility for reading the literature and selecting that which they thought best exemplified nursing leadership practice.

Project phase II: webliography development

Feedback from the NLC was positive with regard to the RefWorks database meeting the project's online and forum goals, but its appearance and navigational structure was perceived as somewhat cumbersome. One of the librarian volunteers created a mock-up bibliography based on a leadership topic, published it on a library web page, and presented it at a NLC meeting. Response to the webliography format was overwhelmingly favourable because at one glance its organization could easily be discerned.

Further meetings with the NLC entailed the creation of a formal partnership, whereby one of four librarians would be assigned to work exclusively with one of four CNOs, under whose guidance the webliographies would be created and linked to the nursing leadership Website. The NLC also delivered a ‘top ten’ article list for each topic under its leadership framework.

The four librarians formed a coordinating committee and developed a plan to direct the activities of the next stage of the project. A new team of librarian volunteers was sought for the creation of the webliographies, divided between the four coordinators, and assigned topics. The coordinators created a house style for the webliographies, detailing publication style, material precedence, white space, and navigational infrastructure on each webliography page. In-house training sessions for volunteers who had little experience with the Libraries’ web page software were arranged, and reinforced by group work sessions.

Team effort by the health sciences librarians made possible the timely completion of and success of the webliographies. Two coordinators presented an overview of the webliographies project at the 2007 Canadian Health Libraries Association conference, a month after the Nursing Leadership Council launched its leadership programme.

Discussion

  1. Top of page
  2. Abstract
  3. Introduction
  4. Background
  5. Aims and objectives
  6. Methods
  7. Literature review
  8. Service Innovation
  9. Discussion
  10. Conclusion
  11. Acknowledgements
  12. Key Messages
  13. References

Nursing leadership webliographies

Nineteen nursing leadership webliographies based on the framework's topics have been created and are accessible from the UMHSL Website. The 19 topics are divided among four major themes: Business of Health Care, Competencies of Leadership, Use of Self, and Profession of Nursing.

The NLC's and Libraries’ Websites are interconnected. The Nursing Leadership Development Website links directly to the Libraries’ webliographies from its topic pages. It contains brief instructions for obtaining full-text articles through the University's authentication software. The UMHSL's webliography home page outlines the leadership framework and provides a link to the NLC's leadership programme home page.

The online strategy is intended to mitigate barriers that nurses encounter with searching and obtaining information such as lack of time at work to undertake literature searching, lack of practice with database and catalogue searching, and difficulty sifting through a plethora of information to find what is relevant for decision-making.30,31

Webliography structure

The organization of content is uniform from webliography to webliography, with common navigation tools appearing in the same place on each page. Journal articles arranged alphabetically by author appear first on the page, followed by books, videos, and an online resources section, which includes practice guidelines, policy papers, and Websites, where applicable. Books, videos, and practice guidelines are directly hyperlinked. Full-text articles are accessible through the Libraries’ link resolver icon (UM Links) found under each article. The resolver's intermediary page contains a link to the Libraries’ Document Delivery service in the event that content, for one reason or another, is no longer available online. The UMHSL runs a regular link checker programme on its entire site that quickly identifies broken links.

Commentary section

The UMHSL uses a content management software package called NtreePoint for posting events and news items on its Website, and for distributing its newsletters. The software contains a separate component for a forum. The NLC requested that nurses be provided with an online forum where a discussion of ideas and reflective thinking can be mediated. Appended to each journal article is a link (Comment on this article) to the forum site.

Project challenges

The online leadership project poses a number of challenges for both the NLC and the UMHSL librarians. The framework is a flexible structure subject to additions, deletions and amalgamations, all of which had occurred during the webliography development phase of the project. The NLC might consider adding new leadership topics, for which librarians will acquire literature, and build and maintain additional webliographies. The NLC has expressed interest in having the librarians build an online archive for older leadership literature, the details of which have yet to be worked out. In the meantime, an update schedule for the leadership literature has been established by the partnership. The NLC is also debating whether to establish a rating system for journal articles, whereby each article would be assigned to one of the five stages of leadership behaviour, as set out under its framework. Although further development of the project will undoubtedly entail additional workload for the librarians involved, they are committed to a long-term partnership. Recruitment of additional volunteers, if necessary, could alleviate the workload. As the Health Sciences Libraries has a significant complement of librarians, this would not pose a major challenge.

The biggest challenge ahead is to assess whether the programme, and the literature made available, has contributed to the development of nursing leadership. As the programme is just a year old, and not yet fully implemented across the WRHA, an assessment might be immature. The librarians are particularly interested in assessing nurses’ use and perception of the webliographies so that improvements can be made.

Conclusion

  1. Top of page
  2. Abstract
  3. Introduction
  4. Background
  5. Aims and objectives
  6. Methods
  7. Literature review
  8. Service Innovation
  9. Discussion
  10. Conclusion
  11. Acknowledgements
  12. Key Messages
  13. References

The nurse-librarian partnership serves as a model of cooperation between two disciplines that serve a healthcare organization. The online literature centre was created in response to a local point-of-need request, but one that transcends local nursing needs. The concept of developing nurse leaders to better manage an environment beset by government funding cuts and healthcare restructuring is a trend being addressed by nursing associations and affiliate bodies internationally. The librarians of the UMHSL are contributing to a clinical project that aims to instil a new style of leadership in its nurses, encourage evidence-based nursing practice, and transform a practice environment to meet the ultimate goal of providing effective patient care. The challenge that lies ahead is to assess the outcome of this project—whether it has in fact contributed to the development of nursing leadership.

Acknowledgements

  1. Top of page
  2. Abstract
  3. Introduction
  4. Background
  5. Aims and objectives
  6. Methods
  7. Literature review
  8. Service Innovation
  9. Discussion
  10. Conclusion
  11. Acknowledgements
  12. Key Messages
  13. References

The author thanks the Director and librarians of the University of Manitoba Health Sciences Libraries, all of whom supported the nursing leadership development programme.

Key Messages

  1. Top of page
  2. Abstract
  3. Introduction
  4. Background
  5. Aims and objectives
  6. Methods
  7. Literature review
  8. Service Innovation
  9. Discussion
  10. Conclusion
  11. Acknowledgements
  12. Key Messages
  13. References

Implications for Practice

  • Partnerships between nursing bodies and librarians are a means by which to foster the development of an evidence-based nursing culture.
  • Librarian commitment to clinical groups enhances the value of health libraries.
  • Health librarians should, in partnership with the client groups it serves, pursue evaluation of their services.

Implications for Policy

  • healthcare organizations can support the development of evidence-based practice by utilizing health library services or by requesting the creation of specific library services.
  • A standardized tool to evaluate health library services is warranted in order to facilitate the ease with which evaluation can be carried out.
  • Involving clinical groups in library service evaluation would facilitate an understanding of the value and use of the service.

References

  1. Top of page
  2. Abstract
  3. Introduction
  4. Background
  5. Aims and objectives
  6. Methods
  7. Literature review
  8. Service Innovation
  9. Discussion
  10. Conclusion
  11. Acknowledgements
  12. Key Messages
  13. References
  • 1
    Nursing Leadership Council, Winnipeg Regional Health Authority. Nursing Leadership Development Program. Available from: http://www.hsc.mb.ca/leadership/ (accessed 7 March 2007).
  • 2
    Canadian Nursing Advisory Committee. Our Health, Our Future: Creating Quality Workplaces for Canadian Nurses: Final Report. Ottawa: Health Canada, 2002.
  • 3
    Commission on the Future of Health Care in Canada & Romanow, R. J. Building on Values: the Future of Health Care in Canada: Final Report. Saskatoon: Commission on the Future of Health Care in Canada, 2002.
  • 4
    Orsolini-Hain, L. & Malone, R. E. Examining the impending gap in clinical nursing expertise. Policy, Politics and Nursing Practice 2007, 8, 15869.
  • 5
    Wong, C. A. & Cummings, G. G. The relationship between nursing leadership and patient outcomes: a systematic review. Journal of Nursing Management 2007, 15, 50821.
  • 6
    Cummings, G., Hayduk, L. & Estabrooks, C. Mitigating the effects of hospital restructuring on nurses. Nursing Research 2005, 54, 212.
  • 7
    Manojlovich, M. The effect of nursing leadership on hospital nurses’ professional practice behaviors. JONA 2005, 35, 36674.
  • 8
    Kilty, H. L. Nursing Leadership Development in Canad: A Descriptive Status Report and Analysis of Leadership Programs. Approaches and Strategies: Domains and Competencies; Knowledge and Skills; Gaps and Opportunities. Ottawa: Canadian Nurses Association, 2005.
  • 9
    Winning, M. A. & Beverley, C. A. Clinical librarianship: a systematic review of the literature. Health Information and Libraries Journal 2003, 20, 1021.
  • 10
    Cimpl Wagner, K. & Byrd, G. D. Evaluating the effectiveness of clinical medical librarian programs: a systematic review of the literature. Journal of the Medical Library Association 2004, 92, 1433.
  • 11
    Sargeant, S. J. & Harrison, J. Clinical librarianship in the UK: temporary trend or permanent profession? Part I: a review of the role of the clinical librarian. Health Information and Libraries Journal 2004, 21, 17381.
  • 12
    Harrison, J. & Sargeant, S. J. Clinical librarianship in the UK: temporary trend or permanent profession? Part II: present challenges and future opportunities. Health Information and Libraries Journal 2004, 21, 2206.
  • 13
    Ward, L. A survey of UK clinical librarianship: February 2004. Health Information and Libraries Journal 2005, 22, 2634.
  • 14
    Lacy, E. & Leslie, S. Library outreach near and far: programs to staff and patients of the Piedmont health care system. Medical References Services Quarterly 2007, 26, 91103.
  • 15
    Fallis, W. & Shaw-Daigle, C. TAKE 5: bringing research and library services to front-line staff in a community hospital. The Canadian Nurse 2007, 103, 101.
  • 16
    Doney, L. Evaluating the impact of a project promoting library and information services to primary care in Nottingham, UK. Health Information and Libraries Journal 2006, 23, 648.
  • 17
    Guillot, L., Stahr, B. & Plaisance, L. Dedicated online virtual reference instruction. Nurse Educator 2005, 30, 2426.
  • 18
    Rader, T. & Gagnon, A. Expediting the transfer of evidence into practice: building clinical partnerships. Bulletin of the Medical Library Association 2000, 88, 24750.
  • 19
    Wozar, J. A. & Worona, P. C. The use of online information resources by nurses. Journal of the Medical Library Association 2003, 91, 21621.
  • 20
    Demczuk, L., Cohen Baker, A., Shaw-Daigle, C. & Raynard, M. Direct to you: innovative information services to support nurses’ continuing competence in Manitoba. Journal of the Canadian Health Libraries Association = Journal de l’Association des Bibliothèques de la Santé du Canada 2006, 27, 10911.
  • 21
    Shaw Morrison, R. & Krishnamurthy, M. Customized library tutorial for online BSN students: library and nursing partnership. Nurse Educator 2008, 33, 1821.
  • 22
    Kaplan Jacobs, S., Rosenfeld, P. & Haber, J. Information literacy as the foundation for evidence-based practice in graduate nursing education: a curriculum-integrated approach. Journal of Professional Nursing 2003, 19, 3208.
  • 23
    Gard Marshall, J. Measuring the value and impact of health library and information services: past reflections, future possibilities. Health Information and Libraries Journal 2004, 24, 417.
  • 24
    Abels, E., Cogdill, K. & Zach, L. Identifying and communicating the contributions of library and information services in hospitals and academic health sciences centers. Journal of the Medical Library Association 2004, 92, 4655.
  • 25
    Abels, E., Cogdill, K. & Zach, L. The contributions of library and information services to hospitals and academic health sciences centers: a preliminary taxonomy. Journal of the Medical Library Association 2002, 90, 27684.
  • 26
    Fama, J., Berryman, D., Harger, N., Julian, P., Peterson, N., Spinner, M. & Varney, J. Inside outreach: a challenge for health sciences librarians. Journal of the Medical Library Association 2005, 93, 32737.
  • 27
    Dowse, F. & Sen, B. Community outreach library services in the UK: a case study of Wirral Hospital NHS Trust (WHNT). Health Information and Libraries Journal 2007, 24, 17787.
  • 28
    Mi, M. Evaluation of a hospital library class for NICU nurses. Medical Reference Services Quarterly 2006, 25, 2135.
  • 29
    Tod, A., Bond, B., Leonard, N., Gilsenan, I. & Palfreyman, S. Exploring the contribution of the clinical librarian to facilitating evidence-based nursing. Journal of Clinical Nursing 2007, 16, 6219.
  • 30
    McKnight, M. Hospital nurses: no time to read on duty. Journal of Electronic Resources in Medical Libraries 2004, 1, 1323.
  • 31
    Estabrooks, C. A., O’Leary, K. A., Ricker, K. L. & Humphrey, C. K. The Internet and access to evidence: how are nurses positioned? Journal of Advanced Nursing 2003, 42, 7381.