The impact of NHS-funded library services in South
Central Strategic Health Authority
Report 3: a survey of recipients of mediated literature searches conducted in
March 2009
1. Introduction
This report collates the data gathered from a pilot study to test the usefulness of
surveying library users who have requested a mediated literature search as a
technique to illuminate the impact on patient care of the various services provided by
NHS-funded library and information services.
This survey of a sample of recipients of literature searches was conducted across
libraries in South Central, in parallel to holding one-to-one interviews with individuals
from two staff groups of Buckinghamshire Hospitals NHS Trust.. An online survey,
mailed to all trust staff, was conducted prior to these.
2. Objectives
This component of the pilot study was designed to:



Test a questionnaire to assess the impact on patient care of the literature
searching service offered by library staff
Obtain rich quantitative and qualitative data regarding the impact of library
services on patient care amongst purposive library users
Identify the uses to which information provided by library services is applied
3. Method
A short questionnaire was sent electronically to South Central SHA libraries, with a
request to keep a list of the name, search topic, and e-mail address of everyone for
whom they completed a mediated search. The form could either be e-mailed to
users, or printed and posted. Similarly, the recipient could either complete online and
e-mail back, or print off and post. Library managers were asked to distribute the
questionnaire, on or around Monday 27 April with a closing date of Thursday 14 May
for the return of completed questionnaires. The questionnaire used is provided as
Appendix 1.
4. Results
38 questionnaires were returned and the quantitative responses are shown in Table
1 below (and the search topics themselves are listed in Appendix 2).
The responses were spread between Mental Health, Acute and Primary Care Trusts,
with the greatest response from Mental Health (three ‘Other’ organisations were
cited; (these were in fact clinical divisions of an Acute Trust).
The returns demonstrate greatest use by Nurses and Midwives, followed by equal
use by Medical and Dental staff and Allied Health Professionals. Only two searches
on which respondents reported were undertaken by “students”.
4.1
The impact of the information provided– quantitative data
Table 1 Questionnaire responses: quantitative data
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1
0
These data indicate that for this sample of respondents, literature searches are
predominantly being used to support 1) guideline or pathway development and 2)
service development and planning.
While many searches are still reported as being significant in supporting coursework
or work on dissertations, the responses indicate that libraries are playing a significant
role in supporting evidence based practice, rather than formal education.
Nevertheless, learning something new and confirming prior knowledge and belief is
also highlighted by respondents.
The significance of sharing information obtained via literature searches with
colleagues and of using information provided by the library to give advice to
colleagues (and to a lesser extent to patients and carers) suggests that the value of
this service lives on and is disseminated by users, demonstrating the part that
libraries play in enabling a culture of learning throughout NHS organisations.
4.2
The impact of the information provided– qualitative data
The qualitative data from the survey is recorded in Table 2, below.
Users were given a free text section to outline anything that they did differently as a
result of the information received. 23 people responded to this question (60% of this
small sample).
Table 3: Qualitative narrative data
I will be writing up a report which will hopefully influence supervision practice by
senior clinicians
I contributed towards an audit project, a qualitative project on the experiences of
people with learning disabilities on seeing a psychologist. I informed my clinical work
with systemic approaches. I satisfied my curiosity on topics such as borderline
personality disorder and approaches such as DBT and CAT. I revised for up coming
courses, etc... This service is invaluable and the librarians are instrumental in
helping me
It is helpful in tailoring the intervention I use with patients more specifically
I feel better able to carry out my own literature research having received support and
tutoring
The information requested was very helpful for improving the accuracy of our reports
In the last question there is no mention of support with research which was the
primary reason I asked for help
Provided evidence for clinical pathway development
The information will be used to inform both commissioning and patient care. It will
form part of a research bid to help improve the qualities of patient care
A funding proposal could be evaluated on the basis of evidence base
I was better prepared for a meeting by having this knowledge. I also knew what I
didn't need which is half the battle. I then went on to do further research on the
internet
The literature I received was purely for an essay assignment on my course
Completed my course which improved my practice
I was able to carry out further literature searches using the information provided. It
was a useful tool in gaining knowledge for my dissertation
A meeting will be held at DMT within Older peoples Mental Health Services to look at
the evidence base for recovery, and to look at developing a strategic approach
ahead
We used the particular piece of work you did around bench marking to help me write
a paper for TMT and PEC re Podiatry Services so as to ensure that the different
aspects are taken into account not just numbers of population but deprivation
indicators etc The outcome of this paper has led on to further work re a full service
review in order to understand how the service is working and what new models of
care are available. The info went Chief Exec level.
As ever the library staff were extremely helpful in providing help and information in
very short notice. The information enabled me to carry out a research proposal. I am
almost certain that this proposal will enable to change/implement visiting hours in
maternity unit especially on labour ward. I am planning to have a working party in
order to take this proposal further. If I can provide you with further information please
let me know.
Development of departmental policy is ongoing
It has provided me with confidence when looking after a patient on pulmonary
oedema as I know now the important aspects of the nursing care and I understand
the pharmacological treatment. I feel that the patient will be now more safely looked
after as I have also learnt how to recognize the signs/symptoms of a pulmonary
oedema and I have passed my knowledge to my colleagues. Thank you very much
for your support.
I am now able to start work on a flowchart for managing constipation in malignant
spinal cord compression to allow a consistent, evidence-based approach by my
team. The evidence so far is helpful in terms of more current thinking and what
would be acceptable to patients and carers. The evidence will definitely influence my
practice and intended outcomes for both patients, families and the acute trust..
I work on policy development rather than front line patient care. The literature
searches we get from Cairns are absolutely essential to our work
This literature search was used to confirm knowledge and update a policy under
review
Can empower the young people I work with, with a sense of research literature
behind my practice.
Has been helpful in increasing my awareness in future practice
5. Conclusions
This survey was conducted as a short term pilot, with a limited number of responses
from a sample of users over just three weeks. Hence, the results are only indicative.
Nevertheless, the questionnaire proved very effective in obtaining data that meets
the objectives of the study.
The questionnaire identified the primary uses to which the information supplied via
these literature searches were applied. Respondents reported on ways in which the
literature searches impacted on patient care, and the survey gathered narrative data
which ‘tells the story’ of the impact of this mediated service supplied by NHS-funded
library services upon the work of library users and ultimately on patient care.
Sue Lacey Bryant and Mark Bryant
31 May 2009.
Appendix 1
Questionnaire
IMPACT OF THE LIBRARY’S LITERATURE SEARCH SERVICE
Dear Colleague,
You recently requested a search on: Library staff insert subject here
I would be grateful if you could complete the following survey, designed to assess the
impact on patient care of the literature searching service that the library offers. Your
feedback will help us improve the quality of our information and library services.
Library staff - insert your name here
YOU
YOUR NAME:
YOUR PROFESSIONAL GROUP:
Medical and Dental
Nursing and Midwifery
Registered
Allied Health Professionals
Additional Clinical Services
Managerial, Administrative and
Clerical
Additional Professional /
Scientific / Technical
Estates and Ancillary
Students
THE ORGANISATION YOU WORK FOR:
PCT
Acute
Mental health
Other (Please specify)
CONTACT DETAILS (optional):
Tel:
e-mail:
YOUR INFORMATION SEARCH
Please answer each question ticking all responses that apply.
DID THE INFORMATION PROVIDED INFLUENCE ANY OF THE FOLLOWING?
Commissioning
Contracting
Audit
Legal or ethical issues
Funded research
Service development and
planning
Advice given to colleagues
Managing costs
No, it didn’t influence any of
these
DID THIS SEARCH LEAD YOU TO CHANGE SOME ASPECT OF PATIENT CARE
OR TREATMENT?
Diagnosis
Choice of tests
Choice of drugs or other
treatments
Reduce the length of hospital
stay
Advice given to patients or
carers
Quality of life for patients or
family
Guideline or pathway
development
No, it did not change any
aspects of patient care or
treatment
DID THE INFORMATION HELP YOU AVOID ANY OF THE FOLLOWING?
Unnecessary hospital
admissions
Patient mortality
Hospital acquired infections
Unnecessary surgery
Unnecessary tests or
procedures
Unnecessary outpatient visits
Unnecessary referrals
Unnecessary costs
No, it didn't help me avoid
adverse events
DID THE INFORMATION YOU FOUND HAVE ANY IMPACT ON YOUR LEARNING
OR TEACHING?
It satisfied my curiosity
It refreshed my memory of the
topic
It confirmed my prior
knowledge or belief
I shared the information with
colleagues
I learned something new
I used it for course work or a
dissertation
I used it for supervision
I used it for teaching purposes
No, it didn't impact on my
learning or teaching
PLEASE TELL US ABOUT ANYTHING YOU DID DIFFERENTLY AS A
RESULT OF RECEIVING THIS LITERATURE SEARCH.
THANK YOU FOR YOUR CO-OPERATION
PLEASE RETURN THIS FORM ELECTRONICALLY TO
OR BY POST IN THE ENVELOPE PROVIDED
7
Appendix 2
Search Topics
South Central SHA Libraries: sample of literature searches Mar 09
Clinical supervision in psychiatry
law and mental capacity in learning difficulties
DBT and suicide/self-harming adolescents
benefits of pilgrimages
feasibility of services for social and therapeutic horticulture for people with long
term mental health problems/ supporting these people back into
employment/social enterprises
checking statistics on mental health
Not given
erectile dysfunctionas an independent predictor of vascular disease
sorry I can't remember
benefits of continuity of care
health inequalities and the Credit crunch
Skills/competences for commissioning
Curriculum design in lifelong learning
Moving and Handling/NHS claims/statistics
Socioeconomic migration influence on mental illness with ethnic minorities
Infection/isolation effects on patients
Recovery principles applied to younger working adults/evidence effective with
people with dementia
Care of dying babies and their family
Nurse led sexual health services
Benchmarking against simlar PCTs
Integrated care pathways for the discharge of difficult clients, including those with
schizophrenia/borderline personality disorder/bipolar disorder
chronic leg ulcers and silver impregnated dressings.
Infection control and limiting visiting hours on the labour ward in the maternity unit
Use of trendelenburg position with anaesthetised patients.
Psychological impact pof Crohns disease on adolescents
Using drilling to treat avascular necrosis of the talus
Diabetic diet
Management of pulmonary oedema - nursing aspects
Bowel and constipation management in paraplegia…..
teaching medical students geriatric medicine
Anti VEGF agents in treatment of macular disease - not ARMD
Conscious sedation in cardiac journals
Integrated care pathways for the discharge of difficult clients, including those with
schizophrenia/borderline personality disorder/bipolar disorder
Knee or hip schools 2-4 weeks prior to surgery
Is entonox an occupational hazard for midwives?
8
Overiding consent regarding parental involvement in adolescent mental health
care
ADHD and maternal substance abuse
Use of traditional Chinese medicine as effective antibiotics against intestinal
bacteria.
9