Partners on the Health Care Team: Librarians Collaborating with Nurses

Guest post by Annie “Nicky” Nickum, BSN, MLIS, AHIP, and Rebecca Raszewski, MS, AHIP, faculty and nursing liaison librarians at the University of Illinois Chicago.

Occasionally we focus on the intersection between libraries and special clinical practices. Librarians are important partners for nurses who seek to improve their practice within their workplace and continue to be indispensable as nurses start their professional and academic careers.

There are many ways librarians contribute to nursing education with the ability to provide expertise on evidence-based research and research strategies for clinical questions. Librarians collaborate with nursing faculty by conducting literature reviews, collaborating on manuscripts, and teaching students. Our patrons range from students just getting started in nursing to faculty and practice leaders within the field, all having access to our library’s resources. We teach them how to search the literature for projects contributing towards completion of their degree whether it be Bachelor’s, Master’s, Doctor of Nursing Practice, or PhD.

The support and partnerships librarians provide to nurses is nuanced and varied. It is dependent on the type of relationship the library has with the given hospital and the nature of their clinical query. At the University of Illinois Chicago, we have a teaching hospital.  Within hospital settings, librarians may also be involved in educational initiatives within nurse residency programs for new nurses or specific programs for nurses who want to conduct evidence-based practice or research. This goes hand in hand with preceptor support for nurses mentoring students. Librarians may provide orientations and collaborate with residency directors and preceptors to develop quality improvement projects.

Hospitals that are pursuing or have Magnet status (the highest credential for a nursing facility within the United States) will usually have a shared governance model in place where nurses of all educational levels advocate for nursing’s role in patient care. Nurses are involved with reviewing updated hospital guidelines and protocols, providing an opportunity to make sure nursing practice is reflected.

Librarians may be members of nursing- and hospital-wide councils — supporting quality improvement initiatives conducted by nurses or other health care professionals by providing the latest evidence. Examples of literature searches that have been conducted at our institution include:

  • Interprofessional patient rounds,
  • Delivery of care in labor and delivery for obese pregnant women, and
  • Examples of the SBAR Tool (Situation, Background, Assessment, Recommendation), which is a technique used for communication and often used in electronic health records. 

The literature that librarians provide lays the foundation for improving patient safety and contributing to staff empowerment.

At the University of Illinois Chicago, we’ve been involved in an external collaboration with nursing faculty. The NExT Project has provided free continuing education to public health and school nurses since 2014. In 2021, the modules were expanded to include ambulatory care nurses. Nurses can go through the modules created by library and nursing faculty on the evidence-based practice process, which involves how to find evidence, appraise the evidence, translate the evidence, and disseminate what they found. These modules give nurses from workplace settings with limited resources the opportunity to learn about evidence-based practice, exemplifying that searching for and implementing evidence-based practice(s) is possible in any work setting.

Librarians are critical to the success of health care teams. Throughout your career how have librarians helped you?

Annie ‘Nicky’ Nickum currently works as an Information Services and Liaison Librarian and Assistant Professor at the University of Illinois Chicago where she supports the College of Nursing and the University of Illinois Hospitals. Her research interests include consumer health literacy amongst nurses and supporting the translation of student health literacy to nursing practice. Before coming to UIC, she worked at the Library of Health Sciences at the University of North Dakota as the Nursing and Biomedical Sciences Librarian. She obtained her MLIS from the University of Wisconsin-Milwaukee in 2013.

Rebecca Raszewski, MS, AHIP is Associate Professor & Information Services & Liaison Librarian at the Library of the Health Sciences at the University of Illinois Chicago. She has worked with nursing on the Chicago campus since August 2008. Her most recent publications have focused on data management education in graduate nursing programs and nursing faculty’s awareness of information literacy standards. She is involved with the NExT Project, a library and nursing faculty partnership that provides free continuing education on evidence-based practice.

Pursuing Data-Driven Responses to Public Health Threats

In my 11th grade civics class, I learned about how a bill becomes a law, and I‘ll bet some of you can even remember the steps. Today, I want to introduce you to another way that the federal government takes actions – executive orders. As head of the executive branch, the president can issue an executive order to manage operations of the federal government.

In light of the COVID-19 pandemic, President Biden has issued executive orders to accelerate the country’s ability to respond to public health threats.

This is where I come in. As Director of the National Library of Medicine (NLM) and a member of the leadership team of the National Institutes of Health, I’m part of a group developing the implementation plan for the Executive Order entitled Ensuring a Data-Driven Response to COVID-19 and Future High-Consequence Public Health Threats.

This order directs the heads of all executive departments and agencies to work on COVID-19 and pandemic-related data issues. This includes making data that is relevant to high-consequence public health threats accessible to everyone, reviewing existing public health data systems to issue recommendations for addressing areas for improvement, and reviewing the workforce capacity for advanced information technology and data management. And, like all good government work, a report summarizing findings and providing recommendations will be issued.

Since March 2021, I have been meeting 2 to 3 times a month with public health and health data experts across the U.S. Department of Health & Human Services (HHS). Our committee includes staff from the Office of the National Coordinator for Health Information Technology, Food and Drug Administration, Centers for Disease Control and Prevention, Centers for Medicare & Medicaid Services, and Office of the Assistant Secretary for Planning and Evaluation.

After creating a work plan, our group arranged briefings with many other groups, including public health officials from states and territories, representatives from major health care systems, and the public, among others. We reviewed many initiatives to promote open data, data sharing, and data protection across the government sphere. We learned about the challenges of developing and adopting data standards, and the ability of different groups to come together to make data more useful in preparing the country to anticipate and respond to high-consequence public health threats. We discussed future strategies for data management and data protection, new analytical models, and workforce development initiatives. Our working group provided a report to the Office of Science and Technology Policy (OSTP), handing it off to the next team who will take the work process and keep moving it toward completion. In coordination with the National Science and Technology Council, OSTP will develop a plan for advancing innovation in public health data and analytics.

This was a beneficial experience for me, and I certainly learned a great deal. Implementing a public health response system requires engagement with many HHS divisions, each of which brings a unique perspective and experience. I also developed new relationships based on trust and collaboration with these colleagues. At NLM, we have experts in data standards and data collection, and we oversee vast data repositories, so we have substantial domain-specific knowledge to contribute. I drew frequently on the knowledge and expertise of NLM staff to inform the process through analyses of information and the preparation of reports. I am grateful for all who helped and supported me.

I believe our country is prepared to have the data necessary to prevent, detect, and respond to future high-consequence public health threats. This is yet another way that NLM is helping shape data-powered health for the future. What else can we do for you?

Investing in a Sustained Partnership: A Data-Driven Human Approach to Social Justice and Equity

Guest post by Patricia Matthews-Juarez, PhD, Chair of the Environmental Health Information Partnership (EnHIP) and Rueben C. Warren, DDS, MPH, DrPH, MDIV, Scientific Advisor for EnHIP

In 1989, after many successful years of developing scientific and technical databases, the National Library of Medicine (NLM) started its first long-term outreach plan to train health professionals how to use NLM’s suite of digital tools. While these efforts helped large medical schools and hospital centers, institutions comprised of substantial minority populations struggled to maintain access to online databases and keep up with rapidly evolving technologies.

As a result, NLM sponsored a one-year pilot project to increase the capacity of historically black colleges and universities (HBCUs), Hispanic-serving institutions, minority-serving institutions, and tribal colleges to access NLM’s toxicological and chemical databases. This program was designed not only to benefit the institutions, but also to investigate environmental toxins commonly found in minority and socio-economically disadvantaged communities, particularly in the southern United States. In 1991, the pilot project grew into a partnership called the Environmental Health Information Partnership (EnHIP).

EnHIP unites heads of the various universities and colleges with NLM leadership and staff. In addition to examining environmental hazards, this program also calculates the impact of hazardous waste on the lives of African Americans using data, technology, and scientific resources.

This single investment made more than 30 years ago to strengthen the capacity of HBCUs resulted in a tremendous payback in terms of education and research. As NLM and EnHIP have evolved, so have the demands for access to complex technology that capture and interpret data as a pathway to scientific explorations, interventions, research endeavors, and discoveries. The return on investment is the systemic organizational change at the member schools of EnHIP and listening channels at NLM. These opportunities create community-based projects in local communities and enhance the capacity of EnHIP member institutions to reduce health disparities in ways never imagined. These opportunities, driven by consistent investments from NLM, are linked to the practice and process of social justice and fairness, trustworthiness, and truth telling.

NLM continues to bring high standards and innovative ideas to the acquisition and management of biomedical data as scientists unravel the impact of the social determinants of health, health disparities, and health equity. The NIH UNITE initiative to end structural racism offers new opportunities to invest in equitable research and determine how data is collected, managed, and accessed with justice and equality in mind. Three decades of collaboration in data science, open access publications, and community/citizen science are paying off. Shared values and networks have been amplified at the international, national, regional, state, and local levels, and across populations. Years of consistently shared and common agendas have led to a strong and effective partnership with the current participating 23 HBCUs, Hispanic-serving institutions, minority-serving institutions, and tribal colleges. These dividends of trust, open communication, and transparency are reflected in the success of our nation in its efforts to reach for equity in science, education, and service.

Dr. Matthews-Juarez is the Senior Vice President for Strategic Initiatives and Innovation and Professor in the Department of Family and Community Medicine at Meharry Medical College. Her work focuses on the social determinants of health, health disparities, and equity in primary care education and community engagement in both the United States and Africa.

Dr. Warren is Director of the National Center for Bioethics in Research and Health Care and Professor at Tuskegee University. He previously served as Associate Director for Minority Health and Associate Director for Environment Justice at the Centers for Disease Control and Prevention and Director of Infrastructure Development at the NIH National Institute on Minority Health and Health Disparities

Thanks, Dr. Fauci!

Perhaps the most famous NIH staffer right now is Anthony Fauci, MD, Director of the National Institute of Allergy and Infectious Diseases (NIAID), and one of the leading voices throughout the COVID-19 pandemic. Prepared by more than 50 years of government service and research on infectious diseases, Dr. Fauci is a public servant who brings reason, expertise, and a keen sense of how to mobilize the public health sector to act against this unprecedented threat to public health.

Like many others around the country and the world, my family and I think of Dr. Fauci as “our doctor.” He speaks to us, giving a personal response to ensure the public’s health. He understands the challenges of having family at a distance during times when travel and family gatherings are discouraged to reduce the spread of infection. He shares the joys of those reunions—full of hugs from family and friends—so long missed. It’s amazing to me that Dr. Fauci has been able to convey such warmth and concern to the world and be the deliverer of trusted knowledge in such a personal manner. More than once, conversation at a family dinner or on a family phone call has included the question, “But what does Dr. Fauci think about . . .?” followed by heartfelt wishes of gratitude from my mother and siblings!

I am privileged to be part of the NIH leadership team who meets weekly to advance the mission of the world’s largest research enterprise. While we address wide ranging issues from advancing biomedical science to NIH infrastructure and operations, discussions about NIH’s response to the COVID-19 pandemic still dominate. Like others, I find Tony a wise and experienced colleague, thoughtful in his contributions, and quick to bring a sometimes much-needed touch of humor into complicated conversations. I marvel at his stamina and the breadth of issues that engage his mind.

Tony Fauci has built a superb team of scientists, clinicians, and administrators within NIAID. The dedication and intellectual generosity evident in his contributions to our efforts are evident across NIAID – clearly an inspirational leader motivates and inspires!

So please join me in expressing gratitude to my colleague, Tony Fauci – a national treasure!

Going Back to School Safely

Guest post by Diana W. Bianchi, MD, Director, Eunice Kennedy Shriver National Institute of Child Health and Human Development at the National Institutes of Health

Originally released on the Director’s Corner blog.

As schools across the United States begin to resume full-time, in-person education, I am hopeful that this academic year may be a more typical one. The in-person school environment and the wide range of services offered there are critical for the development and well-being of our nation’s young people. Without in-person schooling, many children miss out on school-based meals, speech or occupational therapy, and after-school programs. Loss of such services disproportionately affects minorities, socially and economically disadvantaged children, children with disabilities, and those with medical complexities.

Generating robust scientific data to inform policies to return children to the classroom safely and equitably during the ongoing COVID-19 pandemic is of paramount importance not only for children, but also to allow their parents to return to work. We now have safe and effective vaccines available for adults and children ages 12 years and older, as well as established public health measures to prevent transmission of SARS-CoV-2, the virus that causes COVID-19. Yet the emergence of the more transmissible delta SARS-CoV-2 variant and the rising COVID-19 cases across the country remind us that we must remain vigilant and adaptable to changing circumstances.

NICHD manages the Safe Return to School Diagnostic Testing Initiative, launched earlier this year as part of the NIH Rapid Acceleration of Diagnostics-Underserved Populations (RADx-UP) program. This initiative addresses the needs of children with unequal access to COVID-19 testing and who face barriers to attending school remotely, including those who do not have adequate equipment, internet access, or adult supervision at home.

The RADx-UP Return to School projects combine frequent COVID-19 testing with proven safety measures to reduce the spread of SARS-CoV-2. They also are exploring the influence of vaccination for eligible staff and students, addressing vaccine hesitancy, and seeking information on circulating SARS-CoV-2 variants and breakthrough infections. Funding for the first set of projects was announced in April, and additional projects were funded in July. Currently, 16 projects are ongoing at schools across the country, including public, charter, tribal, early education, and special education schools. Participating schools serve racially and ethnically diverse populations, including African Americans, American Indians/Alaska Natives, Latinos/Latinas, Asian Americans, and Native Hawaiians and other Pacific Islanders. Critically, several projects include children with medical complexities and/or intellectual and developmental disabilities who may not be able to use COVID-19 mitigation measures such as wearing masks or social distancing.

On August 9, NIH hosted a virtual workshop that brought together RADx-UP Return to School investigators and other researchers conducting school-based research on COVID-19 diagnostic testing to present data acquired to date, learn from each other, and support the safe return of children to in-person school.

Among other topics, workshop participants discussed the critical importance of engaging local communities in this research. Communities need access to the most up-to-date scientific evidence to weigh the benefits and challenges of implementing different COVID-19 mitigation strategies. Scientists need community input to understand the attitudes, knowledge, and barriers that may influence individual choices to enroll in COVID-19 testing programs and return to in-person learning. By working together, we can ensure a safe return to school for all.

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