Nursing Colloquium & NeLH

This colloquium was organised with the expressed intention to "explore and ascertain the necessary elements that will contribute to the design, development and implementation of the National Electronic Library for Health (NeLH) for the nursing professions.

The areas it was intended to address include;

• Ensure a full understanding of the potential scope of the NeLH
• The process for building the NeLH and links to existing services
• Access to the NeLH
• Ownership and Sponsorship

1. Do the Nursing professions understand and agree with the way forward?
2. What are the mechanisms for securing user involvement in the design and development stage and who needs to be involved?
3. Are nursing knowledge needs known and what supporting information is available?
4. How useful is paper? - what are the problems of coping with present resources of knowledge and how do nurses, midwives and health visitors keep up to date?
5. What is known about physical access and the impact on education and training?

The joint chairs for the day were;
Marie Washbrook (Nursing Professions Advisor for NHS Information Authority)
Muir Gray (NeLH Project team leader)

The intention was to have a series of short presentations followed by general discussion.

Welcome & Introduction
Muir Gray

Muir gave a humorous view of the arrival of the information society from an industrial society & speculated where we are going next - perhaps to a fundamentalist society? he drew an analogy between evidence based medicine & alternative approaches with it's lack of evidence base but much greater popularity. Will we end with a vitamin shop in every hospital foyer?
 

Information for Health
Marie Washbrook

Marie placed information for health in it's political context describing supporting documents & organisations. She reinforced the importance of nursing professions contribution, which was illustrated by the wide attendance, showing a refreshing development from the early stages of NeLH development.

Knowledge management

The NeLH - Muir Gray

Muir described criticisms of the current access to information/guidelines etc & raised some of the issues surrounding the informed patient. He described the 4 floors analogy of the NeLH (now reduced to 3 as the patient floor becomes part of NHS direct. He also touched on the early work on Virtual Brach Libraries & Information Cafes for specific professional groups.

He highlighted the problems of peer review & knowledge selection that is already exercised in publication and libraries as opposed to censorship.

He described how choices about patient care were based on evidence, but also on the patient's values and condition and suggested that the NeLH needs to strive for greater consideration of the later 2 in addition to the evidence. Discussion centred around selection and updating of material & the role of the NeLH as a provider/commisioner of information or providing an index of pointers to information provided by others.

One delegate who argued for a freer & more open access policy walked out suggesting that the decisions had already been made.

Further discussion about relationships with social services information and other services highlighted some of the issues still to be addressed.

Existing Library resources - Veronica Fraser (Library Advisor)

Veronica described current library provision across the NHS identifying resourcing problems & the relationship with HE.
She set out barriers, drivers and opportunities to moving forward electronic access within NHS libraries.

Access and Use at Home - Rod Ward

My presentation can be downloaded here (warning large .ppt file)

It highlighted the different cultural and technical considerations which may be need for access outside NHS work - however it was generally accepted that most nurses accessed from home rather than via NHS net.

NHS/DOH view & Nursing Web Site - Monica Duncan

Monica described how the technology can provide a vehicle for accessing evidence for practice and CPD/PREP. She explored the immediacy of nurses information needs and said it was not minute to minute or diverting them from patient/client care. She explored joint decisions about reasonable use & the utility/relvance of information but was worried about it slowing us down. She used an acronym R.A.T.S. to describe what information should be;

• Relevant
• Accessible
• Timely
• Succinct

Skills for Information Management

Informatics - Rod Ward

I outlined the IT & IM skills needed in my presentation which can be downloaded here (warning large .ppt file)

MIDIRS - an example - Mary Stewart (Editor) & Kathy Levine (Librarian MIDIRS)

Midwives Information and Resource Service (MIDIRS) has been running for 15 years with a database (70,000 refs) and digest service. It's a charitable organisation and is resourced purely by the subscriptions of users. If their information was to be incorporated into the NeLH this would create a serious resourcing problem and the finical models for this sort of service need to be addressed. The informed choice leaflets were used as an example that would be ideal to circulate, but the financial implications (no income) would cripple the organisation.

Professional Contributions to the NeLH - "what the professional oragnisations do?"

CPHVA - Gill Adams

Gill described a survey of their members relating to what they want from NeLH - key point being about fast and equitable access. The other issues were set out by the knowledge floor (including professional facts), knowledge management floor, and know how guidelines.

RCN - Kate Clark (Information Services librarian)

Kate described the RCNs focus groups on information services & the current development of an RCN Information Strategy.

RCM - Ann Jackson-Baker (Director English Board)

Ann questioned the UK wide remit of NeLH, and described the RCMs proactive approach including the delivery of study days for managers. The RCM web site will soon be available.

Summary and the next steps

Muir summarised some of the issues from the day - and said that discussions would continue

Evaluation forms were distributed inviting further contributions.

General comments

Interesting discussion which started to show the wide range of information needs and potential contributions which could be made by the nursing professions.

More discussion of the content would have been useful, but maybe this will be the next step. Many of the issues will require both time and resources but the potential is there for collaboration between members of the different professions and groups and the NeLH project team.

I would advise anyone interested whether you or any organisation you belong to attended the meeting, to visit the NeLH building site & join the mailing list details at: http://www.mailbase.ac.uk/lists/nelh/
To influence developments so that it meets the nursing professions.

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