The Experience of Information Literacy in Evidence-Based Practice (EBP) Among Professional Nurses in the Ho Municipality of Ghana.

Author:Agyei, Dominic Dankwah


Medical and health care is one of the most dynamic human disciplines, and large amounts of money are spent annually on high-quality and sophisticated research, resulting in exponential growth in health care literature (Majid et al., 2011). This phenomenon, most often, arises because there is always new and more effective medicines, medical devices and procedures invented which require new research to investigate their use, efficacy, and effects on their subjects. According to Majid et al. (2011) one major objective behind this investment in high-quality and sophisticated research is to help doctors, nurses, and medical technicians to provide the best possible care and treatment to patients. Again Nursing practice is based on a mixture of research, anecdote, tradition, theory and hunch; and that the education of nurses has tended to reinforce the 'ritual' by placing high value on traditional scientific authority and adherence to well-established clinical protocols and routine practices (Taylor et al., 2011; Shorten et al., 2001). Majid et al. (2011) substantiate this assertion by stressing that aside traditional and well established procedures and practices, health care practitioners are adopting innovative interventions that are based on best practices as well as solid research-based evidence. The importance of research in practice is again underscored by Sackett et al. (1996) who postulate that good doctors (nurses) use both individual clinical expertise and the best available external evidence, adding the neither alone is enough. Without clinical expertise, practice risks becoming tyrannised by evidence, for even excellent external evidence may be inapplicable to or inappropriate for an individual patient. Without current best evidence, practice risks becoming rapidly out of date, to the detriment of patients.

The tendency of health care practitioners adopting interventions that are research based is a key attribute of Evidence-Based Practice (EBP) and it is quickly gaining popularity due to its potential to effectively handle clinical issues and provide better patient care (Majid et al., 2011). Evidence-based medicine according to Jacobs et al. (2003) is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. In the same way, EBP is seen as the integration of best research evidence, clinical research, and patient values in making decisions about the care of individual patients ("Information Literacy Competency Standards for Nursing," 2014). Taylor et al. (2011) define EBP in nursing as a problem-solving approach of making clinical decisions, using the best evidence available (considered "best" because it is collected from sources such as published research, national standards and guidelines, and reviews of targeted literature). Furthermore, Taylor et al. (2011) state that EBP blends both the science and the art of nursing so that the best patient outcomes are achieved. Various researches on EBP suggest it as a key initiative in which clinical practice is based on research evidence. (Ross, 2010; Bailey et al., 2007; Barnard et al., 2005; Shorten et al., 2001). Thus EBP is a development in nursing where clinical practice is informed by research evidence. The advantages of practitioners resorting to EBP are enormous (Majid et al., 2011; Beke-Harrigan et al., 2008) and especially in an era where the patient is privy to many health information. Consequently, the nurse who decides only to resort to traditional methods of practising learnt from school will in no time be questioned by patients who read about their conditions before visiting the hospital.

A demand for safe and efficient health care requires nurses to develop the necessary skills in order to incorporate research findings into practice. Furthermore evidence-based practice necessitates an underlying understanding of how information is organized and accessed (Jacobs et al., 2003), hence competency in information literacy is an essential foundation, a prerequisite to an evidence-based practice and a confident approach to lifelong learning (Shorten et al., 2001). Jacobs et al. (2003) also state that an increasing competency in information literacy is the foundation for evidence-based practice and provides nursing professionals with the skills to be literate consumers of information. To be information literate, the Presidential Committee on Information Literacy of the American Library Association (1989) states that a person must be able to recognize when information is needed and have the ability to locate, evaluate, and use effectively the needed information. Information literacy has also been defined as the set of abilities that enables one to recognize when information is needed and have the ability to locate, evaluate, and use effectively the needed information (Association of College and Research Libraries, 2002). According to Connie (2011) the Medical Library Association went further to define Health Information Literacy (HIL) as the set of abilities needed to recognise health information needs, identify likely information sources and use them to retrieve relevant information, assess the quality of the information and its applicability to a specific situation and analyse, understand and use the information to make good health decisions.

The importance of information literacy has been recognised by many including researchers, practitioners and professional groups. As a result, these admirers of the concept have adopted, adapted and implemented the concept of information literacy to produce information literates in their various fields of endeavour. For instance, the information competency standards for nursing is a set of standards that is developed with the sole aim to making the nursing practitioner information literate ("Information Literacy Competency Standards for Nursing," 2014). As nursing practitioners adhere to this standard, they prepare themselves to be competent in information literacy including an understanding of the architecture of information and the scholarly process; the ability to navigate among a variety of print and electronic tools to effectively access, search, and critically evaluate appropriate resources; synthesize accumulated information into an existing body of knowledge; communicate research results clearly and effectively; and appreciate the social issues and ethical concerns related to the provision, dissemination, and sharing of information (Jacobs et al., 2003). The study employed the descriptive research strategy to explore and describe the experience of information literacy among professional nurses in the Ho Municipality of Ghana.

Statement of the problem

Most nurses, in their efforts to implement EBP have encountered various challenges. Among these challenges is their low information literacy competency. Studies on the information literacy competence of nurses have uncovered that most nurses always assess themselves as information literates, but the conclusions of such studies have always shown that there is much to be done (Majid et al., 2011; Shorten et al., 2001). Again, those who show signs of information literacy competencies are also confronted with challenges like enormous amount of health care literature, published in a variety of sources, which makes it almost impossible for individual practitioners to keep up to date (Majid et al., 2011). This is particularly true as Alper et al. (2004) postulate that about 8,000 articles relevant to family practice alone is published monthly, and a family medicine practitioner would need to dedicate approximately 20 hours a day to stay abreast of new evidence. Again, Dalton (2013) states that health care sector faces unique and pervasive challenges, including the working environment, time constraints and the increasing growth in research output within the discipline. While over 12,000 new articles are added to MEDLINE per week (Glasziou, 2008), Sackett and Strauss (1998) estimate that information resources must be accessible within 25.4 seconds for bedside consultations in order to be of any practical use. This is a great challenge as practitioners' quest for best evidence will eventually require them to spend much time on an ancillary rather than their core duties. Other researchers have reported on lack of time and resources, difficulty in understanding statistical analysis; challenge in understanding and interpreting research findings; inadequate access to information technology, limited IT skills and lack of information searching skills (Dalton, 2013; O'Connor and Pettigrew, 2009; Nail-Chiwetalu and Ratner, 2006; McKenna et al., 2004; Griffiths et al., 2001; Young and Ward, 2001) as other revealing challenges to information literacy in EBP.

Various studies that have been undertaken to assess nurses' perception on EBP have revealed that majority of nurses view EBP as positive and that it leads to better patient care (Upton and Upton, 2006) even though Pravikoff et al. (2005) assert that the pace of acceptance is slow. The gradual acceptance and continuous use of the practice requires that nursing practitioners gain an underlying understanding of how information is organized and accessed. Hence, competency in information literacy is an essential, although often neglected, foundation for evidence-based practice (Shorten et al., 2001). This is because the information literate nurse has...

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