Doctors, nurses, and other members of the patient care team are faced with problems on a daily basis. Some of these problems are easier to solve than others. Some of these require more research to better understand and solve the problem. Clinical guidelines require research to find the highest quality of evidence with the most current, relevant data to determine the appropriate standard of care. Medical librarians are experts at providing that type of research.
In today’s post on a librarian’s impact in hospitals and patients, I would like to present the research done by a librarian at the Oncology Nursing Society who researched and co-authored a clinical practice guideline and a systematic review and meta-analysis.
ONS Guidelines™ for Opioid-Induced and Non-Opioid-Related Cancer Constipation.Rogers B, Ginex PK, Anbari A, Hanson BJ, LeFebvre KB, Lopez R, Thorpe DM, Wolles B, Moriarty KA, Maloney C, Vrabel M, Morgan RL.Oncol Nurs Forum. 2020 Nov 1;47(6):671-691. doi: 10.1188/20.ONF.671-691.PMID: 33063786
Management of Opioid-Induced and Non-Opioid-Related Constipation in Patients With Cancer: Systematic Review and Meta-Analysis.Ginex PK, Hanson BJ, LeFebvre KB, Lin Y, Moriarty KA, Maloney C, Vrabel M, Morgan RL.Oncol Nurs Forum. 2020 Nov 1;47(6):E211-E224. doi: 10.1188/20.ONF.E211-E224.PMID: 33063777
The guidelines included 13 recommendations for the management of opioid-induced and non-opioid-related constipation in patients with cancer. The guidelines were then implemented and their impact was evaluated and published. Translating Evidence to Practice: A Multisite Collaboration to Implement Guidelines and Improve Constipation Management in Patients With Cancer.Ginex PK, Arnal C, Ellis D, Guinigundo A, Liming K, Wade B.Clin J Oncol Nurs. 2021 Dec 1;25(6):721-724. doi: 10.1188/21.CJON.721-724.PMID: 34800103
According to Ginex et al. “Despite the prevalence of OIC (opioid-induced constipation), there is a paucity of research on management strategies.” The clinical practice guideline (PMID: 33063777) was implemented with nurse champions who identified practice gaps and improved the management of constipation among patients with cancer patients who were prescribed opiates. The authors noted that making local practice changes across multiple sites to reflect the national guidelines was not only “feasible but cost-effective.”
As noted in these articles, there were many people who helped research the problem, create the guidelines, and implement them across multiple locations. The librarian was part of the health care team that lead to improving patient care in a cost-effective way. As I mentioned the authors said there was a “paucity of research,” which is academic speak for there was not a lot of information on this topic and what was found, was hard to find. Thankfully they had a medical librarian on their team to find that hard to find research to help them.
Just as hospitals have experts who directly care for patients, it is also important for them to have librarians as experts to do the research and support the patient care teams. I can sew on a button, but you wouldn’t want me to close. You want a doctor who does that all the time. A doctor can find a good article, but if you want to find the evidence to impact patient care, you get a expert who spends everyday searching for evidence…a librarian.
Who knows it might just lead to improved patient care in a cost effective way.