Overview
Located in Toronto, Mount Sinai Hospital is an internationally recognized, 442-bed acute care academic health sciences center and is affiliated with the University of Toronto. The hospital is part of the Sinai Health System that also includes a rehabilitation and complex care site and employs over 1,400 nurses. In 2015, Mount Sinai became the first hospital in Canada to achieve Magnet® recognition for its nursing excellence. Currently, the hospital is using Nursing Reference Center™ Plus as a source of evidence to support evidence-informed practice and its re-designation.
Nursing Reference Center Plus is an evidence-based point-of-care resource designed specifically for nursing, health disciplines and leaners that provides quick and easy access to the most current information on diseases, medications, best practices and more. This information supports patient care and patient education, as well as the development of hospital policies and procedures. In addition, the tool’s continuing education modules offer nurses a convenient way to complete required contact hours.
Challenges
William Mundle, RN MN CMSN(C), Manager of Quality and Performance, has been with Mount Sinai Hospital for 12 years. In 2018, after the Chief Nursing Executive paid a visit to the Neonatal ICU, it was discovered that frontline nurses were struggling with a lack of readily available point-of-care resources. While the nurses had access to a wealth of research materials through the health system’s library, none offered the quick and reliable answers to clinical questions that nurses needed at the patient’s bedside.
“We've got a large health sciences library in the organization, but if you're working a 12-hour shift, the likelihood of your being able to take time out to pull up some of the articles, review them and identify the information that you need is probably not that feasible,” William said, adding that nurses were interested in having a point-of-care tool with validated and up-to-date materials that they could search when needed.
To make the case for bringing an evidence-based information e-resource to the hospital, members of the leadership team were able to show how a tool of this nature could improve clinical decision-making, ultimately leading to quality improvement at all levels of the organization. With quality of care at the heart of Magnet, this tool would support the hospital’s journey to re-designation as well as advance care.
At the request of leadership, Library Services completed an analysis of available point-of-care products on the market and selected three for trial. During the trial period, a group of frontline nurses and other health disciplines were assembled to use and evaluate the solutions, noting what worked well, what they found beneficial, and any challenges they encountered.
Solutions
In late 2018, after evaluating Nursing Reference Center Plus and two other clinical decision support tools, the decision was made to subscribe to Nursing Reference Center Plus, citing its ease of use and high-quality evidence-based content as deciding factors.
Implementing the tool was simple. Since Nursing Reference Center Plus integrates with Cerner, Mount Sinai’s Electronic Health Record system, nurses can access point-of-care information directly from the patient record. They can also access the tool through the library portal and download the Nursing Reference Center Plus mobile app for on-the-go use.
The product was officially launched during “Pair & Share,” an annual interactive drop-in event that showcases exemplary inter-professional teamwork and collaboration.
“We thought it would be a good opportunity for us to be able to highlight the fact that there was a strong collaboration between health disciplines, nursing, the library and the senior leadership team to bring this tool into the organization,” William said, adding that the library distributed promotional materials to encourage adoption and gave nurses some hands-on time to learn the tool.
After the initial rollout, EBSCO hosted several drop-in training events over several days. Each 15- to 20-minute session reinforced the value of Nursing Reference Center Plus, giving staff members the opportunity to ask questions and familiarize themselves with the tool’s content.
You know that the information is accurate and current [...] The fact that it is comprehensive enough that you can really apply the content to any area in the organization is another added plus.
— William Mundle, RN MN CMSN(C), Manager of Quality and Performance
Mount Sinai Hospital, Toronto
Benefits & Results
Usage statistics show that Nursing Reference Center Plus experienced nearly 5,500 searches within its first year. William cited the automated updates and user-friendly interface as key success factors.
“You know that the information is accurate and current,” William said, adding that the tool is easy to use because it’s so well-organized. “You can search for all of the information that's in the tool or you can search based on skills, videos, care plans, etc. The fact that it is comprehensive enough that you can really apply the content to any area in the organization is another added plus.”
Since Magnet® recognition depends on a hospital’s commitment to new knowledge, innovation, evidence-based nursing practice and improved patient outcomes, William expects the implementation of Nursing Reference Center Plus will support Mount Sinai in achieving Magnet® re-designation.
“We were able to use Nursing Refence Center Plus as one of our examples to demonstrate how we've met the requirements around evidence-based practice and supporting knowledge translation in the organization,” William said.