Yuma, APRN Guide to Library Resources: Point of Care

• Access Medicine Quick Reference Tools

• MedCalc (In STAT!Ref)

• UpToDate Calculators This link opens in a new window

  Calculator tool on UpToDate to help practitioners determine patient ailments.

What are Point-of-Care Tools?

Time-saving resources are valuable in the clinical environment. Point-of-care tools offer synthesized information/evidence evaluated by experts that often includes rating scales or graded recommendations. Point-of-care tools are generally easier to use than large databases (such as MEDLINE) and produce results in the form of systematic reviews, meta-analyses, guidelines, and critically appraised topics. These examples, known as secondary literature sources, summarize information and assist clinicians in making decisions. Point-of-care databases usually provide immediate access to full text.

Resource Types: Systems, Synopses, Syntheses, Studies 

Resources categorized at the top of this hierarchy are most efficient to use at the point-of-care. Library resources containing authoritative, evidence-based information at the top of this hierarchy ("Systems") include 1) ACP Smart Medicine (in STAT!Ref - there is a mobile version available), 2) UpToDate, and 3) Clinical Evidence. Other point-of-care resources on this page that contain synthesized information, yet are not quite as efficient as those previously mentioned, include systematic reviews (such as those in the Cochrane Library) and clinical practice guidelines, which are available from several sources. Full details of the 4-S Hierarchy of Evidence developed by R. Brian Haynes are available at: http://ebm.bmjournals.com/cgi/content/full/6/2/36

MEDLINE, the premier source of primary literature and studies in medicine, contains over 19 million references, which can make it challenging to search. The full process of searching, synthesizing, and evaluating original research reports is time-intensive. Point-of-care tools, in contrast, synthesize the best available evidence from multiple studies and resources for busy clinicians. Critical appraisal and consideration of the individual patient scenario by the clinician, of course, always remains necessary. Point-of-care tools are meant to save time in a clinical environment, but it is important to maintain proficiency with the larger databases, especially Medline, to stay up-to-date with the latest information, to identify targeted primary studies, and to research topics that are not found in point-of-care systems.

Mobile Applications can also be very helpful at the point-of-care; however, use caution since nearly anyone can develop an app! You must carefully evaluate the information & source. 

Library Point of Care Database

• UpToDate This link opens in a new window

  Physician-authored clinical decision support resource used by clinicians to make point-of-care decisions. (In support of healthcare education in Arizona, Blue Cross Blue Shield of Arizona has sponsored this for your use.)

Clinical Practice Guidelines - Websites

• ACP (American College of Physicians) Clinical Recommendations

• AHRQ Electronic Preventive Services Selector

• American Academy of Pediatrics

• American College of Cardiology

• CMA Infobase Clinical Practice Guidelines Database

• Institute for Clinical Systems Improvement

• NICE Published Clinical Guidelines (Alpha)

Web Links - Free Point of Care Tools

• AFP by Topic

• AFP Point-of-Care Guides

• AHRQ Electronic Preventive Services Selector

• American Family Physician Immunizations (excluding influenza)

• APEA Mobile

• BCM Age-based Pediatric Blood Pressure Reference Charts

• Centers for Disease Control & Prevention

• NIH National Center for Complementary & Alternative Medicine- Search

          Search A-Z health topics from the National Center for Complementary and Alternative Medicine (NCCAM)

• National Guideline Clearinghouse

  • PEPID