REVIEWS / CRITIQUES

Nursing-Sensitive Outcomes: State of the Science
Christina Wallace
16

Design Wise: A Guide for Evaluating the Interface
Design of Information Resources
Vicky Duncan
17
# Nursing-Sensitive Outcomes: State of the Science.

Edited by Diane M. Doran. Toronto: Jones and Bartlett, 2003.

ISBN 0763722871. 363 pages (softcover). US$44.95.

This text is divided into nine chapters based on type of outcome indicator. The book includes a list of tables and an index. Most chapters are structured similarly in that they provide an introduction to the topic, theoretical background, conceptual definitions, evidence, and recommendations for future research.

Since accountability is important in the health care field, outcomes have become an essential measurement tool as well as being evidence for the effectiveness and value of certain treatments. Measuring the effect nurses and nursing care have on patient outcomes is a way of proving positive contribution to the health care system and demonstrating quality of patient care. Examining patient outcomes is also a way of monitoring and improving patient care. Generally, nurse researchers and clinical practice managers have created and implemented outcomes measurement. However, this text is not written solely for the experienced researcher. Each chapter takes on a mentoring tone, guiding nurses of all levels, including nursing students, through the steps of researching and designing outcome measures. By breaking down the process, each chapter provides a model of how to create outcomes. Few nurses are familiar with the systematic collection, analysis and presentation of patient data required for outcomes research. This text acts not only as an outcomes resource but also as a practical guide to outcomes, benefiting both those nurses providing direct patient care and those managing and assessing nurses on the front lines.

The text is written by seven Canadian contributors, who are all R.N.'s and mostly Ph.D.'s. These nurses are mostly faculty from the University of Toronto and the University of Western Ontario. The text is well written, with extensive coverage of the literature in the field. Instruments and tools are presented in an easy-to-use chart format, which could easily operate as a quick-reference tool. While the measurement tools covered are limited mostly to the measurement of patient satisfaction, nurses' satisfaction, self-care, pain, and a few other symptoms, the coverage for each topic is thorough. While the editor describes the text as being useful to

students, researchers, policy-makers, decision-makers, and practicing nurses, librarians may find this text useful as well. As a librarian in a medical setting, I am often mystified about measurement tools. While I can locate the tools, I am unsure about their usage and how to relate them to nursing practice. The demand for outcomes measurement seems to be increasing along with the popularity of evidence-based medicine resources. I would recommend this book to librarians who wish to understand the research process in providing evidence-based nursing outcomes as well as understand the general applicability of such outcomes. For librarians, the most useful sections of each chapter might be the conceptual definitions and the tables conveniently collating studies and measurement tools. Each chapter builds a conceptual definition out of analysis of the outcome concept and defining characteristics of the outcomes measurements.

While many excellent outcomes measurement books are on the market, this one distinguishes itself in its academic and didactic nature, and also in its Canadian origin. The main shortcoming of the text is that none of the authors is a practising nurse, and, therefore, the authors cannot provide direct perspective on the practical application of the measurement tools in a hospital or health care setting. Admittedly, the book attempts to provide “a critical review and analysis of the literature on outcomes considered to be the indicators of nursing care effectiveness” (Preface, p. viii), which means this text is not truly a practical tool for outcomes measurement and use. While it does not entirely succeed as an empirical tool, *Nursing-Sensitive Outcomes: State of the Science* is an essential resource for understanding the theoretical structure and function of outcomes measurement.

**Christina Wallace**

*Health Sciences Library*
*Windsor Regional Hospital*
*1995 Lens Avenue*
*Windsor, ON N8W 1L9*
*E-mail: cwallace@wrh.on.ca*
# Design Wise: A Guide for Evaluating the Interface Design of Information Resources. Alison J. Head.
Medford, N.J.: CyberAge Books, 1999. ISBN 0910965315.
196 pages. US$29.95.

Alison J. Head's goal in *Design Wise: A Guide for Evaluating the Interface Design of Information Resources* is to assist us in making better choices when selecting or purchasing an information resource. Her premise is that "if we understand the principles of interface design, we can more knowledgeably evaluate an information resource" and not focus solely on the product's price or availability. Well qualified to pen such a book, Head has a Ph.D. in Library and Information Sciences from the University of California at Berkeley, and was a Visiting Scholar at Stanford University, where she studied Human-Computer Interaction (HCI). Head is also an information management consultant and has conducted usability tests for companies such as Hewlett-Packard.

The book is divided into two parts. The first part provides the basics of interface design and resource evaluation techniques. The principles of HCI, a process that looks both at the "human side of interaction" as well as the "machine side" (when humans use computers to complete a task) provide the foundation to the discussion. The HCI process stresses the importance of involving the user at the *beginning* of the design process and of ensuring that users will be successful in completing the tasks the system was designed to accomplish.

The third chapter entitled "Deconstructing Evaluation" provides a template for evaluators to use when considering an information resource purchase. Head outlines three "cruel design basics that form a framework for understanding design and user interaction of interfaces".

1. Task support: "The interface should meet user expectations and support the tasks users need to get done"

2. Usability: "The interface should be easy to learn, easy to remember, pleasant to use, and cause few errors"

3. Aesthetics: "The interface should communicate visually, helping users absorb information and carry out the tasks they need to do while minimizing information overload"

These principles, along with the specific questions that arise from them, will prove to be the most useful feature of this book. Although many of us intuitively address some of the questions posed here, such as "What is the tool for?" and "Is this tool a good fit for users' levels of expertise and the job at hand?", probably very few of us use such a thorough and thoughtful mental template to evaluate new information resources. It was probably possible in the past, however, to

focus just on price, availability, and content, but that is no longer the case. We have many more choices now — witness the many different *flavours* of CINAHL offered through OVID, WebSPIRS, Ebsco and ProQuest, etc. Head encourages us to take a closer look at the *design* of the system and offers us a template to work from. I believe this template will enable us to make smarter choices when selecting online information resources.

The second part of the book takes these principles and applies them to the analyses of CD-ROMs, Web sites, and online commercial databases. Although parts of the discussion seem slightly dated (it was first published in 1999), Head's message is certainly still relevant. What stood out for me in this section was Head's description of the migration from online databases primarily designed for information professionals to Web sites designed primarily for the end user. Back in the days of command searching, searchers invested time in training and memorizing commands, but the payoff was a flexible, highly responsive user-driven system. Today's Web-based databases rely on graphical user interfaces (GUI) that are easier for end users to learn, but perhaps do not offer the responsiveness and flexibility of a command system. As selectors of information resources, we should look for systems that allow for *both* kinds of searching: command searching for information professionals and GUIs for the end user. Products that allow this flexibility will appeal to both groups of users.

This book provides plenty of food for thought. It is well written and includes thoughtfully selected suggestions for further reading, interviews with industry leaders, and practical examples from a variety of sites, which provide depth and authenticity. A thorough discussion of designing for users with special needs reminds us that the needs of *all* potential users should be taken into account. I recommend this book for any librarian responsible for the selection and evaluation of online information resources.

Vicky Duncan

*Information Services Librarian*
*Health Sciences Library*
*University of Saskatchewan*
*107 Wiggins Road*
*Saskatoon, SK S7N 5E5*
E-mail: Vicky.Duncan@usask.ca