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Searching for the Evidence

Andrea Ball MLS, MSIMFrances Chu MLIS, MSN

PollEverywhere Instructions

When the poll is open, – Go to PollEv.com/chuf in a browser in your phone and

select a response.

OR

– Text 22333 and in body of text, enter CHUF, and then your selection.

Objectives

Formulate a research question using PICO(T)

Employ PICO(T) to develop a search strategy

Describe how to perform a focused literature search to support an Evidence-Based Practice (EBP) initiative

Formulating Your Question

Background vs. Foreground Questions

Background:

Questions asked to fill a knowledge gap

What is…?

What do I do in this situation?

Foreground:Questions asked in order to make clinical decisions• Will X or Y

produce a better outcome?

• What is the impact of doing X compared to Y?

PICO(T)

> Use the PICO(T) formula to break a case into it’s most basic informational components to create a clinical question

– Patient or Population group with the condition

– Intervention

– Comparison (optional)

– Outcome

– Time (optional)

Example

> With the increased focus on fall prevention in hospitals, many hospitals have implemented technologies to prevent falls. One technology is the Bed Alarms. How effective are Bed Alarms in preventing falls?

Example

> PICO(T)

– P: Inpatient hospitals

– I: Bed alarms

– C: None or standard of care

– O: Decrease frequency of falls

> Clinical Question

– In hospitals, do bed alarms decrease the frequency of falls?

What are the questions?

> You are taking care of a 73 y.o. woman admitted to the ICU s/p Aortic Valve Replacement (AVR) and Septal Myomectomy. Upon admitting to the ICU, she develops delirium. You wonder how do you assess for delirium? In managing delirium, you hear about early ambulation and that it can prevent delirium in the ICU. For future patients, you wonder how effective is early mobilization for preventing ICU delirium?

Your turn

> Think about a problem you have and that you need evidence for or against a solution.

> Turn to your neighbor and try to create a PICO(T) and clinical question.

Searching for the Evidence

Selection of Databases

Think about: Specialization / Subject matter Access Indexing

Examples of Databases

UW Affiliate LicensedNurse in WA

Everyone

PubMed X X X

CINAHL X X (Check with your institution)

DynaMed X X (Check with your institution)

Databases in HEAL-WA

X

Best Practices for Searching

Broad search

Alternate terms

Boolean and filters

Multiple resources

All of this depends on your question

Boolean Operator - AND

Boolean Operator - OR

Truncation

Used with keyword searching

Used to find plurals

Careful with too short a root Child* - search results are limited for the first 600

variations

Almost always an *

When do I use…

Keywords?

Quick search

New terminology

Acronyms

Truncation

Combine with controlled vocabulary

Controlled Vocabulary? Deeper search Established content Acronyms Combine with

keywords More control (Major

topics / subheadings)

Using PICO(T) to Search

> PICO(T)

– P: ICU patients s/p surgery

– I: early mobilization

– C: None or standard of care

– O: Prevention of delirium

> Clinical Question

– In ICU patients s/p surgery, does early mobilization prevent the development of delirium?

Keywords

ICU early mobilization delirium (49)

ICU early ambulation delirium (21)

ICU early (mobilization OR ambulation) delirium (56)

ICU early (mobilization OR ambulation) delirium prevention (24)

Controlled Vocabulary [MeSH]

ICU > Intensive Care Units[Mesh]

Early mobilization > Early Ambulation[Mesh]

Delirium > Delirium[Mesh]

ICU early ambulation delirium (keywords) > 21

Intensive Care Units AND Early Ambulation ANDDelirium (Mesh) > 10

Limits

> Help define patient/population– Age, gender, human

> Publication type– Review, clinical trial, systematic review

Use to focus / narrow / fine-tune your search

What if my results are too…

Broad?

Check your clinical question

Add limits

Add another term

Ask a librarian

Narrow? Check your

clinical question Remove limits Remove a term Ask a librarian

Demo time! DynaMed Plus via HEALWA

CINAHL Complete via HEAL-WA

Demo time! PubMed.Gov

Now you can…

Formulate a research question using PICO(T)

Employ PICO(T) to develop a search strategy

Describe how to perform a focused literature search to support an EBP initiative

Questions?Thank you!

Contact: heal-wa@heal-wa.org