Principles of nursing evidence-based information seeking

Kristen L. Young, MLIS, AHIPGeorgia Health Sciences University

Tuesday October 2, 2012

“Principles of nursing evidence-based information seeking: collaborating and teaching with students, graduate researchers, and faculty”

Nursing Information Specialist PartnershipsProgram developmentOpen communicationCollaborationIdentifying and exceeding needsAwareness of servicesConsultations amd committeesInstruction and research education

Know your Institution/FacultyReference Interview

Teach back MethodTeachable Moment Office Hours MeetingsLunch and LearnsEnhancing Quality Through Information Literacy Orientations Marketing CommitteePhysical Presence in the Department

Meet demands Traits: organization, foresight, follow up,

initiativeSWOT analysis of populations/programs servedAlways be thinking

Information literacy Evidence based practice What can I offer that is new, more effective, or

exhaustive?Though what medium and how? Evaluation Education

Populations – challenges Pervious experiences Information seeking behaviorsDifficulty levelTime allotted Starting points

Challenges within information literacyWhere do you go to search for information?Database selectionWhat type of information is this? How do I cite this source?When do I have enough information?Understanding database structure and

terminologykeywords vs. subject headingsBoolean operators

Comfort level – using the databases

What is the point?

“Developing information literacy skills involves being

aware of the nursing literature and acquiring the skills to

locate and retrieve it. Studies have shown that positive

changes in a nurse’s information literacy skills, and

confidence in those skills have a direct impact on nurses’

appreciation and application of research. These skills are

vital for effective lifelong learning and are a prerequisite

to evidence based practice” – Johns Hopkins Nursing evidence-based practice

model and guidelines

Information seeking process LibGuide/Information SpecialistAsk a specific clinical questionCreate a search strategy

Selecting search termsBoolean operators

Levels of evidence Where? Documenting Evaluate the evidence

LibGuide/Information Specialist

Question or problem statement “It is flu season. A teacher stops you in the

hall to ask you a question about his 10-year-

old daughter, who has a cold. He has heard

that Zinc lozenges can help to relieve cold

symptoms and is wondering if they really do

work and whether it is ok to give them to

children.”

Classification of questions

PICOP

Patient

How would I describe

patients like mine?

Children with colds

IIntervention

What intervention

or treatment` am I

considering?

Zinc lozenges

CComparison

What is the main

alternative to compare to

the intervention?

Other treatment/

no treatment

OOutcome

What is the

desired outcome?

Relief of symptoms

Creating a search strategy List main topics and alternate terms from

PICOInitial: Zinc, child, cold Related: lozenges, zinc acetate, zinc gluconate

Common cold, rhinovirus, children, youth

Inclusion criteria Gender, age, year of publication, language

Selecting your search terms Wound

Carexxxxxx xxxxxxx wound xxxxxxxxxxxxxxxxxxxxxxxxxxxxxx care xx xxxxx xxxxxxxxxxxxxxxxx xxx xxxxxx wound xxxxxxxxxx xxxxxxxxxxx xxxxxxxxxxx xx wound care xxxxxxxx xxxxxxxxxxxxxxxxxxxxxxxxxx care for wounds xxx xxx xxxxxxxxxxxxxx xxxx

xxxxxxx serious burn xx xxxx injuries xxx xxxxxxx xxxxxx xxx xxx dressings xx open sores xxxxxx xxx xxx bandaging xxxxxxx x xxxxxxxx xxxxxx xxx xxx x treatment of wounds x

MeSH: Wound HealingWounds and InjuriesHoney

Keyword = MY words, wherever they appear

Subject = DATABASE’s words, must have tag

Subject = consistent; covers many variations

Selecting your terms

Wound*

Wound

Wounds

Wounded

Wounding

Connector WordsConnect words with AND…

Connect words with OR…

…to find articles that include both words

…to find articles that include either or both of the words

Back Pain

Acupuncture

acupuncture AND

back pain

Hypertension OR high blood pressure

Hypertension

High blood pressure

Levels of EvidenceLevel 1 - Systematic review & meta-analysis of

randomized controlled trials; clinical guidelines based on systematic reviews or meta-analyses

Level 2 – Single randomized controlled trialsLevel 3 - Controlled trial (no randomization)Level 4 - Case-control or cohort studyLevel 5 - Systematic review of descriptive & qualitative

studiesLevel 6 - Single descriptive or qualitative studyLevel 7 – Opinions of authorities and/or reports of expert

committees

Source: Melnyk, B.M. & Fineout-Overholt, E. (2011). Evidence-Based Practice in Nursing and Healthcare:

A Guide to Best Practice (2nd Ed.). Philadelphia: Lippincott, Williams & Wilkins.

Levels of evidence

Library Research DatabasesCINAHL

• Cumulative Index to Nursing and Allied Health

• Includes journal articles and many other types of publications about nursing and allied health

• Contains subject headings specific to nursing

• Covers literature from 1982-present

Medline

• The largest database available for searching in medicine, nursing and other health fields.

• Uses Medical Subject Headings (MeSH).

• Covers literature 1950-present.

EBM Reviews

• Important resource for finding systematic reviews

• Contains four databases, including the Cochran Systematic Reviews

• Searches by keyword, not subject heading

• Includes the full text of reviews

Documenting the search Where and when did you search? What terms did you use?How many articles did you locate?Of those articles, how many did you look

through and find relevant?

Evaluate Quality of each study Could draw conclusions about overall body of

evidenceGaps in the evidenceCritiques usually focus on methodologic

aspectsDid it reflect truth?Biases and flaws undermine?

Identification of important themes

Information Management Saving search strategies and resultsAuto alertsRSS FeedsEvaluating web resources

Texts Newhouse, R. P. (2007). Johns Hopkins nursing evidence-based practice

model and guidelines. Indianapolis: Sigma Theta Tau International Honor Society of Nursing.

Polit, D. F., & Beck, C. T. (2010). Essentials of nursing research: Appraising evidence for nursing practice. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.

Nordenstrom, Jorgen. (2008). Evidence-Based Medicine In Sherlock Holmes' Footsteps. Blackwell Pub.

Straus, S. E. (2005). Evidence-based medicine: How to practice and teach EBM. Edinburgh: Elsevier/Churchill Livingstone.

THANK YOU!