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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
