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Janet G Schnall, MS, AHIPJanet G Schnall, MS, AHIP Library Liaison to the UW School of NursingLibrary Liaison to the UW School of NursingHealth Sciences LibrariesHealth Sciences LibrariesAffiliate Instructor, UW School of NursingAffiliate Instructor, UW School of NursingUniversity of Washington, Seattle, WA University of Washington, Seattle, WA [email protected]@uw.edu
Teaching Evidence-Based Teaching Evidence-Based Practice Resources to Nurses Practice Resources to Nurses and Nursing Studentsand Nursing Students
ObjectivesObjectives
Describe how to teach web resources to Describe how to teach web resources to nurses and nursing students to use for nurses and nursing students to use for evidence-based nursing practiceevidence-based nursing practice
Highlight importance of EBNP to improve Highlight importance of EBNP to improve patient carepatient care
Identify evidence-based nursing resources on Identify evidence-based nursing resources on the web the web
Describe strategies to find evidence on the Describe strategies to find evidence on the web for EBNPweb for EBNP
What is evidence-based practice?What is evidence-based practice?
Evidence based medicine is the Evidence based medicine is the conscientious, explicit, conscientious, explicit, and judicious use of current best evidence in making and judicious use of current best evidence in making decisionsdecisions about the care of individual patients. about the care of individual patients.
The practice of evidence based medicine means The practice of evidence based medicine means integrating individual clinical expertise with the best integrating individual clinical expertise with the best available external clinical evidenceavailable external clinical evidence from systematic from systematic research. research.
Sackett DL et al. Evidence based medicine: what it is and what it isn't. Sackett DL et al. Evidence based medicine: what it is and what it isn't. BMJ BMJ 1996 Jan 13; 312 (7023): 71-2. 1996 Jan 13; 312 (7023): 71-2.
Evidence-Based PracticeEvidence-Based Practice
What is evidence-based nursing What is evidence-based nursing practice?practice?
"Evidence-based nursing (EBN) means using the best "Evidence-based nursing (EBN) means using the best available evidence from research, along with patient available evidence from research, along with patient preferences and clinical experience, when making preferences and clinical experience, when making nursing decisions."nursing decisions."
Cullum N. Users' guides to the nursing literature: an introduction. Cullum N. Users' guides to the nursing literature: an introduction. Evid Based Nurs Evid Based Nurs 2000 Jul;3(3):71-2. doi:10.1136/ebn.3.3.71 2000 Jul;3(3):71-2. doi:10.1136/ebn.3.3.71
Why do nurses need to do EBP?Why do nurses need to do EBP?
Results in better patient outcomesResults in better patient outcomes Failure to use evidence results in lower quality, Failure to use evidence results in lower quality,
less effective, more expensive care less effective, more expensive care Berwick DMBerwick DM. . Disseminating innovations in health care. Disseminating innovations in health care. JAMAJAMA
2003 Apr 16;289(15):1969-752003 Apr 16;289(15):1969-75
Keeps practice current and relevantKeeps practice current and relevant Increases confidence in decision makingIncreases confidence in decision making Experience greater autonomy in practiceExperience greater autonomy in practice Increases level of job satisfactionIncreases level of job satisfaction
Barriers to Nurses using EBPBarriers to Nurses using EBP
Lack of TIMELack of TIME Lack of value of research in practiceLack of value of research in practice Lack of understanding of electronic Lack of understanding of electronic
databases to find evidencedatabases to find evidence Lack of computer skillsLack of computer skills Lack of EBP mentors at point of careLack of EBP mentors at point of care Difficulty understanding research articlesDifficulty understanding research articles
Pravikoff DS, Tanner AB, Pierce ST. Readiness of U.S. nurses for evidence-based practice. Amer J Nurs 2005 Sep;105(9): 40-52.
5 (7) Steps for EBN Practice5 (7) Steps for EBN Practice
1. Convert your information into an answerable question 1. Convert your information into an answerable question ((PICOPICO))
2. 2. Search the literature Search the literature for the best available evidencefor the best available evidence3. 3. Critically appraise Critically appraise the evidence for validity and the evidence for validity and
usefulnessusefulness4. 4. ApplyApply the findings to your clinical practice along with the findings to your clinical practice along with
clinical expertise and patient’s perspective to plan careclinical expertise and patient’s perspective to plan care5.5. Evaluate Evaluate the outcomes of your practice decisions or the outcomes of your practice decisions or
changes based on evidence.changes based on evidence.
2 Additional Steps for EBP=7 Steps2 Additional Steps for EBP=7 Steps
Step 0: Cultivate a spirit of inquiryStep 0: Cultivate a spirit of inquiry
Step 6: Disseminate EBP results Step 6: Disseminate EBP results
Melnyk BM, Fineout-Overholt E, Stillwell SB, Williamson KM. Evidence-Melnyk BM, Fineout-Overholt E, Stillwell SB, Williamson KM. Evidence-based practice: step by step: the seven steps of evidence-based practice. based practice: step by step: the seven steps of evidence-based practice. Am J Nurs Am J Nurs 2010 Jan;110(1):51-3. PMID: 20032669.2010 Jan;110(1):51-3. PMID: 20032669.
What makes good evidence?What makes good evidence?
Based on scientific Based on scientific researchresearch
RCTRCT Systematic reviewSystematic review Meta-analysisMeta-analysis Clinical guidelinesClinical guidelines
OpinionOpinion ConsensusConsensus Because it’s been Because it’s been
done this way for 100 done this way for 100 yearsyears
GoodGood ShoddyShoddy
See’s Chocolates
Slide adapted from Edward G. Miner Library, University of Rochester School of Medicine and Dentistry
Chocolate Decadence Pyramid
Lots of Evidence Pyramids!Lots of Evidence Pyramids!
Searching for Evidence Pyramid: BasicSearching for Evidence Pyramid: BasicMetaSearch Engines ex. TRIP
ex. Cochrane
ex. DynaMed, Nursing Reference Center, NGC
ex. MEDLINE/PubMed, CINAHL
ex.Textbooks, UptoDate
Systematic Reviews, Meta-
Analyses
Evidence Summaries, Evidence Guidelines
Randomized Controlled Trials (RCTs), Cohort Studies, Qualitative Studies
Background Information, Expert Opinion
Searching for Evidence Pyramid: Searching for Evidence Pyramid: DetailedDetailed
healthlinks.washington.edu/ebp/ebptools.html Modified from University of Virginia Health Sciences Library
5S and 6S Pyramids5S and 6S Pyramids
5S Model
Read about 5S and 6S ModelsRead about 5S and 6S Models
The 5S Model The 5S Model Haynes B. Of studies, syntheses, Haynes B. Of studies, syntheses, synopses, summaries, and systems: The "5S" evolution synopses, summaries, and systems: The "5S" evolution of information services for evidence-based healthcare of information services for evidence-based healthcare decisions. decisions. ACP J ClubACP J Club 2006 Nov-Dec;145(3):A8. 2006 Nov-Dec;145(3):A8.
The 6S Model The 6S Model DiCenso A, Bayley L, Haynes RB. DiCenso A, Bayley L, Haynes RB. Accessing pre-appraised evidence:fine-tuning the 5S Accessing pre-appraised evidence:fine-tuning the 5S model into a 6S model. model into a 6S model. Evid Based NursEvid Based Nurs 2009 2009 Oct;12(4):99-101. doi:10.1136/ebn.12.4.99-b Oct;12(4):99-101. doi:10.1136/ebn.12.4.99-b
HealthLinks: DNP ToolkitHealthLinks: DNP Toolkit healthlinks.washington.edu.offcampus.lib.washington.edu/nurse/dnhealthlinks.washington.edu.offcampus.lib.washington.edu/nurse/dn
pp
HealthLinks:HealthLinks: Basic Introduction to Basic Introduction to Evidence-Based Practice ResourcesEvidence-Based Practice Resources
healthlinks.washington.edu/hsl/classes/evidencehealthlinks.washington.edu/hsl/classes/evidence
Create your own Evidence Pyramid Create your own Evidence Pyramid
www.ebmpyramid.org/home.phpwww.ebmpyramid.org/home.php
EBM Page GeneratorEBM Page Generator
EBN Resources Flow ChartEBN Resources Flow Chart
Kendall S. Evidence-based resources simplified. Kendall S. Evidence-based resources simplified. Can Fam PhysicianCan Fam Physician 2008 Feb; 54(2):241-3. 2008 Feb; 54(2):241-3.
Search for the Best Evidence Search for the Best Evidence to answer the Questionto answer the Question
Search Databases Efficiently for Search Databases Efficiently for
Research Journal Articles Research Journal Articles MEDLINEMEDLINE
or PubMedor PubMed pubmed.gov pubmed.gov
CINAHL/CINAHL PlusCINAHL/CINAHL Plus
CINAHL or [CINAHL Plus] CINAHL or [CINAHL Plus] cinahl.comcinahl.com
Cumulative Index to Nursing and Allied Cumulative Index to Nursing and Allied Health LiteratureHealth Literature
Provides coverage from 1982 Provides coverage from 1982 [1937][1937] to to date, of nursing and 17 allied health date, of nursing and 17 allied health disciplines literaturedisciplines literature
1700+ 1700+ [3800+][3800+] journals indexed including journals indexed including virtually all English-language nursing virtually all English-language nursing journals journals
Can easily search for Can easily search for ResearchResearch articles articles
CINAHL: enter search termsCINAHL: enter search terms
CINAHL Limit Your Results Screen
CINAHL Publication Type LimitsCINAHL Publication Type Limits
Clinical trialClinical trial Critical pathCritical path Practice guidelinesPractice guidelines ResearchResearch StandardsStandards Systematic reviewSystematic review
CINAHL Results
link to full text
Abstracts
Full text article
healthlinks.washington.edu/howto/cinahlplushealthlinks.washington.edu/howto/cinahlplus
Search Search MEDLINE or PubMed MEDLINE or PubMed
PubMed includes MEDLINE (1940’s+)PubMed includes MEDLINE (1940’s+) Indexes 5,000 biomedical journalsIndexes 5,000 biomedical journals Covers all aspects of biosciences and Covers all aspects of biosciences and
healthcarehealthcare 75%-80% of citations have abstracts75%-80% of citations have abstracts Updated 5x/weekUpdated 5x/week
22 MEDLINE/PubMedMEDLINE/PubMed Strategies for Strategies for
Finding Evidence-Based CitationsFinding Evidence-Based Citations
1. Use Limits: Publication Type of Article1. Use Limits: Publication Type of Article Randomized Controlled TrialRandomized Controlled Trial Meta-Analysis Meta-Analysis Practice GuidelinePractice Guideline Clinical TrialClinical Trial Consensus Development ConferenceConsensus Development Conference
2. Use2. Use Clinical Queries sectionClinical Queries section
MEDLINE Search Screen
Randomized controlled trial
Strategy #1: Strategy #1: Limit to RCTs under Publication TypeLimit to RCTs under Publication Type
MEDLINE Results
link to full text
link to full text
Strategy #2: Clinical Queries – Link on Advanced Search or Home page
healthlinks.washington.edu/howto/pubmed
CINAHL vs MEDLINECINAHL vs MEDLINE
CINAHLCINAHL Coverage: 1982+Coverage: 1982+ Indexes 1700 journalsIndexes 1700 journals Focuses on nursing and Focuses on nursing and
allied health literatureallied health literature CINAHL Thesaurus with CINAHL Thesaurus with
more nursing termsmore nursing terms Has peer-reviewed limitHas peer-reviewed limit Includes cited references Includes cited references
at end of many refsat end of many refs
MEDLINEMEDLINE Coverage: late 1940’s+Coverage: late 1940’s+ Indexes 5000 journalsIndexes 5000 journals Focuses on biomedical Focuses on biomedical
literatureliterature Uses MeSH as its Uses MeSH as its
controlled vocabularycontrolled vocabulary No peer-reviewed limitNo peer-reviewed limit No cited referencesNo cited references
Locating E-JournalsLocating E-Journals
Check with Check with your library your library for access to for access to full-text e-journalsfull-text e-journals
Use Use HEAL-WA HEAL-WA for WA State nursesfor WA State nurses Includes CINAHLIncludes CINAHL and MEDLINE full-textand MEDLINE full-text A-Z Journals: 2,600 full-text journalsA-Z Journals: 2,600 full-text journals
UWUW AffiliatesAffiliates: use the Proxy service to : use the Proxy service to access full-text ejournals from off-campusaccess full-text ejournals from off-campus
HEAL-WA HEAL-WA Health Electronic Resource for WashingtonHealth Electronic Resource for Washington
heal-wa.org heal-wa.org Began: January 2009Began: January 2009 Website: offers online access to a collection of Website: offers online access to a collection of
health information resources health information resources Who has access? selected health care Who has access? selected health care
providers in Washington providers in Washington YES, NURSES !YES, NURSES ! Funded by: license fees Funded by: license fees Mission: provide evidence-based information to Mission: provide evidence-based information to
support patient caresupport patient care
What is included in HEAL-WA?What is included in HEAL-WA?
Resources: Resources: electronic databases, online texts, electronic databases, online texts, and e-journalsand e-journals
Includes information resources specific to nurses, Includes information resources specific to nurses, such as such as CINAHL CINAHL andand the the Nursing Reference Nursing Reference CenterCenter
Other excellent resources: Other excellent resources: MEDLINEMEDLINE, , DynaMed, DynaMed, Cochrane, Natural StandardCochrane, Natural Standard
Gives practitioners access to timely, Gives practitioners access to timely, evidence-based answers evidence-based answers to patient care Q’sto patient care Q’s
hheal-wa.org
HEAL-WA Toolkit: Registered Nurse
HEAL-WA Toolkit: ARNP
HEAL-WA Journals A-ZHEAL-WA Journals A-Z2,600 full-text health-related journals2,600 full-text health-related journals
Open Access and Free Journal SitesOpen Access and Free Journal Sites
BioMed Central BioMed Central biomedcentral.combiomedcentral.com Independent publishing house providing immediate free Independent publishing house providing immediate free
access to peer-reviewed biomedical researchaccess to peer-reviewed biomedical research Includes Includes BMC Nursing, BMC Nursing, etc.etc.
PubMed CentralPubMed Central pubmedcentral.govpubmedcentral.gov National Library of Medicine's free digital archive of National Library of Medicine's free digital archive of
biomedical and life sciences journal literaturebiomedical and life sciences journal literature Free Medical Journals Free Medical Journals freemedicaljournals.comfreemedicaljournals.com Highwire Press Highwire Press highwire.stanford.eduhighwire.stanford.edu
Provides full-text to over 1,000 peer-reviewed scientific, Provides full-text to over 1,000 peer-reviewed scientific, medical and social science journals.medical and social science journals.
Search ClinicalSearch ClinicalPractice Guideline ResourcesPractice Guideline Resources
National Guideline ClearinghouseNational Guideline Clearinghouse Nursing Reference CenterNursing Reference Center MEDLINE/PubMedMEDLINE/PubMed CINAHL/CINAHL PlusCINAHL/CINAHL Plus Advanced Google or Google Scholar Advanced Google or Google Scholar
Clinical Practice GuidelinesClinical Practice Guidelines Systematically developed statements of Systematically developed statements of
appropriate care designed to assist the appropriate care designed to assist the practitioner and patient make decisions about practitioner and patient make decisions about appropriate health care for specific clinical appropriate health care for specific clinical circumstancescircumstances
Usually based on the most current available Usually based on the most current available research if from reputable, authoritative research if from reputable, authoritative organizationsorganizations
Developed using widely varying standardsDeveloped using widely varying standards CostCost may be considered as well as may be considered as well as health outcomeshealth outcomes
or or politicspolitics
National Guideline ClearinghouseNational Guideline Clearinghouseguideline.govguideline.gov
Initiative of the Agency for Healthcare Initiative of the Agency for Healthcare Research and Quality (AHRQ)Research and Quality (AHRQ)
Database of clinical practice guidelines Database of clinical practice guidelines and related documentsand related documents
FreeFree Updated weekly Updated weekly Voluntary participationVoluntary participation
Guideline Summary
Searching for Practice Guidelines in:Searching for Practice Guidelines in:
MEDLINE/PubMedMEDLINE/PubMed CINAHLCINAHLLimit to Practice Guidelines under Publication Typeunder Publication Type
Limit to Practice Guideline
In In MEDLINE, under Pub Typeunder Pub Type:
InIn PubMed, under Type of Article:under Type of Article:
Search for Evidence SummariesSearch for Evidence Summaries
DynaMedDynaMed Evidence-based clinical resource providing summaries Evidence-based clinical resource providing summaries
of 3,500+ diseases and conditionsof 3,500+ diseases and conditions Nursing Reference CenterNursing Reference Center
ComprehensiveComprehensive point-of-care resource for nurses, point-of-care resource for nurses, including Evidence-based Care Sheetsincluding Evidence-based Care Sheets
Evidence-Based NursingEvidence-Based Nursing Quarterly journal that assesses clinical relevance of Quarterly journal that assesses clinical relevance of
research studies from international journalsresearch studies from international journals
DynaMed DynaMed
Provides summaries of the best evidence Provides summaries of the best evidence for over 3,500 clinical topicsfor over 3,500 clinical topics
Can quickly browse and find key Can quickly browse and find key recommendationsrecommendations
Updated dailyUpdated daily Monitors content of over 500 journals and Monitors content of over 500 journals and
systematic review databasessystematic review databases Available for PDA and mobile devicesAvailable for PDA and mobile devices
DynaMed: Treatment Overview
Level 1 evidence
DynaMed Treatment,DynaMed Treatment,detaileddetailed
Level 1evidence
Full-text
DynaMed: Reviews and Guidelines
Levels and Grades of EvidenceLevels and Grades of Evidence
REPROLINE, Johns Hopkins University www.reproline.jhu.edu
Nursing Reference CenterNursing Reference Center
Evidence-based Care SheetsEvidence-based Care Sheets Evidence-based summaries on key topics incorporating the best Evidence-based summaries on key topics incorporating the best
available evidence through vigorous systematic surveillanceavailable evidence through vigorous systematic surveillance Diseases & ConditionsDiseases & Conditions Quick LessonsQuick Lessons Drug informationDrug information Skills & ProceduresSkills & Procedures Practice GuidelinesPractice Guidelines Patient Education materialsPatient Education materials CE modulesCE modules
Nursing Reference Center: Basic Search
Nursing Reference CenterNursing Reference CenterEvidence-Based Care Sheet Evidence-Based Care Sheet
April 2009
Evidence-Based NursingEvidence-Based Nursing
Surveys a wide range of international medical journals Surveys a wide range of international medical journals applying strict criteria for the quality and validity of applying strict criteria for the quality and validity of researchresearch
Practicing clinicians assess the clinical relevance of the Practicing clinicians assess the clinical relevance of the best studiesbest studies
Key details of these essential studies are presented in a Key details of these essential studies are presented in a succinct, informative succinct, informative abstractabstract with an with an expert commentaryexpert commentary on its clinical applicationon its clinical application
Evidence-Based NursingEvidence-Based Nursing review review
Additional Point of Care Evidence-Based Additional Point of Care Evidence-Based Resources for Nursing: Resources for Nursing: [have [have somesome level of evidence-based information] level of evidence-based information]
Clini-eguide Nursing Advisor Clini-eguide Nursing Advisor www.clineguide.com/nursing-standards-care-plan.aspxwww.clineguide.com/nursing-standards-care-plan.aspx
Lippincott’s Nursing Procedures & SkillsLippincott’s Nursing Procedures & Skills www.healthstream.com/Lippincott/www.healthstream.com/Lippincott/
Mosby’s Nursing Consult Mosby’s Nursing Consult www.nursingconsult.comwww.nursingconsult.com Mosby’s Nursing Skills Mosby’s Nursing Skills mosbysnursingskills.commosbysnursingskills.com UptoDateUptoDate uptodate.comuptodate.com
Essential Nursing Resources Essential Nursing Resources from ICIRN from ICIRN icirn.orgicirn.org
Search for Evidence in Natural Search for Evidence in Natural Medicines and Herbal ResourcesMedicines and Herbal Resources
Natural Medicines Comprehensive DatabaseNatural Medicines Comprehensive Database naturaldatabase.comnaturaldatabase.com
Natural Standard Natural Standard naturalstandard.comnaturalstandard.com high quality, evidence-based information about high quality, evidence-based information about
complementary and alternative therapiescomplementary and alternative therapies Also available partially through Also available partially through MedlinePlus: Drugs, Herbs, and SupplementsMedlinePlus: Drugs, Herbs, and Supplements www.nlm.nih.gov/medlineplus/druginformation.htmlwww.nlm.nih.gov/medlineplus/druginformation.html
Natural Medicines Comprehensive Database Natural Medicines Comprehensive Database
Natural Standard Natural Standard
Professional reading level
12th grade reading level
Patient handout 5th grade
Aloe
Natural Standard Professional MonographNatural Standard Professional Monograph
AloeAloe
Natural StandardNatural Standard
Use a Meta-Search EngineUse a Meta-Search Engine to find evidence sites to find evidence sites
Allows you to search multiple other search Allows you to search multiple other search engines simultaneously and combine the resultsengines simultaneously and combine the results
Special Meta -Search EnginesSpecial Meta -Search Enginesthat find evidence sitesthat find evidence sites
TRIPTRIPtripdatabase.com
SUMSearch 2SUMSearch 2sumsearch.org SUMSearchSUMSearch
TRIP DatabaseTRIP Databasetripdatabase.comtripdatabase.com
Metasearch engine Metasearch engine Performs a simple search of more than Performs a simple search of more than
75 databases75 databases Finds evidence based resourcesFinds evidence based resources Searches Searches Cochrane, National Guideline Cochrane, National Guideline
Clearinghouse, BandolierClearinghouse, Bandolier, etc., etc.
SUMSearch 2SUMSearch 2 sumsearch.org
Search for Systematic Reviews and Search for Systematic Reviews and Meta-Analyses ResourcesMeta-Analyses Resources
Cochrane Database of Systematic Reviews Cochrane Database of Systematic Reviews MEDLINE or PubMedMEDLINE or PubMed
Clinical QueriesClinical Queries CINAHLCINAHL
Systematic review vs Meta-analysisSystematic review vs Meta-analysis
Systematic reviewSystematic review:: a literature review of RCTs focused on a single a literature review of RCTs focused on a single
question which tries to identify, appraise, select and question which tries to identify, appraise, select and synthesize all high quality research evidence relevant synthesize all high quality research evidence relevant to that question.to that question.
Uses explicit methods to identify, select and critically Uses explicit methods to identify, select and critically evaluate relevant research.evaluate relevant research.
Meta-analysis: Meta-analysis: --systematic review combining results of several studies systematic review combining results of several studies using quantitative statistics.using quantitative statistics.
Cochrane Database of Systematic ReviewsCochrane Database of Systematic Reviews
‘‘Gold standard’ for high quality systematic Gold standard’ for high quality systematic reviewsreviews
Includes full-text reviews and protocolsIncludes full-text reviews and protocols Cochrane Abstracts available in CINAHL Cochrane Abstracts available in CINAHL
and MEDLINE/PubMedand MEDLINE/PubMed
Cochrane SearchCochrane Search
link to full text
Systematic Review
Authors’ conclusionsAntibiotics have a small treatment effect in patients with uncomplicated acute sinusitis in a primary care setting with symptoms formore than seven days. However, 80% of participants treated without antibiotics improve within two weeks. Clinicians need to weigh the small benefits of antibiotic treatment against the potential for adverse effects at both the individual
and the general population level.
Finding Systematic Reviews and Finding Systematic Reviews and Meta-Analyses in Meta-Analyses in CINAHLCINAHL
Limit search to Pub Type: Limit search to Pub Type: Systematic ReviewSystematic Review
Search for Search for Meta Analysis Meta Analysis as a Subject Heading as a Subject Heading
Finding Systematic Reviews Finding Systematic Reviews and Meta-Analyses in and Meta-Analyses in PubMedPubMed
Use Clinical Queries: Systematic Use Clinical Queries: Systematic ReviewsReviews
Limit to Type of Article: Meta-Limit to Type of Article: Meta-AnalysisAnalysis
Systematic reviews
Results for Systematic ReviewsResults for Systematic Reviews
Searching for Evidence PyramidSearching for Evidence PyramidMetaSearch Engines ex. TRIP
ex. Cochrane
ex. DynaMed, Nursing Reference Center, NGC
ex. MEDLINE/PubMed, CINAHL
ex.Textbooks, UptoDate
Systematic Reviews, Meta-
Analyses
Evidence Summaries, Evidence Guidelines
Randomized Controlled Trials (RCTs), Cohort Studies, Qualitative Studies
Background Information, Expert Opinion
So, you want to use Google?So, you want to use Google?
CINAHL resultsCINAHL results 150 articles150 articles Top result:Top result:
Schatz M, Dombrowski MP. Schatz M, Dombrowski MP. Clinical practice: asthma in Clinical practice: asthma in pregnancy. pregnancy. NEJMNEJM 2009 Apr 2009 Apr 30; 360(18):1862-930; 360(18):1862-9
Google results Google results 2, 530,00 hits2, 530,00 hits Top result:Top result:
Asthma in pregnancy. Asthma in pregnancy. eMedicine HealtheMedicine Health. Last . Last editorial review 10/24/2005editorial review 10/24/2005
Search June 2009: Search June 2009: asthma and pregnancyasthma and pregnancyby Dolores Judkins, OHSU Library, Portland, OR by Dolores Judkins, OHSU Library, Portland, OR
Navigating the Web Beyond Basic Navigating the Web Beyond Basic Google to Find Evidence?Google to Find Evidence?
GoogleGoogle google.comgoogle.com Largest search engine: over Largest search engine: over 25 billion25 billion pages pages Relevance rankingRelevance ranking based on link analysis based on link analysis
Google Advanced SearchGoogle Advanced Searchwww.google.com/advanced_search?hl=enwww.google.com/advanced_search?hl=en
Google Scholar Google Scholar scholar.google.comscholar.google.com
Searching Advanced Google for GuidelinesSearching Advanced Google for Guidelines
.gov, .edu
in title
pressure ulcer prevention guidelines
pressure ulcer prevention guidelines
Google Scholar Google Scholar scholar.google.comscholar.google.com
Searches for Searches for scholarly literaturescholarly literature, including peer-, including peer-reviewed papers, theses, books, abstracts and reviewed papers, theses, books, abstracts and technical reportstechnical reports
Finds articles from academic publishers, professional Finds articles from academic publishers, professional societies, universities, etc. as well as scholarly articles societies, universities, etc. as well as scholarly articles on the web on the web
""Cited by" link Cited by" link identifies # that have cited the originalidentifies # that have cited the original Access to full text only available with subscriptionAccess to full text only available with subscription Caution:Caution: Not a reliable sole source for searching Not a reliable sole source for searching
scholarly literature scholarly literature
Google ScholarGoogle Scholar
Must Evaluate Web Resources: Must Evaluate Web Resources: Evaluation StrategiesEvaluation Strategies
Evaluate using Evaluate using Criteria for Evaluating Web Criteria for Evaluating Web ResourcesResources
Determine the type of site by analyzing Determine the type of site by analyzing Web Site AddressesWeb Site Addresses
A User's A User's GuideGuide to Finding and Evaluating to Finding and Evaluating Health Information on the WebHealth Information on the Webwww.mlanet.org/resources/userguide.htmlwww.mlanet.org/resources/userguide.html
Criteria for Evaluating Web SitesCriteria for Evaluating Web Siteshealthlinks.washington.edu/howto/navigating/criteria.pdfhealthlinks.washington.edu/howto/navigating/criteria.pdf
AuthorityAuthority
AccuracyAccuracy
ObjectivityObjectivity CurrencyCurrency
CoverageCoverage
DesignDesign
Analyze the Website AddressAnalyze the Website Address
eduedu orgorg comcom govgov netnet
The URL (Uniform Resource Locator) includes the name The URL (Uniform Resource Locator) includes the name of the host computer which can indicate the purpose of of the host computer which can indicate the purpose of the web site.the web site.
http://www.cdc.gov/nip/child.htm
sub directory
name of host computer
how information is transmitted
filename
ResourcesResources
Basic Introduction to Evidence-Based Practice (UW HSL) Basic Introduction to Evidence-Based Practice (UW HSL) healthlinks.washington.edu/hsl/classes/evidencehealthlinks.washington.edu/hsl/classes/evidence
Video (2009,60 min) based on Basic Intro to EBP Res Video (2009,60 min) based on Basic Intro to EBP Res healthlinks.washington.edu/hsl/classes/evidence/EBP_2009/EBP_2009.htmlhealthlinks.washington.edu/hsl/classes/evidence/EBP_2009/EBP_2009.html
DNP Toolkit (UW HSL) DNP Toolkit (UW HSL) healthlinks.washington.edu.offcampus.lib.washington.edu/nurse/dnphealthlinks.washington.edu.offcampus.lib.washington.edu/nurse/dnp
Essential Nursing Resources (ICIRN) Essential Nursing Resources (ICIRN) www.icirn.org/Homepage/Essential-Nursing-Resources/Essential-Nursing-www.icirn.org/Homepage/Essential-Nursing-Resources/Essential-Nursing-Resources.aspxResources.aspx
Schnall Liaison page with links under PresentationsSchnall Liaison page with links under Presentations healthlinks.washington.edu/hsl/liaisons/schnall/healthlinks.washington.edu/hsl/liaisons/schnall/
Overview of EBP for NursesOverview of EBP for Nurses Series full-text available FREE on Series full-text available FREE on AJNAJN website: website:
journals.lww.com/ajnonline/pages/collectiondetails.aspx?TopicalCollectionId=10 journals.lww.com/ajnonline/pages/collectiondetails.aspx?TopicalCollectionId=10
1: Fineout-Overholt E, Melnyk BM, Stillwell SB, Williamson KM. Evidence-based practice, step 1: Fineout-Overholt E, Melnyk BM, Stillwell SB, Williamson KM. Evidence-based practice, step by step: critical appraisal of the evidence: part II: digging deeper--examining the "keeper" by step: critical appraisal of the evidence: part II: digging deeper--examining the "keeper" studies. studies. Am J Nurs. Am J Nurs. 2010 Sep;110(9):41-8. PMID: 20736710. 2010 Sep;110(9):41-8. PMID: 20736710.
2: Fineout-Overholt E, Melnyk BM, Stillwell SB, Williamson KM. Evidence-based practice step 2: Fineout-Overholt E, Melnyk BM, Stillwell SB, Williamson KM. Evidence-based practice step by step: Critical appraisal of the evidence: part I. by step: Critical appraisal of the evidence: part I. Am J Nurs. Am J Nurs. 2010 Jul;110(7):47-52. PMID: 2010 Jul;110(7):47-52. PMID: 20574204. 20574204.
3: Stillwell SB, Fineout-Overholt E, Melnyk BM, Williamson KM. Evidence-based practice, step 3: Stillwell SB, Fineout-Overholt E, Melnyk BM, Williamson KM. Evidence-based practice, step by step: searching for the evidence. by step: searching for the evidence. Am J Nurs. Am J Nurs. 2010 May;110(5):41-7. PMID: 20520115. 2010 May;110(5):41-7. PMID: 20520115.
4: Stillwell SB, Fineout-Overholt E, Melnyk BM, Williamson KM. Evidence-based practice, step 4: Stillwell SB, Fineout-Overholt E, Melnyk BM, Williamson KM. Evidence-based practice, step by step: asking the clinical question: a key step in evidence-based practice. Am J Nurs. by step: asking the clinical question: a key step in evidence-based practice. Am J Nurs. 2010 Mar;110(3):58-61. PMID: 20179464. 2010 Mar;110(3):58-61. PMID: 20179464.
5: Melnyk BM, Fineout-Overholt E, Stillwell SB, Williamson KM. Evidence-based practice: step 5: Melnyk BM, Fineout-Overholt E, Stillwell SB, Williamson KM. Evidence-based practice: step by step: the seven steps of evidence-based practice. Am J Nurs. 2010 Jan;110(1):51-3. by step: the seven steps of evidence-based practice. Am J Nurs. 2010 Jan;110(1):51-3. PMID: 20032669. PMID: 20032669.
6: Melnyk BM, Fineout-Overholt E, Stillwell SB, Williamson KM. Evidence-based practice: step 6: Melnyk BM, Fineout-Overholt E, Stillwell SB, Williamson KM. Evidence-based practice: step by step: igniting a spirit of inquiry: an essential foundation for evidence-based practice. Am by step: igniting a spirit of inquiry: an essential foundation for evidence-based practice. Am J Nurs. 2009 Nov;109(11):49-52. PMID: 19858857. J Nurs. 2009 Nov;109(11):49-52. PMID: 19858857.
