1. Evidence-Based Nursing Practice: Literature Search

2. Education and Information Consultant for
Min-Lin E. Fang, MLIS
Education and Information Consultant for
Nursing and Social and Behavioral
Sciences
April 17, 2017

3. Objective After completing this lecture, you should be able to:
Effectively find best evidence from PubMed,
CINAHL and the Cochrane Library
April 17, 2017

4. Nursing Subject Guide in CLE http://tinyurl.com/ucsfnursing
Key databases
EBM resources
Nursing Theories
Tests & Measurements
Comp Exam Examples
Citation Management
RefWorks Tutorials (NEW)
Get Help
Show students how to find the Nursing Subject Guide in CLE
Shawn students how to find comp exam examples. ***Ask the students to learn RefWorks from the new online tutorials. After learning from the tutorials, if they still need in-person class, they can contact Min-Lin to coordinate a RefWorks class for the group.
April 17, 2017

5. Hierarchy of Evidence (Evidence Pyramid) Source: Med Research Library Brooklyn
April 17, 2017

6. Key Databases UptoDate (background clinical info) PubMed@UCSF CINAHL
Cochrane Library
PsycInfo
SocAbstracts
April 17, 2017

7. Asking Searchable, Answerable Questions Using PICO Model
P patient
I intervention
C comparison
O Outcomes
In African American female adolescents with hepatitis (P), what is the effect of acetaminophen (I) compared with ibuprofen (C) on liver function (O) ?
NO need to run this search. Just explain to them how to put together an answerable question using PICO
April 17, 2017

8. Development of Search Strategies
Formulate the question; Break your question into multiple concepts
Locate the proper MeSH/thesaurus for each concept; Use AND to connect different concepts;
Use OR to connect similar concepts
Refine your search
Too Many? Apply limit options (language, subset, age, publication type, major heading, subheading)
Too Few? Google Scholar, Scopus

9. My NCBI Features Highlight PubMed search words in your retrieval
Set “Abstract” format on MyNCBI account
to open the supplemental data (MeSH, PTs)
Save searches and set up alerts
Set up evidence-based filters
(Make sure every student sets up filter for systematic reviews,
RCT, meta analysis and practice guidelines in the class.)
Set up highlighting preference in the class and show students how it helps browse through the search results quickly when they use the title word search.
Explain to students the reason why we want them to set “Abstract” format open.
April 17, 2017

10. PubMed Quick Tips When you get too many results, try these tips.
Use “quotation marks” to search on a phrase
Use [tiab] to find a word/phrase in the title or the abstract
Use [ti] to find a word/phrase in the title
Use * to find alternative endings (child*=> child, children, childbearing)
Use “LIMITS” (language, subsets, age, publication types), subheadings and major headings to refine your search
Exercise:
Find systematic reviews on obesity prevention programs for Hispanic populations
Show students the different results from keyword search, tiab, ti search. Then show them to use limits from Advanced Search page
Obesity [tiab] AND prevention [tiab] AND (latino [tiab] OR hispanic [tiab])
obesity/prevention and control [mh] AND hispanic americans [mh]
April 17, 2017

11. Find the Most Recent Studies
New studies not yet indexed
Do a keyword search and limit a search
to the last couple of months.
Search strength exercise to show the students the most recent studies not yet indexed
April 17, 2017

12. Finding Relevant MeSH Terms Use Medical Subject Headings to focus your search.
Tips: Do a title word search
probiotics [ti] AND "acute diarrhea" [ti] AND child* [ti]
acute disease [mh] AND diarrhea/therapy [mh] (ages: all child)
Exercise: What is the effect of probiotics in treating/preventing acute diarrhea
in children?
At this point, everyone has already set “Abstract Supplemental Data” Open.
So ask students to choose “Abstract” as their display setting, which allows them to identify the appropriate MeSH terms.
end of life [ti] AND pediatric [ti] AND cancer [ti] => terminal care [mh] AND neoplasms [mh] then use “All Child” as a limit to narrow the search to pediatric patients.
April 17, 2017 12

13. Search Tips: Narrow Your Search to Be More Focused
Use the MeSH database
Subheadings: nursing, prevention and control, therapy…
nursing [Subheading] Links Used with diseases for nursing care and techniques in their management. It includes the nursing role in diagnostic, therapeutic, and preventive procedures.
Restrict Search to Major Topic headings only
Exercise:
Systematic reviews on end-of-life care in pediatric cancer patients (English articles)
Etiology, genetics, prevention and rehabilitation of cardiovascular diseases among elderly (major topics), English articles, published in the nursing and core clinical journals in the past 5 years
Cardiovascular disease [ti]

14. PubMed: Clinical Queries
Finding the highest levels of evidence: systematic reviews and meta-analyses faster and easier
Providing further analysis of randomized controlled trials
Exercise:
Find systematic reviews on complementary care in pediatric oncology
(complementary care) AND pediatric oncology
April 17, 2017 14

15. PubMed vs CINAHL Type of Publication Covered MEDLINE: articles only
CINAHL: articles, books, book chapters, nursing dissertations, standards of practice, educational software, clinical innovations, research instruments, etc.
Year Coverage
MEDLINE: 1948-present
CINAHL: 1937-present
Subject Coverage:
MEDLINE: Focuses on biomedical journal literature
CINAHL: Focuses on nursing and allied health literature
Updates
MEDLINE: daily
CINAHL: daily

16. PubMed vs CINAHL Overlap Controlled Vocabulary MEDLINE: Uses MeSH
CINAHL: Based on MeSH & unique nursing and allied health terms called CINAHL Subject Headings
Peer-Reviewed Articles
MEDLINE: can’t easily identify peer-reviewed articles: CINAHL: can use peer-reviewed limiter or use journal subset: peer-reviewed to locate peer-reviewed articles
Medication Errors/nursing*
Medication Errors/prevention & control*
Medication Errors/psychology
Nurse's Role*

17. CINAHL Nursing theories (Nursing theory, nursing models, theoretical)
Evidence-based Care Sheets
Quick way to find Evidence-Based practice info.
Show students how to find nursing theories using CINAHL Headings tag. Enter nursing theory, then click on nursing models theoretical
Show students the EB care sheets and quick way to find EBP info using the limit option EBP

18. CINAHL
Exercise:
Find EB literature on interventions to prevent childhood and adolescent obesity (Show students how to use limits options – age group, EB practice)
April 17, 2017

19. Cochrane Databases http://www.library.ucsf.edu/db/cochrane-library
International collaboration
Evidence-Based Databases
Cochrane Database of Systematic Reviews
Database of Abstracts of Reviews of Effects (DARE)
Cochrane Central Register of Controlled Trials
TIP: Use to run a search.
Exercise: Is educational intervention effective for asthma in children?
No need to show students how to run a Cochrane search using MeSH. “Title abstract or keywords” is a good way to do it. If students don’t
Get enough articles, then they can use “Full text” to search.
Asthma education AND child*--run title abstract or keywords search
April 17, 2017

20. Evidence-Based Practice Guidelines
National Guidelines Clearinghouse
Exercise:
Guideline for HPV vaccine use to prevent cervical cancer
At the end of the lecture, encourage students to sign up for the RefWorks class.
April 17, 2017