Evidence-Based Nursing Practice: Literature Search

Education and Information Consultant for Min-Lin E. Fang, MLIS Education and Information Consultant for Nursing and Social and Behavioral Sciences 415-476-3397 Min-lin.fang@ucsf.edu April 17, 2017

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

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

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

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

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

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

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

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

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

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

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]

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

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

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*

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

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

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

Evidence-Based Practice Guidelines National Guidelines Clearinghouse http://www.guideline.gov/ 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