1. Get Started with CINAHL Michelle Henley, MLS Instruction & Consultation Services

2. Class outline Intro to evidence based literature Using CINAHL to find best evidence Cases and exercises CINAHL Other tools in CINAHL Managing searches & results Accessing full text articles

3. What is evidence-based lit? The evidence pyramid demonstrates types of clinical studies. Best practice is to limit to those at the top of the pyramid -- systematic reviews, meta-analyses and randomized controlled trials. Source: SUNY Downstate Medical Center. Medical Research Library of Brooklyn. The Evidence pyramid. Accessed January 3, 2013 from http://library.downstate.edu/EBM2/2100.htmhttp://library.downstate.edu/EBM2/2100.htm

4. Best evidence study types Study typeDescription Systematic Review Comprehensive, methodical literature review; summarizes findings from multiple studies Meta-Analysis Combines findings from multiple studies using statistical methods Randomized, Controlled Trial (RCT) Blinded clinical trial with participants randomly assigned to different groups; best study type for therapy questions* * Note that any question best answered by a RCT may also be answered by a systematic review or meta-analysis

5. What is CINAHL? Full text articles for over 770 journals in nursing, biomedicine, alternative medicine, consumer health & allied health disciplines Over 3 million citations dating back to 1937 Includes evidence-based care summaries and patient handouts

6. How to access CINAHL @ SFGH

7. Basic search keywords limited by date, age group publication date slider

8. Advanced search Use AND to search multiple concepts, OR to search similar concepts

9. Advanced search: best evidence check box for RCTs only OR limit to publication type meta analysis, systematic review, RCT

10. Guidelines search Enter search terms, limit to publication type practice guidelines

11. Case example #1 A 55 yo woman presents to the ED complaining of chest pain, fatigue and weakness. She is diagnosed with heart failure and prescribed a diuretic. Based on the evidence, can diuretics effectively reduce her risk of death from heart failure? SEARCH STRATEGY heart failure AND diuretics LIMIT TO –last 5 years –meta-analysis, randomized controlled trial, systematic review

12. Case example #2 A 35 yo man is admitted after a motorcycle accident. He is semi- conscious but having difficulties breathing on his own, so is placed on a ventilator. You are concerned about ventilator-associated pneumonia and want to know whether there are any guidelines for prevention. SEARCH STRATEGY ventilator associated pneumonia LIMIT TO –last 5 years –practice guideline

13. Exercise #1 A 45 yo man is brought to the ED for acute alcohol withdrawal. He is prescribed benzos for withdrawal symptoms, including mild to moderate seizures. Is there any evidence that other therapies may be more effective for managing withdrawal related seizures? For this exercise: 1.Run a search in CINAHL 2.Limit to best evidence for therapy questions 3.Select 1 result from the past 5 years

14. Exercise #2 A 5 yo boy with a family history of type 2 diabetes visits the clinic for immunizations. He appears healthy but ranks in the 85 th percentile for weight. You are concerned he may develop diabetes and want to know if there are any guidelines for prevention in children his age. For this exercise: 1.Run a search in CINAHL 2.Limit to practice guidelines for his age 3.Select 1 result from after 2008

15. Continuing education materials Check CE module box to limit to lit with CE activities

16. Evidence-Based Care Sheets Summaries on specific conditions, focused on nursing practice

17. Managing results and searches View and save recent searches and results Save this article to a folder Folder for saved articles

18. Need more help? CINAHL Libguide http://sfghdean.ucsf.libguides.com/cinahl CINAHL Help Sheets & User Guides http://support.epnet.com/cinahl/documentation.php

19. Contact Michelle Henley Barnett-Briggs Medical Library San Francisco General Hospital 415-206-6638 or michelle.henley@ucsf.edu michelle.henley@ucsf.edu