Finding Evidence-based Nursing Information Gail Sorrough, MLISOctober 6, 2010 Gloria Won, MLIS H.M. Fishbon Memorial Library at Mount Zion 1600 Divisadero.

Finding Evidence-based Nursing Information

Gail Sorrough, MLIS October 6, 2010 Gloria Won, MLIS

H.M. Fishbon Memorial Library at Mount Zion1600 Divisadero Street [email protected]

H.M. Fishbon Memorial Library • UCSF Medical Center at Mount Zion

Goals

Know where to find evidence-based nursing information

Know how to construct a basic search


A little history…

• 1972: Archie Cochrane publishes'Effectiveness and efficiency: random reflections on health services'

collective ignorance about the effects of health care

Professor Archibald Leman Cochrane, CBE FRCP FFCM, (1909 - 1988)


Levels of evidence

4 ©HSLS – University of PittsburghSystematic Review Workshop

EBM Pyramid and EBM Page Generator, copyright 2006 Trustees of Dartmouth College and Yale University. All Rights Reserved.

Produced by Jan Glover, David Izzo, Karen Odato and Lei Wang.


Where do I search for answers?

• Databases, e.g.:– PubMed

– CINAHL

– Cochrane Library

– PsycINFO (psychology)

– Sociological Abstracts (sociology)

• Full-text resources, e.g.:– Up-To-Date

– Society Guidelines

– Organization [nursing] Manuals

– Books


Universal Search Tips

• Opt for “Advanced Search” interface

• Start with a “title word” search if you have a broad topic or a “keyword” search for a narrow topic

• Use Subject Headings if available

• Always limit last

• Remember – less is more!

• Select output options: print, email, save for later, or export to RefWorks


PICOan acronym to help frame the research question

• Patient population

• Intervention/exposure

• Comparison

• Outcomes


A PICO question

• P: In African American female adolescents with

hepatitis

• I: what is the effect of acetaminophen

• C: compared with ibuprofen

• O: on liver function?


Boolean power

John Venn


ANDLocates all records containing BOTH terms

Narrows your search

herbicides AND tadpoles =


ORLocates all records containing EITHER term

Increases retrieval

Use for synonyms or related terms

tadpoles OR frogs =


NOTLocates all records containing ONLY the 1st term

Warning: May eliminate good results

herbicides NOT pesticides =


Boolean logic

AND reduces retrieval

OR increases retrieval

NOT eliminates selected data

• Use OR before AND in simple statements

• Nest terms with parentheses ( ) for complex statements


PubMed “MY NCBI”

• Your personal account for PubMed

• Use “My NCBI” to

– save your searches and data

– create alerts

– set display preferences, eg., search term highlighting, article abstracts, search filter links


Why use a filter? Because…

• (systematic review [ti] OR meta-analysis [pt] OR meta-analysis [ti] OR systematic literature review [ti] OR (systematic review [tiab] AND review [pt]) OR consensus development conference [pt] OR practice guideline [pt] OR cochrane database syst rev [ta] OR acp journal club [ta] OR health technol assess [ta] OR evid rep technol assess summ [ta]) OR ((evidence based[ti] OR evidence-based medicine [mh] OR best practice* [ti] OR evidence synthesis [tiab]) AND (review [pt] OR diseases category[mh] OR behavior and behavior mechanisms [mh] OR therapeutics [mh] OR evaluation studies[pt] OR validation studies[pt] OR guideline [pt])) OR ((systematic [tw] OR systematically [tw] OR critical [tiab] OR (study selection [tw]) OR (predetermined [tw] OR inclusion [tw] AND criteri* [tw]) OR exclusion criteri* [tw] OR main outcome measures [tw] OR standard of care [tw] OR standards of care [tw]) AND (survey [tiab] OR surveys [tiab] OR overview* [tw] OR review [tiab] OR reviews [tiab] OR search* [tw] OR handsearch [tw] OR analysis [tiab] OR critique [tiab] OR appraisal [tw] OR (reduction [tw]AND (risk [mh] OR risk [tw]) AND (death OR recurrence))) AND (literature [tiab] OR articles [tiab] OR publications [tiab] OR publication [tiab] OR bibliography [tiab] OR bibliographies [tiab] OR published [tiab] OR unpublished [tw] OR citation [tw] OR citations [tw] OR database [tiab] OR internet [tiab] OR textbooks [tiab] OR references [tw] OR scales [tw] OR papers [tw] OR datasets [tw] OR trials [tiab] OR meta-analy* [tw] OR (clinical [tiab] AND studies [tiab]) OR treatment outcome [mh] OR treatment outcome [tw])) NOT (letter [pt] OR newspaper article [pt] OR comment [pt])


PubMed record


Medline format

PMID- 18537845VI - 63IP - 2DP - 2008 JulTI - School-based drama interventions in health promotion for children and adolescents: systematic review.PG - 116-31AB - AIM: The paper is a report of a review of the literature on the effects of school-based drama interventions in health

promotion for school-aged children and adolescents. BACKGROUND: Drama, theatre and role-playing methods are commonly used in health promotion programmes, but evidence of their effectiveness is limited. The educational drama approach and social cognitive theory is share the assumption that learning is based on self-reflection and interaction between environment and person. However, educational drama also emphasizes learning through the dialectics between actual and fictional contexts. DATA SOURCES: A search was carried out using 10 databases and hand searching for the period January 1990 to October 2006. METHODS: A Cochrane systematic review was conducted. RESULTS: Nine studies met the criteria for inclusion. Their topics included health behaviour (five studies), mental health (two) and social health (two). Actor-performed drama or theatre play followed by group activities was the intervention in five studies, and classroom drama in four studies. Four of the studies were randomized controlled trials and five were non-randomized controlled studies. Four reports gave the theory on which the intervention was based, and in eight studies at least some positive effects or changes were reported, mostly concerning knowledge and attitudes related to health behaviour. The diversity of designs and instruments limited comparisons. CONCLUSION: There is a need for well-designed and theory-based studies that address drama interventions in health promotion for children and families. The challenge is to find or develop a theory, which combines educational, drama and health theories with valid and reliable measurements to examine the effects of the intervention.

AD - Department of Nursing Science, University of Tampere, Tampere, Finland. [email protected] - Joronen KAU - Rankin SHAU - Astedt-Kurki PLA - engPT - Journal ArticlePT - Research Support, Non-U.S. Gov'tPT - ReviewTA - J Adv NursJT - Journal of advanced nursingMH - AdolescentMH - Adolescent Behavior/psychologyMH - ChildMH - *Drama


PubMed Tips:

• Automatic Term Mapping (ATM) search hierarchy

1. MeSH – searches for your terms plus finds MeSH equivalents

2. Journals

3. Authors

4. Breaks apart your terms & searches each separately

• Save “in process”, “as supplied by publisher”, etc. citations to your Clipboard before searching with MeSH or they will be lost

• ATM turned off when phrase searching with

– Quotation marks “health promotion”

– Truncation * health promot*


Exercises

• Find systematic reviews on obesity prevention programs for Hispanic populations

• What is the effect of probiotics in treating/preventing diarrhea in children?

• Find systematic reviews on end-of-life care in pediatric cancer patients

• Search for etiology, genetics, prevention, and rehabilitation of cardiovascular diseases among the elderly

• Find systematic reviews on complementary care in pediatric oncology

• Find EB literature on interventions to prevent childhood and adolescent obesity


Output options

• Use print command in your browser

• Send to [see drop down menu for options]

– Clipboard

– “MY NCBI” Collections

– e-mail

– Save as file for export to RefWorks or EndNote

• Save your search strategy in My NCBI


PubMed CINAHL Plus with Full Text

World’s largest biomedical database, includes nursing

Comprehensive coverage of nursing & allied health literature

Coverage: 1948 to present Coverage: 1937 to present

Size: 19+ million records

up-dated daily

Size: 2+ million records

up-dated daily

Subject terms - 23,000 Subject terms - 12,700

Indexes 5,000+ peer-reviewed medical/nursing journals & books

Indexes 3,800+ journals, plus books, dissertations, conference proceedings, standards of practice, educational software, AV materials

Access: Free to all Access: Proprietary access


CINAHLCumulative Index to Nursing and Allied Health Literature

• Universal search tips apply

• Overlaps with journals in PubMed plus indexes other resource types

• Easy to find:– Evidence-based practice – check box under Limits

– Peer-reviewed articles – check box or select journal subset under Limits

– Nursing theories - use CINAHL Headings: Nursing theory; Nursing models, theoretical


What is the Cochrane Collaboration?

23

• “Is an international not-for-profit and independent organization, dedicated to making up-to-date, accurate information about the effects of healthcare readily available worldwide”

• “It produces and disseminates systematic reviews of healthcare interventions and promotes the search for evidence in the form of clinical trials and other studies of interventions”

• http://www.cochrane.org/faq/general


Cochrane Library

• Evidence-Based Databases

– Cochrane Database of Systematic Reviews

– Database of Abstracts of Reviews of Effects (DARE)

– Cochrane Central Register of Controlled Trials (CENTRAL)

– Cochrane Review Groups

Tip: Use to run a search.


Primary Databases to Find Journal Articles Nursing Theories Tests and MeasurementsEvidence-Based (EB) Nursing Practice (EBNP)E-Reserves and Comp Exam Citation ManagementRefWorks Tutorials (new)

http://tinyurl.com/ucsfnursing


References

• Cochrane, A. L. (1989). Archie Cochrane in his own words. selections arranged from his 1972 introduction to "effectiveness and efficiency: Random reflections on the health services" 1972. Controlled Clinical Trials, 10(4), 428-433.

• Corazon B. Cajulis, Corazon B., Beam, P. S., & Davis, S. M. (2010). Making evidence-based decisions in nursing. In F. Chiappelli (Ed.), Evidence-based practice: Toward optimizing clinical outcomes, p. 53-66.

• Elkins, M. Y. (2010). Using PICO and the brief report to answer clinical questions. Nursing, 40(4), 59-60.

• Hujoel, P. (2008). Grading the evidence: The core of EBD. The Journal of Evidence-Based Dental Practice, 8(3), 116-118.

• Hujoel, P. (2009). Grading the evidence: The core of EBD. The Journal of Evidence-Based Dental Practice, 9(3), 122-124.


…more references

• Kleinpell, R. (2010). Evidence-based review and discussion points. American Journal of Critical Care : An Official Publication, American Association of Critical-Care Nurses, 19(2), 147-148.

• Marshall, D. R. (2010). Evidence-based management: Making decisions with the best available theory and data. The Journal of Nursing Administration, 40(5), 197-200.

• Parfrey, P., & Ravani, P. (2009). On framing the research question and choosing the appropriate research design. Methods in Molecular Biology (Clifton, N.J.), 473, 1-17.

• Shultz, S. M., Dell, E. Y., & Bodan, C. L. (2009). Are we there yet? when is a literature review complete? The American Journal of Nursing, 109(9), 78-79.

• Stillwell, S. B., Fineout-Overholt, E., Melnyk, B. M., & Williamson, K. M. (2010). Evidence-based practice, step by step: Searching for the evidence. The American Journal of Nursing, 110(5), 41-47.

Finding Evidence-based Nursing Information Gail Sorrough, MLISOctober 6, 2010 Gloria Won, MLIS H.M. Fishbon Memorial Library at Mount Zion 1600 Divisadero.

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