Finding the right information to answer a given question often depends on the source of the information Searching for evidence that has already been appraised for the quality of the study methodology and the reliability of its findings is desirable Pre-appraised literature Dr SA 2012 Begin with a PICOT question Determine the source from which the best evidence is available Clinicians need peer-reviewed research Dr SA 2012 Textbooks and journals Consolidated resources Dr SA 2012 Dr SA 2012 Which of the following sources of evidence is best able to inform a nurse’s clinical practice? a. A well-designed randomized controlled trial (RCT) b. A systematic review that encompasses multiple studies c. Expert opinion of experienced and educated nurses d. A case study that addresses an unique clinical scenario Dr SA 2012 b. A systematic review that encompasses multiple studies Rationale: Systematic reviews are considered to be higher on the hierarchy of evidence than expert opinion or individual RCTs and case studies. Dr SA 2012 Online databases Grey literature Bibliographic versus full-text databases Dr SA 2012 Librarians are a rich source of assistance They are especially valuable when time is of the essence Dr SA 2012 Keyword searching is searching using simple, everyday language Controlled vocabulary systems, e.g., MeSH Normally have a hierarchical structure that helps the searcher retrieve the more specific terms that fall under a general term Most large bibliographic databases (MEDLINE, CINAHL, and PsycINFO) use a controlled vocabulary to describe the content of references Dr SA 2012 Tell whether the following statement is true or false. A controlled-vocabulary system may yield fewer hits than a keyword search, but these hits are more likely to be relevant to the clinical question. Dr SA 2012 True Controlled vocabulary systems exist to increase the relevance of search results while limiting the number of less-relevant hits. Dr SA 2012 Combining search terms from within a PICOT question focuses the search results Consider that different search engines process terms in the search box in different ways Using the “limit” function is designed to help the searcher pare down the large results list Manage inclusion and exclusion criteria carefully Dr SA 2012 Managing citations Saving searches Organizing searches Dr SA 2012 A collection of 6 different databases “Gold standard” database is the Cochrane Database of Systematic Reviews (CDSR) Systematic reviews are based on critical appraisal Dr SA 2012 A comprehensive database of evidence-based clinical practice guidelines Guidelines are systematically developed statements about a plan of care for a specific set of clinical circumstances involving a particular population Dr SA 2012 MEDLINE - covers medicine, health, and the biomedical sciences CINAHL – covers 13 nursing and allied health disciplines EMBASE - major European biomedical and pharmaceutical database PsycInfo – covers psychology, behavioral sciences, and mental health Dr SA 2012 Which of the following online evidence sources is most likely to provide pre-appraised evidence? a. CINAHL b. MEDLINE c. PubMed d. Cochrane Library Dr SA 2012 d. Cochrane Library Rationale: The Cochrane Databases consist of systematic reviews that synthesize evidence from multiple peerreviewed sources. CINAHL, MEDLINE, and PubMed may contain evidence at a synthesis level, but are more often sources of individual articles that a nurse must appraise. Dr SA 2012 PubMed Ovid EBSCO Any search for evidence must be followed by critical appraisal Dr SA 2012 Dr SA 2012