Evidence Based Practice Essay
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Searchingforevidence.pptxStatistics and Evidence Based practice SDL
Searching for evidence I
In this session learners will be able to:
List the search strategies and databases used in conducting research EBP.
Perform a search for own identified clinical topic.
Learning Outcomes
Steps of finding evidence-based information
Formulate your PICO(T) question
Plan your search
Decide where to search
Evaluate
Steps of finding evidence-based information
Formulate your PICO(T) question
Plan your search
Decide where to search
Evaluate
Mark is a final year nursing student posting to a geriatric ward in a community hospital, and he is participating a project that is focuses on improving hand hygiene among nurses in his ward.
The team plan to search the best available evidence, summarize their finding and propose an education workshop to the nurse manager.
(Hopp & Rittenmeyer, 2012)
Case scenario
The first step of locating best available evidence is to form a PICO(T) question.
From the case scenario, Mark and his team would need to identify their population, intervention, comparison and outcome.
The team also need to consider the education workshop would increase the adherence to the hospital’s hand hygiene among nurses.
Formulate a PICO(T) question
They begin with a general question:
“ what is the best way to improve hand hygiene among nurses at the community hospital?”
General question will resulting too much information and loose the focus
Hence the team further develop a narrower question:
“what is the best way to increase nurses’ adherence to the community hospital’s hand hygiene protocol?”
missing Intervention and comparison (if there is any)
Formulate a PICO(T) question
After a discussion, the team would like to compare a very specific type of education program e.g. online seminar, or a workshop, to a very specific marketing campaign e.g. print posters and displayed throughout the ward.
Formulate a PICO(T) question
| Example | |
| Patient problem / population | Nurses in the geriatric ward |
| Intervention | An education workshop |
| Comparison | Displaying posters |
| Outcome | Increase adherence to the current hand hygiene protocol |
The final PICO is:
Make sure you develop a specific PICO question
What is the effectiveness of a mandatory training session or displaying posters throughout the ward on improving adherence to the hospital’s hand hygiene protocol among nurses in the geriatric ward?
Steps of finding evidence-based information
Formulate your PICO(T) question
Plan your search
Decide where to search
Evaluate
Decide which terms / keywords you should use to search.
Avoid long descriptive phrases
Focus on the Intervention, what and who as the searchable concepts:
Nurses
Hand hygiene
Education workshop
You may consider any synonyms or alternative terms
E.g. “handwashing”, “hand washing” “hand sanitation”, “seminar”, “orientation session”, “online workshop” and etc.
You can use dictionaries, thesaurus, simple internet search and list out the search terms.
Writing up a Search Strategy
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If you are not getting enough articles broaden your keywords, reduce limits or add synonyms
Ways of identifying relevant Literature – e.g.
Electronic databases
Reference lists
Citation searching
Other relevant sources
The Major and Minor subjects listed can also provide possible alternative search terms
Wikipedia is only at the planning stage!
Anyone can write a Wikipedia article, will it be accurate?
Wikipedia can be useful to have a quick overview of the topic or to find alternative term/keywords for your search strategy.
For quality Wikipedia articles will contain references to their source listed at the end of the page.
They can often be credible quality sources of information that that you can cite in your assignments.
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Planning of search tools
Hand washing
“hand sanitation”
OR
Hand washing
or
“hand sanitation”
Nurs*
AND
Boolean operators: is the use of AND, OR and NOT to join search phrase and words to broaden or narrow a search.
Additional tool e.g. wildcards and truncation
Wildcards – insert question mark (?) within a word to retrieve all the words with alternative spellings.
E.g. randomi?ed,
Truncation – use asterisk (*) at the end of the keyword to retrieve all the words beginning with that word.
E.g nurs* = nurse, nursing, nurses
Planning of search tools
Steps of finding evidence-based information
Formulate your PICO(T) question
Plan your search
Decide where to search
Evaluate
Significant Health Science databased
CINAHL (nursing and allied health literature), MEDLINE (Medical literature), Ovid
Specific evidence-based health Databases:
Joanna Briggs Institution
Cochrane library
You may find out more from NYP library
Source of databases
UpToDate
Clinical practice guidelines from Ministry of Health
https://www.moh.gov.sg/content/moh_web/healthprofessionalsportal/nurses/guidelines/cpg_nursing.html
And many more…
You also visit credible website that is related to your topic, e.g.
CDC - https://www.cdc.gov/
Duke University - http://guides.mclibrary.duke.edu/nursing/guidelines
Clinical Practice Guideline
JBI contains of systematic review, Evidence Summaries, Evidence Based Recommended Practices, Consumer Information Sheets, Systematic Review Protocol and Technical Reports.
Accessing and using JBI
The Cochrane library contains high quality, independent evidence. It is one of the most comprehensive collections of systematic review, controlled trials and evidence-based health-care
Accessing and using Cochrane Library
Cochrane library can be search in various way. E.g.
Basic search
Enter keywords or phrases into the search bar
Advanced Search
Choose advanced search to toiler your search
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2
3
4
Click on the search
results number and
view the list of found articles.
57 search results
CINAHL http://www.ebscohost.com/academic/cinahl-plus-with-full-text
Start with individual broad concepts
and combine them together,
gradually narrowing your
search down
as you
go
Search Principles
Results can be limited by a number of other factors e.g.
Publication date
Human research
Language
Full text (but be wary of doing this as relevant articles can be overlooked)
Methodological filters – RCTs, systematic reviews etc
Limiting Search Results
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| Advice on how to find qualitative research articles, University of Washington | http://healthlinks.washington.edu/howto/qualitative/ |
| Aries Knowledge Finder | http://www.kfinder.com/newweb/ |
| CINAHL | www.cinahl.com |
| EBSCO host | http://www.ebscohost.com/ |
| ISI Web of Knowledge | http://www.thomsonisi.com/ |
| Ovid | http://www.ovid.com/site/index.jsp |
| ProQuest | http://www.proquest.com/ |
| PubMed | http://www.ncbi.nlm.nih.gov/PubMed |
Common electronic databases
Science direct --add
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Steps of finding evidence-based information
Formulate your PICO(T) question
Plan your search
Decide where to search
Evaluate
In the searching process, you should scan and skim the search results for relevancy – from the title and abstract
Scan your finding by –
Find relevant content from abstract, introduction, conclusion, summary, tables and etc.
This allow you to locate the relevant sections and read only as much as you need to find the relevant information
Skim the article by quick initial reading the piece of information or evidence summary to:
Determine it usefulness
Obtain an overview
Evaluate the search result
You have your evidence in hand now
The next step is to appraise the credibility of the paper.
Duke University (2018), Medical Center Library & Archives. Retrieved from: http://guides.mclibrary.duke.edu/nursing/guidelines
Edith Coven University (2017), Finding evidence-based information. Retrieved from: http://ecu.au.libguides.com/ld.php?content_id=31394853
Lisa, H. & Rittenmeyer, L. (2012). Introduction to evidence-based practice: A practical guide for nursing. Philadelphia: F.A. Davis Company.
Polit, D.F., & Beck, C.T. (2014). Essentials of nursing research: Appraising evidence for nursing practice (8th ed.). Wolters Kluwer: Lippincott Williams & Wilkins.
Reference
