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Using the Library


       DNP Bound
 Frontier Nursing University
Alice Whitman Memorial Library
Alice Whitman Memorial Library
 Library Home Page   Library 101 in ANGEL
Evidence Based Practice

SEARCHING FOR THE EVIDENCE
Gebb, B.A., Young, Z., & Anderson, B.A. (2012). Evaluating and using the evidence. In B.A. Anderson &
      S. Stone (Eds.), Best practices in midwifery: Using the evidence to implement change. New York:
      Springer Publishing.
Evidence Based Practice
• What is EBP?
  – Most commonly cited definition is “the
    conscientious, explicit, and judicious use of
    current best evidence in making decisions about
    the care of individual patients.”
        – Sackett, D.L., Rosenberg, W.M.C., Gray, J.A.M., Haynes, R.B., &
            Richardson, W.S. (1996, January 13). Evidence-based
            medicine: what it is and what it isn’t. BMJ, 312(71).
            Retrieved from
            http://www.bmj.com/content/312/7023/71.full
Evidence Based Practice
                       The EBP Cycle
•   Identifying a clinical problem
•   Formulating a focused, answerable question
•   Locating relevant and appropriate resources
•   Searching for information
•   Critically appraising the information
•   Implementation in clinical practice
What is Evidence?
                                              Systematic




                                                                        Hierarchy of Research Evidence
Hierarchy of Research Evidence



                                               Reviews


                                            Meta-Analyses



                                           Critical Appraisal



                                     Randomized Controlled Trials



                                   Cohort and case-controlled studies



                                        Consensus Statements



                                        Anecdotal Information
Search Strategy
• Form a clinical question
  – Must be focused and answerable
          NOT
            What are therapies for depression?
          INSTEAD
            Does exercise reduce depressive symptoms in
            women?
Form a Clinical Question
PICO framework:

  P – patient/problem
  I – intervention
  C – comparison
  O – outcome
Form a Clinical Question
Does exercise reduce depressive symptoms in
women?

  P – women with depression (age group?)
  I – exercise (how strenuous? how often?)
  C – medication
  O – symptom reduction, quality of life
Boolean Operators
    AND – both terms must be present
    (will narrow a search)




    OR – either term is present (will
    broaden a search)



    NOT – only first term is present
    (will exclude terms)
Boolean Operators
• exercise AND depression – will retrieve articles
  with both words
• zoloft OR sertraline – will retrieve articles with
  either word
• exercise NOT running – will retrieve articles
  with exercise and exclude those with running
Field Searching
Subject Headings
• Specific words or phrases selected from a
  controlled vocabulary that describe a work
  – MEDLINE = MeSH
  – CINAHL = CINAHL Headings
Limiters
• Parameters for your search
  – MEDLINE limiters include:
     •   Age group
     •   Publication type
     •   Language
     •   Dates
Research Filters
• Research filters are pre-designed search
  strategies
• Clinical Queries
   – PubMed page: http://www.ncbi.nlm.nih.gov/pubmed/clinical
   – Limiter in MEDLINE (EBSCOhost)



   – ((clinical[Title/Abstract] AND trial[Title/Abstract]) OR clinical
     trials[MeSH Terms] OR clinical trial[Publication Type] OR
     random*[Title/Abstract] OR random allocation[MeSH
     Terms] OR therapeutic use[MeSH Subheading])
Where is the Evidence?
• Traditional bibliographic databases
• Meta-search engines
• Point of Care resources
Bibliographic Databases
• MEDLINE
  – via EBSCOhost
  – via PubMed
• CINAHL
• Cochrane Library
• Joanna Briggs Institute
Meta-search Engines

• SUMsearch – http://sumsearch.org
• TRIP database – http://www.tripdatabase.org
Point of Care Tools
•   DynaMed
•   Essential Evidence Plus
•   Natural Standard
•   Lexicomp
Additional Tools
• Search Alerts
  – MyNCBI
  – MyEBSCOhost
  – RSS Feeds
Citation Management
Finally…
• Don’t forget about librarians as a resource!
• Call us before starting your literature review!
Library Staff
• Billie Anne Gebb, Director of Library Services
  – billieanne.gebb@frontier.edu
  – (859) 899-2519
• Zach Young, Information Service Librarian
  – zach.young@frontier.edu
  – (859) 899-2511
• Kristy Nowak, Library Technician
  – kristy.nowak@frontier.edu
  – (859) 899-2526
Stay in Touch!
• Library Information Forum in the Frontier
  Community Connection
• Find us on Facebook
• Follow us on Twitter @FSMFNLibrary
• Read the FNU Library blog:
  http://frontierlibrary.blogspot.com/
• Email
• Phone

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Using the Library - DNP Bound

  • 1. Using the Library DNP Bound Frontier Nursing University
  • 3. Alice Whitman Memorial Library Library Home Page Library 101 in ANGEL
  • 4. Evidence Based Practice SEARCHING FOR THE EVIDENCE Gebb, B.A., Young, Z., & Anderson, B.A. (2012). Evaluating and using the evidence. In B.A. Anderson & S. Stone (Eds.), Best practices in midwifery: Using the evidence to implement change. New York: Springer Publishing.
  • 5. Evidence Based Practice • What is EBP? – Most commonly cited definition is “the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients.” – Sackett, D.L., Rosenberg, W.M.C., Gray, J.A.M., Haynes, R.B., & Richardson, W.S. (1996, January 13). Evidence-based medicine: what it is and what it isn’t. BMJ, 312(71). Retrieved from http://www.bmj.com/content/312/7023/71.full
  • 6. Evidence Based Practice The EBP Cycle • Identifying a clinical problem • Formulating a focused, answerable question • Locating relevant and appropriate resources • Searching for information • Critically appraising the information • Implementation in clinical practice
  • 7. What is Evidence? Systematic Hierarchy of Research Evidence Hierarchy of Research Evidence Reviews Meta-Analyses Critical Appraisal Randomized Controlled Trials Cohort and case-controlled studies Consensus Statements Anecdotal Information
  • 8. Search Strategy • Form a clinical question – Must be focused and answerable NOT What are therapies for depression? INSTEAD Does exercise reduce depressive symptoms in women?
  • 9. Form a Clinical Question PICO framework: P – patient/problem I – intervention C – comparison O – outcome
  • 10. Form a Clinical Question Does exercise reduce depressive symptoms in women? P – women with depression (age group?) I – exercise (how strenuous? how often?) C – medication O – symptom reduction, quality of life
  • 11. Boolean Operators AND – both terms must be present (will narrow a search) OR – either term is present (will broaden a search) NOT – only first term is present (will exclude terms)
  • 12. Boolean Operators • exercise AND depression – will retrieve articles with both words • zoloft OR sertraline – will retrieve articles with either word • exercise NOT running – will retrieve articles with exercise and exclude those with running
  • 14. Subject Headings • Specific words or phrases selected from a controlled vocabulary that describe a work – MEDLINE = MeSH – CINAHL = CINAHL Headings
  • 15. Limiters • Parameters for your search – MEDLINE limiters include: • Age group • Publication type • Language • Dates
  • 16. Research Filters • Research filters are pre-designed search strategies • Clinical Queries – PubMed page: http://www.ncbi.nlm.nih.gov/pubmed/clinical – Limiter in MEDLINE (EBSCOhost) – ((clinical[Title/Abstract] AND trial[Title/Abstract]) OR clinical trials[MeSH Terms] OR clinical trial[Publication Type] OR random*[Title/Abstract] OR random allocation[MeSH Terms] OR therapeutic use[MeSH Subheading])
  • 17. Where is the Evidence? • Traditional bibliographic databases • Meta-search engines • Point of Care resources
  • 18. Bibliographic Databases • MEDLINE – via EBSCOhost – via PubMed • CINAHL • Cochrane Library • Joanna Briggs Institute
  • 19. Meta-search Engines • SUMsearch – http://sumsearch.org • TRIP database – http://www.tripdatabase.org
  • 20. Point of Care Tools • DynaMed • Essential Evidence Plus • Natural Standard • Lexicomp
  • 21. Additional Tools • Search Alerts – MyNCBI – MyEBSCOhost – RSS Feeds
  • 23. Finally… • Don’t forget about librarians as a resource! • Call us before starting your literature review!
  • 24. Library Staff • Billie Anne Gebb, Director of Library Services – billieanne.gebb@frontier.edu – (859) 899-2519 • Zach Young, Information Service Librarian – zach.young@frontier.edu – (859) 899-2511 • Kristy Nowak, Library Technician – kristy.nowak@frontier.edu – (859) 899-2526
  • 25. Stay in Touch! • Library Information Forum in the Frontier Community Connection • Find us on Facebook • Follow us on Twitter @FSMFNLibrary • Read the FNU Library blog: http://frontierlibrary.blogspot.com/ • Email • Phone

Notas do Editor

  1. Library is housed in Aunt Hattie’s BarnMost resources are online
  2. The library website is your gateway to our online resourcesLibrary 101 is a tutorial on information literacy and using our libraryShould already be enrolled and will stay enrolled so you can consult at any timeExcellent review
  3. We want to talk mainly today about searching for evidence – search strategies to use in evidence based practiceWe wrote a chapter in Best Practices in Midwifery about using evidence and this presentation follows that chapter outlineThis is a word cloud of the chapter
  4. Most commonly cited definition from seminal article in BMJ
  5. EBP cycle – we come in mostly in 3 and 4
  6. Evidence Hierarchy – best evidence on topSystematic Reviews – an overview of all primary studies on a topic; “interrogating the literature”Meta-analyses – combine statistical data from individual studies and recalculateCritical appraisal – summaries to answer specific clinical questions – often found in point of care toolsRCTs – patients/subjects assigned to either receive treatment or serve as a control; other variables do not come into playCohort and case-controlled studies – compare two groups (one with condition or intervention, one without); cohort follows the groups over time, case control looks at historiesConsensus statements – guidelines from respected authorities (professional organizations)Anecdotal information – least reliable since it cannot be verified, but uses experience
  7. Field – individual piece of information within a record
  8. Older JBI stuff in ProQuest; evaluating JBI database from OVID
  9. These are the ones we have – there are others
  10. Zach will demo RefWorks
  11. Most important resource…Once you pick your topic, talk to us before starting lit reviewWe can discuss subject headings and keywords, resources; brainstorm search strategies, etc.