The document provides an overview of evidence-based practice and how to search for evidence to answer clinical questions. It discusses forming a focused clinical question using the PICO framework and searching strategies like Boolean operators, subject headings, and limiters. Resources for finding evidence are also outlined, including bibliographic databases, point of care tools, and citation management software.

1. Using the Library
DNP Bound
Frontier Nursing University

2. Alice Whitman Memorial Library

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

13. Field Searching

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

22. Citation Management

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