Nursing: Evidence-Based Practice

"Evidence-based practice (EBP) is a problem-solving approach to the delivery of health care that integrates the best evidence from studies and patient care data with clinician expertise and patient preferences and values." -AJN 2010. Evidence-Based Practice, Step by Step.

Searching for Evidence using PICO(T)

PICO is a search strategy acronym used to formulating a strong clinical question. It can guide your search for evidence in the biomedical literature. Use a PICO worksheet to:

• Organize your question into concepts
• List potential search terms and searching methods, with examples
• Create an effective search strategy

CINAHL and PubMed are good starting databases for applying PICO to a clinical query search. The databases are available from the homepage of the library. If full text of the article isn’t available directly through the database, contact the librarians for further assistance.

Evidence-Based Practice Tutorials:

• Evidence-Based Practice: An Interprofessional Tutorial | University of Minnesota
  An interactive tutorial that includes the five steps of evidence-based practice and how to use PICO.
• Evidence-Based Practice, Step by Step | American Journal of Nursing
  The purpose of this series is to give nurses the knowledge and skills they need to implement EBP consistently, one step at a time. Articles appeared every two months to allow time for staff to incorporate information as they worked toward implementing EBP at their institutions.

Use this worksheet to break down the parts of your PICO question: The Well-Built, Patient-Oriented Clinical Question

Search Tips Using PICO for CINAHL:

Search Strategy Help:

1. Step 1 Enter keywords, they represent the concepts of your search topic. Use "and" and "or" to connect concepts.
2. Step 2 Check the "apply related words" checkbox, to search on subject terms related to the keywords entered in the search box.
3. Step 3 Select needed limits. Consider, "full text" and "peer reviewed."
4. Step 4 Click search.
5. Step 5 Review your results and revise as needed.

Tips:

• Using the "full text" limit will remove articles that may be essential in clinical queries.
• Removing limits broaden a search. Adding limits narrows a search.
• Use the "AND" and "OR" options to nest concepts as needed.
• Use the search history link to keep track of previous searches.
• Consider using the "suggest subject terms" checkbox, when you're having trouble finding what you need, and when comprehensive searching of a topic is needed.