nursing leadership institute presentation
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DESCRIPTIONDiscusses free resources available for EBP and how to conduct a good search.
- 1.EBP & Database BasicsRoy Brown, MLISEducation and Research LibrarianTompkins-McCaw Library, VCU Libraries
2. CONFIDENCE IN YOURSEARCHING SKILLS 3. Objectives:By the end of this class you will : Be aware of the process for doing effective research & whereit falls in the practice of EBP Understand the difference between keyword and subjectheading searching Know how to use Boolean operators & limits Be able to identify appropriate databases for different informationneedsEffective Searching = Less Time & Reading 4. In order to keep up with whats new in the literature, youwould have to read 43 articles a day for 365 days a year!!Why do you need to search efficiently? 5. WHAT IS EVIDENCEBASED PRACTICE? 6. PatientValuesClinicalData/KnowledgeResearchEvidenceOptimalDecision What does the patientwant? What are they willing todo? What does yourexperience tell you? What has been theexperience of yourcolleagues?What does theresearch say? 7. Evidence Based Practice Inquiry ProcessBox 4FocusthequestionBox 6Adequateevidence?Box R2Assign /FindmentorBox R3IRBproposalBox R4DatacollectionBox R5DataanalysisBox 7DisseminateBox R6Impactand/oroutcomeBox 1InitialquestionBox 2UnitordepartmentresourceBox E2Assesstranslationof evidenceintopracticesettingBox E3CreateactionplanandimplementchangeBox E4Evaluateoutcomeand/orimpactBox E1Finalize teammembershipand scheduleconferencesBox E5Reportresultstodecision-makersBox E6Adoptchangeandidentifynext stepsBox R1Contact ResearchAdvisory CouncilorGroup (If Applicable)Box 6AppraisalofliteratureBox 3AssembleinitialprojectteamIf answer is yes,proceed to EBPProject.If answer is no,proceed to researchprojectBox 5ConsultLibrarianAdapted from VCUHS Nursing Inquiry Process Diagram 8. Levels of Evidence PracticeGuideline 9. Practice GuidelineAdvantagesCreated by panels of expertsBased on professional publishedliteraturehttp://www.gwumc.edu/library/tutorials/studydesign101/practiceguidelines.htmlStatement produced by a panel of experts that outlines current bestpractice to inform health care professionals and patients in makingclinical decisions. Where Can They Be Found?o PubMedo CINAHLo National Guidelines ClearinghouseDisadvantages Slow to change or be updated Not always available, espeicallyon controversial topics Recommendations might beaffected by the type oforganization creating theguideline 10. Review ArticlesReview Articles Provide Overview of a field or subject Synthesize Previous Research Useful when you need background information and additional referencesSystematic Review Evidence based search and review of the literature on a topic by anestablished method.Meta-Analysis A systematic method that takes data from a number of independent studiesand integrates them using statistical analysis (Dorlands Medical Dictionary for HealthConsumers) 11. Research Articles Present new and original scientific findings Explain research methodology and provide dataRandomized Controlled Trials (RCTs)Cohort StudiesCase-Controlled StudiesStudies that randomly assign individuals toan intervention group or to a control group,in order to measure the effects of theintervention.Study in which a particular outcome, such asdeath from a heart attack, is compared in groupsof people who are alike in most ways but differby a certain characteristicStudy that compares patients who have a diseaseor outcome of interest (cases) with patients whodo not have the disease or outcome (controls),and looks back retrospectively to compare howfrequently the exposure to a risk factor is presentin each group to determine the relationshipbetween the risk factor and the disease.Types of Research ArticlesCause & Effect 12. Selecting the Right Resource Research Guides Nursing Research Guide Important Databases PubMed/Medline (Free) CINAHL APA PsycNet/PsychInfo Cochrane Library TRIP Database (Free) National GuidelinesClearinghouse (Free) PubMed Health (Free) Medline Plus (Free)PracticeGuidelinehttp://guides.library.vcu.edu/nursing 13. THE SEARCH PROCESS 14. The Search Process Search Steps2.5. Evaluatethe Results6. Good Results = Use the Data Bad = Start Over3. Choose the appropriatedatabase(s) or resource foryour topic4. Perform theSearch1. Problem/ ConstructQuestionImage: http://evidencebasedhealth.blogspot.com/Formulate Your SearchStrategy Synonyms for Search Terms Subject Heading vs. Keyword Boolean Operators & Limits 15. Starting Your Search..Step 1Starts with aProblem or Needfor Information 16. The Problem. Helping a patient to dealwith the pain/issues offibromyalgia Improve Quality of LifeQuestion - Brings Focus to Search of the Literature 17. Formulate Your QuestionQuestionIs therapeutic touch or guidedimagery more effective whentreating a patient withfibromyalgia?P I C O T T 18. Type of Question/ Best Type of StudyType of Question Best Type of StudyTherapyHow to select treatments to offer patients that do moregood than harm and that are worth the efforts and costs ofusing themRandomized Control Trial (RCT)PreventionHow to prevent a disease or conditionRCT/ Cohort Study / Case ControlPrognosisHow to estimate the patients likely clinical course overtime and anticipate likelycomplications of diseaseCohort Study/ Case Control/ Case Series or Case ReportDiagnosisHow to select and interpret diagnostic testsBlind RCT Compared to the Gold Standard(best treatment/test for diagnosis)Etiology/HarmHow to identify causes for diseaseRCT/ Cohort Study /Case ControlCost analysisEconomic costs of all facets of a intervention or diseasetreatmentEconomic AnalysisSearch Process Checklist 19. PICO & Breaking Search Into ConceptsMain ConceptsBreak Search in Groups/Concepts20Fibromyalgia | Guided Imagery & Therapeutic TouchThese concepts will be used to search the databasesFind Synonyms/ Related Terms for ConceptsP I C O T TPatient withFibromyalgiaTherapeuticTouchGuidedImageryAlleviatingthesymptoms ofFibromyalgiaTherapyRCT 20. What are some alternative terms Guided Imagery Fibromyalgia Therapeutic Touch 21. Fibromyalgia Therapeutic Touch Guided Imagery 22. Fibromyalgia Therapeutic Touch Guided Imagery"Fibromyalgia"[Majr] OR"Fatigue Syndrome,Chronic"[Majr]OR "Diffuse MyofascialPain Syndrome" OR"Fibromyalgia" OR"Fibromyalgia-FibromyostitisSyndrome" OR "ChronicFatigue Syndrome" OR"Chronic Fatigue andImmune DysfunctionSyndrome" OR"Postviral FatigueSyndrome""Massage"[Mesh]) AND"TherapeuticTouch"[Mesh:NoExp]OR Therapeutic TouchOR Laying-on-of-Hands OR Reiki ORMassage OR ZoneTherap* OR Bodywork*OR Reflexology("Imagery(Psychotherapy)"[Mesh]OR Imagery OR"Guided Imagery" OR"Directed ReverieTherapy" OR HypnosesOR Mesmerism) OR"Hypnosis"[Mesh:NoExp] 23. Background Information Good Sources:1. Point-of-Care Tools2. Government Sites3. Google ScholarTerm/Concept Mining 24. Google vs. Google Scholar main purpose of is tohunt for text in Webpages Displays results basedon Page Rank Does not really coverinformation contained inlibrary catalogs, officialgovernment documents,phone books, etc. Indexes the full text ofscholarly literature across anarray of publishing formatsand disciplines Includes most peer-reviewed online journals ofEurope and Americaslargest scholarly publishers Tends to put weight oncitation counts whendisplaying search resultsFalagas, M. E., Pitsouni, E. I., Malietzis, G. A., & Pappas, G. (2008). Comparison of PubMed, scopus, web of science, and google scholar: Strengths and weaknesses The FASEB Journal :Official Publication of the Federation of American Societies for Experimental Biology, 22(2), 338-342. doi:10.1096/fj.07-9492LSFVine, #., & Rita. (2006). Google scholar Journal of the Medical Library Association, 94(1), 979.Wikipedia contributors.Google search Retrieved, 2012, 25. Step 2: Formulate Your Search Strategy 26. The Search Process Search Steps2.5. Evaluatethe Results6. Good Results = Use the Data Bad = Start Over3. Choose the appropriatedatabase(s) or resource foryour topic4. Perform theSearch1. Problem/ ConstructQuestionImage: http://evidencebasedhealth.blogspot.com/Formulate Your SearchStrategy Synonyms for Search Terms Subject Heading vs. Keyword Boolean Operators & Limits 27. DESCRIBE THEFOLLOWING ITEM 28. Keyword Also called natural language searching Search for words or phrases found in title, abstract, orother parts of articles Keyword searching used for New terminology Rare terms Other terms that have no related subject heading Spelling variations Truncation - Train* Trained, Trainer, Training, etc. Grouping Using Guided Imagery Use Quotation Marks Without Quotes AND Terms TogetherPerspectiveSynonyms 29. All searched when searching bykeyword 30. All Places that are searched whendoing a keyword search in PubMed 31. Pepsi CokePopSoda SodaPopSubject Headings/ Controlled Vocabulary Controlled Vocabulary Thesaurus Help to return results that directlyapply to subject of the search Hierarchy Tree Structure Broad Specific Minor / Major Heading Major Heading - Focuses your searchresults to returning articles thatspecifically address the topic PubMed have stars beside them CINAHL Divided into Major & MinorHeadings Scope Note Term DefinitionSoftDrink 32. May need to move backward in order to moveforward 33. Searched when searching with SubjectHeadings/ Controlled Vocabulary 34. Subject heading field in PubMed 35. Fibromyalgia Therapeutic Touch Guided Imagery"Fibromyalgia"[Majr] OR"Fatigue Syndrome,Chronic"[Majr]OR "Diffuse MyofascialPain Syndrome" OR"Fibromyalgia" OR"Fibromyalgia-FibromyostitisSyndrome" OR "ChronicFatigue Syndrome" OR"Chronic Fatigue andImmune DysfunctionSyndrome" OR"Postviral FatigueSyndrome""Massage"[Mesh]) AND"TherapeuticTouch"[Mesh:NoExp]OR Therapeutic TouchOR Laying-on-of-Hands OR Reiki ORMassage OR ZoneTherap* OR Bodywork*OR Reflexology("Imagery(Psychotherapy)"[Mesh]OR Imagery OR"Guided Imagery" OR"Directed ReverieTherapy" OR HypnosesOR Mesmerism) OR"Hypnosis"[Mesh:NoExp]Good Search Combination of SubjectHeadings and Keywords 36. Boolean Operators - AND