1. In Search of Evidence
Teresa Hartman, MLS / Associate Professor
Head, Education Department, UNMC McGoogan Library of Medicine
Quarterly Updates
Evidence-Based Practice for Public
Health Nurses
Session II
November 4, 2008
Objectives PICO Question 1
• Demonstrate searching for evidence for PICO For the 4 year old pre-K age group, are
question. there fewer injection site complications
with giving the immunizations in the thigh
• Explain resources available to search for as compared to giving the immunizations
evidence related to PICO questions for public in the arm?
health nurses in Nebraska, including methods to
order articles if not available online. P preschool children, pre-K, 4 years old
I injection in thigh
• Describe services provided by McGoogan C injection in arm
Library and the National Library of Medicine O fewer site complications
You could start with a simple text word search in PubMed
Question 1:Searching PubMed
MeSH = Medical Subject Headings: these are the
terms that the over 18 million citations are
indexed by in the database.
MeSH terms used for Question 1 (access the link
on the left hand blue PubMed sidebar, under
PubMed Services, and search terms like you do
using a dictionary):
“Child, preschool”[MeSH] “Injections ”[MeSH]
“Vaccination ”[MeSH] “Immunization ”[MeSH]
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2. Type in a term you are searching for – example, preschool.
To search for MeSH terms, click on the
MeSH database link on the left side of PubMed screen.
Check the results to see if any of them fit your search. Click on the box Note: PubMed and MeSH tutorials: http://www.nlm.nih.gov/bsd/disted/pubmed.html
next to it, then click on Send To, and select Search Box with And.
The term will be added automatically to a new box that appears on the next screen.
Now, search for your next term – example ‘injections’ After clicking on the box next to Injections, and then the Send to
drop down menu and selecting Search Box with And,
this is how your screen should look. Click on Search PubMed to run the search.
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3. You can also use Clinical Queries to search for evidence. Type in text words – example: preschool injections thigh
What other complications than ‘pain’ are you searching for?
Question 1: Searching PubMed
Clinical Queries – Find Systematic Reviews
(access the link on the left hand blue PubMed
sidebar, under PubMed Services):
Search terms used:
preschool injections thigh
Located: PMID 17473085
Note – could search by specific types of vaccine
injections, like chickenpox, to find out the best
method to reduce complications . Also, define
“complications”.
PICO Question 2 Question 2: Searching PubMed
For adults who are 21-50 years old, is there a MeSH terms used:
higher incidence of influenza vaccination with
those who attend a group education session “Adult”[MeSH] (equals age 19-40)
during pre-school and elementary parent- “Health education”[MeSH]
teacher conferences as compared to those who
did not attend? “Patient acceptance of health care”[MeSH]
P adults, aged 21-50 “Influenza vaccines”[MeSH]
I attended childhood education session on
benefits of flu vaccine Best results were retrieved with this search:
C did not attend childhood education sessions quot;Health Educationquot;[Mesh] AND quot;Patient
O more adults vaccinated Acceptance of Health Carequot;[Mesh] AND
quot;Influenza Vaccinesquot;[Mesh]
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4. Question 2: comments PICO Question 3
My questions – are there other public health issues For teenage mothers enrolled in a high school teen
that have been shown through established parenting class, are their children more current
research that they were changed/improved with immunization guidelines/schedules as
through education, during childhood or at other compared to children of teenage mothers who
times? (Would seat belt/helmet use be similar?) do not receive the education?
Maybe there is research in another area that P teenage mothers
could be applied to this question. Example: there I attended high school based parenting class
is a lot of research on health care professionals
(adults) and their compliance with flu shots C did not attend high school based parenting
(possibly related to preparations for pandemic class
flu prevention.) O children current on immunizations
Question 3: Searching PubMed PICO Question 4
MeSH search used: (quot;Childquot;[Mesh] OR For parents who receive SCHIP benefits and a nurse
quot;Child, Preschoolquot;[Mesh] OR provided telephone education intervention, are their
quot;Adolescentquot;[Mesh]) AND quot;Pregnancy in children more current with immunization
guidelines/schedule as compared to children of
Adolescencequot;[Mesh] AND parents who do not receive the education?
quot;Parentingquot;[Mesh] immuniz* (←this is a P parents/families receiving SCHIP benefits, state health
truncated text word) plans for uninsured children
Clicking on Related Articles for the first I nurse provided telephone education/intervention
C no nurse provided telephone education/intervention
citation retrieves promising citations that
O children current on immunizations
may lead to further MeSH terms to use
when conduct further searches.
Question 4: Searching PubMed Tips to improve searches
MeSH terms used: First and foremost: Use the expert librarians
“Telephone”[MeSH] “Nurse”[MeSH]
“State health plans”[MeSH] “Child”[MeSH]
at UNMC – we are here to serve you.
“Child, preschool”[MeSH] “Adolescent”[MeSH] Email askus@unmc.edu , or call toll-free
immuniz* (←this is a truncated text word) 1-866-800-5209 with your search
Note: I could not locate a mention in the research of an request. Put our graduate degrees and
SCHIP program that used nurse telephone
intervention/education (that does not mean it isn’t there – post-graduate education to work for your
just that I didn’t find one.). Only successful search was: information needs! (Plus, we can search
“State health plans”[MeSH] AND immuniz*, resulted in
33 citations. One citation appeared particularly useful: the CINAHL and Cochrane full-text
PMID 15867017 databases for you).
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5. Tips to improve searches Tips to improve searches
Start with a text word search, using Hone in on the results you need by using
synonyms for the terms you are looking Limits: limit to years published, humans,
for. Think like an author – what terms do language article is written in, and level of
you think they used when writing about research (note – you can limit too much):
– Clinical Trials
what you are hunting? Identify relevant
– Randomized Controlled Trials
citations; use the MeSH terms found on
– Practice Guideline
those citations to create more focused
– Meta-Analyses
searches
– Review
Tips to improve searches Tips to improve searches
Use the Clinical Queries/Systematic Limit results to free full text and McGoogan
Reviews search function to locate Library of Medicine holdings to your
“citations for systematic reviews, meta- search by adding this search term:
analyses, reviews of clinical trials,
evidence-based medicine, consensus AND (free full text[sb] OR loprovuneblib[sb])
development conferences, and
guidelines.”
Additional Resources
You can access tutorials and additional Questions?
resources on the blog that has been
created for this session: Call the Reference Desk:
Evidence Based Public Health •559-6221
Information Resources
http://ebpublichealth.blogspot.com/ •866-800-5209 (toll-free)
Email:
•askus@unmc.edu
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