NURS 660: Planning for Evidence-Based Practice: Finding Sources

Developing Your Search

In your previous courses, we've discussed the concept of using keywords to search for information.  Most library databases don't do well when you type in your whole question, like, "Does follow-up care positively impact the health of patients with diabetes?", so you've been taught to identify keywords using the following method:

1. Identify your research topic (Does follow-up care positively impact the health of patients with diabetes?)
2. Identify the major concepts in your topic (diabetic patients and follow-up care)
3. Develop keywords related to the major concepts and search for them (diabetes AND follow-up care)
4. If you don't get enough results, think of synonyms that may also describe those concepts (Type I diabetes, care plan)
5. Search again with the synonyms (Type I diabetes AND follow-up care, diabetes AND care plan)

When searching for EBP information, the same basic principles will apply, but your questions tend to be more complex.  We often use the PICO(T) process to develop research questions that can be answered with EBP materials.

The PICO(T) Question

PICO(T) is an acronym that stands for:

P - Population
I - Intervention
C - Comparison
O - Outcome
T - Time (not always a factor)

PICO(T) questions are more complex than a simple research question because they contain so many elements.  For example, if you tried to put the earlier example question into PICO(T) format, you'll find that several parts are missing:

"Does follow-up care positively impact the health of patients with diabetes?"
P - Patients with diabetes
Intervention - Follow-up care
Comparison - ?
Outcome - Positive impact on health
Time - ?

The example has no comparison or time, and "positive impact" is too vague to be an outcome.  To make this a PICO(T) question, you'd have to modify it into something like:

"For patients who experienced an incidence of diabetic ketoacidosis, does follow-up care reduce the number of return visits to the ER within the first year, compared with no follow-up care?"
P - Patients who experienced an incidence of diabetic ketoacidosis
Intervention - Follow-up care
Comparison - No follow-up care
Outcome - Lowered number of return visits
Time - 1 year after hospitalization

Once you've formatted your PICO(T) question, you can follow the same method from above to brainstorm keywords.

Searching with Keywords in OneSearch

OneSearch is a library search tool that looks in several (although not all) of our library databases, as well as our catalog.  OneSearch is multidisciplinary, meaning that if you search there, you will usually find many results from different fields and disciplines, including nursing:

Searching with Keywords in Databases

However, OneSearch may not be the best resource for a PICO(T) question because this type of information is very specific.  You're unlikely to find information about patients with diabetes in religion or military history databases, so OneSearch might not help you much.  Instead, try these databases that contain information about nursing, medicine, and healthcare management:

Trouble Searching?

Because PICO(T) questions are complex and specific and have many parts, it may be difficult to find articles and studies that discuss all the parts of your question.  Remember that the example question had five parts:

"For patients who experienced an incidence of diabetic ketoacidosis, does follow-up care reduce the number of return visits to the ER within the first year, compared with no follow-up care?"

If you're having trouble finding sources, try searching for two or three parts of your PICO(T) question at a time.  You may find articles about:

Search 1:

Search 2:

Search 3:

If you find multiple sources that address all the parts of your PICO(T) question, you can still use them, even if they don't address all the parts.