LIBRARY RESOURCES
EVIDENCE BASED PRACTICE
CLINICAL NURSE FELLOWSHIP PROGRAM
Michelle DeMars
Health Sciences Librarian
Michelle.DeMars@csulb.edu

BY THE END OF THIS
SESSION YOU WILL:
• Be able to identify the 5 stages of Evidence Based Practice
• Identify and develop PICOT questions
• Use keywords from your question to search the databases
• Refine search: limiters, Boolean operators, synonyms
• Know how to locate journal articles in databases
• Evaluate your results to find the best evidence available

THE 5 STAGES OF
EVIDENCE BASED PRACTICE
ASK
FIND
EVALUATE
APPLY
REVIEW

ASK:
DEVELOP A CLEARLY WORDED CLINICAL
QUESTION USING PICO(T)
The PICOT question format is a consistent "formula" for developing answerable, researchable questions.
P: Population/disease ( i.e. age, gender, ethnicity, with a certain disorder)
I : Intervention or Variable of Interest (disease, risk behavior, etc.)
C: Comparison: (could be a placebo or alternative treatment)
O: Outcome: (risk of disease)
T: Time: The time it takes to demonstrate an outcome (e.g. the time it takes to
achieve an outcome or how long participants are observed).
Note: Not every question will have an intervention (as in a meaning question) or time (when it is implied in
another part of the question) component.

PICO(T)
A concerned new mother comes in with her
premature infant. She is concerned about the baby’s
weight gain and growth. She wants to know if she
should start feeding her baby formula or just
continue with breastfeeding.
Patient, problem or population
Intervention
Comparison
Outcome
Premature Infants
Breastfeeding
Formula Feeding
Development/Growth

ASK YE SHALL FIND:
DIFFERENT TYPES OF CLINICAL QUESTIONS &
DIFFERENT TYPES OF STUDIES
In addition to composing a well-built clinical question,
one must keep in mind the type of question
and the type of study that would provide the best evidence
Most common types of questions Types of Studies
Diagnosis
How to select and interpret diagnositc tests
Therapy
How to select treatments that have more
benefit than risk
Prognosis
How to estimate a patient’s clinical course
over time
Etiology
How to identify causes for disease
Remember the higher up you go on the pyramid the more rigorous the studies are and often have less bias.

FIND:
SEARCHING FOR THE EVIDENCE
• Use keywords from your PICOT question to search the
databases
• Determine the level of evidence that best answers the question
• Select relevant databases to search
• Refine search: subject headings, Boolean operators, limit your
results

SEARCH AND
EVALUATEUse Databases like PubMed, CINAHL and Cochrane to find the best evidence

TODAY WE LEARNED
To identify the 5 stages of Evidence Based Practice
• To identify and develop PICOT questions
• To use keywords from your question to search the databases
• To refine search: limiters, Boolean operators, synonyms
• To know how to locate journal articles in databases
• To evaluate your results to find the best evidence available

THANK YOU!
MICHELLE M. DEMARS
HEALTH SCIENCES LIBRARIAN
MICHELLE.DEMARS@CSULB.EDU

RESOURCES FOR FURTHER
RESEARCH
Duke University Library EBP Page:
http://guides.mclibrary.duke.edu/content.php?pid=274373&sid=2289252
http://guides.mclibrary.duke.edu/c.php?g=158201&p=1036074
Worksheet Examples
http://www.cebm.net/index.aspx?o=1157 (Centre for Evidence-Based
Medicine)
http://tinyurl.com/82zmjlw (Duke University Medical Center Library)

COCHRANE LIBRARY
Collection of six databases that contain different types of high-quality, independent
evidence to inform healthcare decision-making, and a seventh database that
provides information about groups in The Cochrane Collaboration.
• Cochrane Database of Systematic Reviews
• Cochrane Central Register of Controlled Trials
• Cochrane Methodology Register
• Database of Abstracts of Reviews of Effects
• Health Technology Assessment Database
• NHS Economic Evaluation Database
• About The Cochrane Collaboration