Evidence-Based Practice for Nurses

that nurses need to be able to assist patients with their healthcare-information-
seeking behaviors. In a qualitative study, Cader (2013) identified six evaluative
tasks for nurses when evaluating WWW/Internet resources:

» Assessing user-friendliness of web pages

» Assessing the outlook of web pages

» Assessing authority of web pages

» Assessing relationship to nursing practice

» Appraising the nature of evidence

» Applying cross-checking strategies

In other words, if you discover a piece of evidence that is not confirmed in
any other sources and is never mentioned as new, foundational, or ground-
breaking, the information may be questionable. The complexity and amount
of healthcare-related information available to both professionals and patients
are staggering. Nursing professionals will do well to assess such information
in a consistent and contextual manner, much as the practice followed in
patient assessment.

Formulating a Search Strategy

Creating a plan for searching by combining the suggestions offered in this
chapter about where and how to search is wise. Begin by planning the order
of databases that will be searched and the key terms that will be used. Keeping
notes of the search is recommended, especially because key terms may vary
between databases (McGrath et al., 2012). Good notes can be invaluable when
there is a need to search in another database.

Searches are rarely completed in one sitting (McGrath et al., 2012); thus refer-
ring to notes during subsequent sessions can save time by avoiding duplication.
Time can also be used efficiently by saving the search results and having an
account for items obtained through interlibrary loan. It is also possible to set up
an automatic, periodic search whereby alerts are sent directly to your account.

Mastering the skill of searching databases is important to assure that you have
found the best evidence for a PICOT question. It is helpful to use a planned,
systematic approach. A worksheet (see Exhibit 4-1) assures that a systematic
approach is used because each step is documented. It is also helpful because
sometimes a search cannot be completed in one sitting. Having a record will
be beneficial when you resume the search at a later time. If you encounter dif-
ficulties during the search, it will be easier for a librarian to provide assistance.
Having a record of the systematic search can save time and effort if you need
to retrieve one of the sources at a later time.

Before entering words into a database, it is helpful to reflect on which words
are key to the search. Using components of the PICOT question is a good place

4.4 How to Search for Evidence 119