Using Guide on the Side (GotS)
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1. Understand PubMed's scope and content.
2. Perform a simple subject search to find relevant material.
3. Apply PubMed filters.
4. Conduct a Clinical Queries search to find systematic reviews.
5. Find and use the Nursing Journals collection
This continuing nursing education activity has been approved by the Montana Nurses Association for .9 contact hours. Montana Nurses Association is accredited as an approver of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.
For more information regarding contact hours, please call Kathy Murray, 907-786-1611.
To receive a completion certificate, learners must answer all the questions posed throughout the tutorial.
PubMed is a free online collection of article citations, often with abstracts, from the National Library of Medicine. PubMed includes descriptions of more than 25 million articles in the biomedical literature.
Journal publishers decide whether the articles are available for free or at a cost.
Begin your PubMed search from the Alaska Medical Library's home page:
PubMed is the first link in the left column.
The Alaskan flag (red arrow) is shown when the article is free to anyone living in Alaska.
What is in PubMed?
1. Create a well-defined clinical question.
2. Identify the key terms in your question using PICO.
3. Execute a simple subject search.
PICO is an acronym to help formulate a clinical question and guide your search for evidence. Using this format can help find the best evidence available in a quicker, more efficient manner.
Open this PICOS Worksheet to help develop a search strategy.
Today we will apply PICO to this scenario to formulate a clinical question.
You have noticed that physicians in your office recommend exercise to patients age 65 and older who have high blood pressure. You wonder if the patients will follow this recommendation after overhearing a patient tell his spouse that he does not know how exercise will help.
You are considering whether creating handouts and holding classes on the benefits of physical activity might encourage patients to exercise.
Using PICO, the Patient or Problem is Patients age 65 and older with high blood pressure. The Intervention is Patient Education. The Comparison is no patient education. The Outcome is patient participation in exercise.
PICO can also help identify keywords that could be used. The keywords for this question are:
To perform a simple subject search, enter the key terms with no punctuation or operators. Be as specific as possible.
Enter: high blood pressure patient education exercise
Notice that we are not including AND between the terms. PubMed will do this automatically.
The results are displayed in a list. Each entry lists the title, authors, name of the journal, date of publication, volume, issue, and page numbers. Click on the title of an article to see additional information, including the abstract.
To see how PubMed interprets the search, view the Search Details in the right column. Click See More to view the full Search Details.
PubMed maps the search terms to Medical Subject Headings, also known as MeSH. MeSH is a thesaurus of terms applied to articles in PubMed. These subject headings describe the concepts covered in the articles. MeSH improves your search by accounting for variations in language.
The Translation table shows that PubMed included
"hypertension" along with "high blood pressure". Both "patient education" and "exercise" are MeSH terms. If your search term does not map to a MeSH term or PubMed does not translate it how you expected, try the search again using a synonym.
Use this scenario to answer the following 4 questions.
An elementary school nurse has noticed an increase in unhealthy eating habits among the students in her school. She is interested in beginning a health promotion program in her school to promote healthy eating.
Identify the PICO elements in this scenario.
What is the clinical question for this scenario?
Answer. This question could be answered using either students OR schools. Try both.
Conduct this search in PubMed.
How many articles did you find?
Which of the following are MeSH terms?
Translation Table for this Search.
Using filters can help narrow your search to the most relevant results. PubMed's list of filters is in the left column of the results page.
Enter these search terms into the PubMed Search box:
patient education hypertension
How many articles did you get?
PubMed includes publications in the fields of veterinary medicine and clinical and basic science research. It also includes journals from all over the world. Knowing this, the first two filters to apply are Humans and English. Notice that there is no filter for languages. Click Show Additional Filters at the bottom of the left column. Click Languages, Ages, and Publication date.
Now that these options appear in the left column, choose the appropriate options: English, Aged: 65+ years, and publication date that is no more than 10 years old.
How many articles remain?
Depending on the topic you are searching, the currency of the results may be more or less important.
Another useful filter is to select the type of journals that have published the articles. Journal categories includes the option to limit to Nursing Journals. These articles are written from the nursing perspective.
Apply this filter.
ALL the filters will be applied to your searches until you remove them. To remove a filter, click on Clear to the right of the filter title. All filters can be removed by clicking on Clear All at the bottom of the left column.
Returning to our earlier question, enter this in the PubMed search box: (schools OR students) health promotion nutrition
Use filters to limit results to articles published in the last 5 years in Nursing journals. Limit the ages to 6-12 years.
Because PubMed is so large (over 25 million articles), it can be difficult to narrow your results to just those articles that are relevant to clinical questions.
The Clinical Queries were designed to help search the clinical literature and are useful when conducting evidence-based practice research.
The Clinical Queries apply built-in search filters. Click on Clinical Queries from the PubMed home page - found in the middle column under PubMed Tools.
Open the Clinical Queries page and enter the following in the search box:
hypertension exercise aged
How many systematic review articles were found?
The Systematic Reviews filter displays systematic reviews, other reviews, and guidelines. Systematic Reviews are useful in Evidence-Based Practice research because they evaluate the available evidence.
There are five study categories: Etiology, Diagnosis, Therapy, Prognosis, and Clinical prediction guides. Change the category to each of these options and read the titles of the first five articles.
Which category seemed the most relevant?
When the Category is Therapy, approximately how many fewer articles are found when the Scope is set to Narrow vs. Broad?
1. Select Clinical Queries from the PubMed homepage.
2. Enter self care diabetes children in the search box and click search.
3. Review the articles listed under Systematic Reviews. Click See all to view all results in the normal PubMed display.
Find the article with the title "[Type 1 diabetes mellitus: evidence from the literature for appropriate management in children's perspective". This article is written in which language?
Article titles enclosed with [square brackets] will be in a foreign language. The abstract may be in English, but not the full text of the article.
PubMed citations are displayed in Summary format, 20 at a time, "last in, first out," except results that retrieve a single citation, which will display the Abstract view. You can change the display for all or selected citations by selecting a new display format from the Summary link.
Summary format: Short bibliographic citation.
Abstract format: Bibliographic citation plus abstract of the article and the first 5 Related Articles. Use also for links to full text.
After displaying your search results, view single records by clicking on the title of the article or mark a set of references by clicking on the boxes to the left of each citation. Click on the 20 per page link to increase the number of citations per page (up to 200). Use the Sort by Most Recent to change the sort the order of the citations displayed, e.g., by journal title instead of date.
Clipboard: Use the Send To link to place citations on the Clipboard, if desired, for later review. The Clipboard is a temporary holding file for all citations collected during your online session. The Clipboard will be lost after 8 hours of inactivity.
The Manage Filters link takes you to My NCBI, your personal space in PubMed where you can configure your results filters.
More information on how to search in PubMed is available in the freely available online guide. The Find Full Text includes tips for finding articles, as well as how to print, save, and email the results of a PubMed search.
How many systematic review articles did you find when looking for whether nurses workloads lead to medication error?
If you limit to the Nursing Journals collection, what happens?
You have completed the PubMed for Nurses tutorial.
You may want to review using My NCBI - this tool is used to set your preferences when searching in PubMed, allows saving searches and creating alerts for new articles, and permits creating Collections of articles on a particular clinical or research topic.
To get credit for this tutorial:
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Adapted from PubMed for Nurses Online Training, created by Megan Kellner.
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