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Using Evidence Based Nursing in Practice
Step Two: Acquire
In this step, you will locate the highest quality, relevant information from the medical literature to answer your question. To do this, you need to select the databases and journals you will use to find the answer to your question. Information about these databases and journals is available in the EBN Databases and Journals section.
Some resources, such as the Cochrane databases are "prefiltered". This means that the authors of the database have already systematically reviewed the articles to make sure that they are relevant and of high quality. Systematic reviews are an overview of all of the evidence addressing a focused clinical question. Other resources, such as PubMed and CINAHL, are "unfiltered". This means that you conduct a search based on your question and filter through the results yourself.
You should examine your search strategy based on the tool you are using. Some databases, such as PubMed, have a controlled vocabulary. For example, instead of classifying "cancer", they classify "neoplasm". When using their controlled vocabulary, you may receive greater accuracy in terms or the topic on which you are searching. See our suggested PubMed Tutorials for assistance and more information.
PubMed (MEDLINE) search:
Let's perform a PubMed (MEDLINE) search to find articles related to the following situation:
You are a nursing administrator responsible for cutting the personnel budget with the least amount of impact on patient care. The question you are asking yourself is, "Will decreasing the number of RNs (versus unlicensed assistive personnel) have a low impact on patient care?"
To access PubMed, go to the Health Sciences Library website http://www.hsl.unc.edu. From there, click on the PubMed (MEDLINE) link. Accessing through this link both on campus and off campus (if connected through the proxy server) will allow you to access any of UNC's electronic journals and resources.
A possible set of search terms that could be used include: nurses' aides AND staffing AND patient outcomes Three of the resulting articles are listed below.
Needleman J, Buerhaus P, Mattke S, Stewart M, Zelevinsky K.
Nurse-staffing levels and the quality of care in hospitals.
N Engl J Med. 2002 May 30;346(22):1715-22.
Sovie MD, Jawad AF.
Hospital restructuring and its impact on outcomes: nursing staff regulations are premature.
J Nurs Adm. 2001 Dec;31(12):588-600.
Blegen MA, Vaughn T.
A multisite study of nurse staffing and patient occurrences.
Nurs Econ. 1998 Jul-Aug;16(4):196-203.