Evidence Based Practice (92790) Library Session ‘Finding the evidence’

Practice scenarios for:

1. developing a searchable question using PICO or PS framework

2. developing key search terms

3. performing a database search

Scenario 1: Tooth brushing

You are thinking about purchasing a new electric toothbrush for a family member. There are some nice new ones on the market, available to purchase at your local electrical store. They boast of patent oscillating action, and that they are highly effective in the removal of plaque. However, they are quite costly, with the top of the range being $300. You query the cost involved, and wonder if they are really any better than a manual toothbrush at a fraction of the price, from your local super market. In making your choice, you decide to review the available evidence.

Scenario 2: Nurse Led Models of Chronic Care Management in Primary Care

Within your role, you have the opportunity to advise as a consultant towards a primary care service redesign project. Currently, there are few nurse-led clinics for chronic care management. Availability of these programs is mixed throughout your local health district, and there have been lots of attention in reducing the burden placed on general practitioners in primary care. You have worked in primary care for a while, and understand how complex individuals living with chronic conditions like chronic heart failure, asthma, atrial fibrillation and diabetes can be. Some local clinicians are keen to get nurse led chronic heart failure clinics up and running; however there has been some opposition to this. You recognise that you need to be better informed on the benefits of these nurse-led clinics, so you decide to consult the evidence, of how these may impact patient outcomes including hospitalisations and mortality.

Scenario 3: Pressure relieving mattress equipment

There are a range of pressure area relieving devices on the market. These include alternating pressure relief mattresses including ‘AutoExcel’ and ‘Nimbus III’. These mattresses range in specification and superiority and are used for different clinical indications. Nurses are responsible for ensuring patients are cared for on an appropriate type of bed and mattress. You are working as the health service manager at a Sydney metropolitan teaching hospital. You notice that the expenditure for the hire of top grade pressure relieving mattresses is increasing. You discuss this with the nurse unit manager, who explained that they had seen an increase in patient complexity and rates of pressure ulcers, and the increase was warranted. You want to gain better insight into the different specifications of mattress, and review the evidence that supports their use for treating pressure ulcers.

TASK 1: For each of the above scenarios, find a randomised controlled trial and a systematic review applicable to inform decision making in each scenario.

Caleb Ferguson, Evidence Based Practice (92790) Autumn 2015. You are required to gain experience in using the following 3 electronic databases: Medline, CINAHL and Scopus.

Caleb Ferguson, Evidence Based Practice (92790) Autumn 2015.