Step 2: Searching for Available Literature

Step 2: Searching for Available Literature After asking the PICO question for nursing, you should proceed to looking for appropriate literature. This is the second step in EBP and entails searching available materials for respective evidence. In this step, you should use the PICOT question components to help identify the search terms instrumental to your search strategy. This is as illustrated below.  

	Search terms	Alternatives
	The elderly Cholinesterase	Geriatric, aged, old, etc. Memantine
Patient
Intervention
Comparison
Outcomes

  The search should utilize the different PICOT elements. This search should involve both internal evidence (practice data in healthcare records) and external evidence (journal articles). Notably, there are two major categories of external evidence that include 1) textbooks and journals and 2) consolidated resources. Journal articles could be searched through numerous journal articles websites like Google Scholar, JSTOR, and Bioline International. On the other hand, consolidate resources (databases) may include CINAHL, MEDLINE, and PsycINFO. As earlier noted, the search process should involve a combination of the PICOT elements, where you should employ the Boolean operators “OR” and “AND to control the search results. While “OR” will stretch your search by producing results for either of the terms derived from the PICOT elements, “AND” will restrict the search by producing results containing the two terms.     Step 3: Appraising Literature for Evidence This step requires you to evaluate the articles found through the search process to determine whether they are good for use in clinical practice, not good for use in clinical practice, or okay but containing some limitations that require discretion when applying the results in clinical practice. As such, critical appraisal seeks to determine whether the research in the articles is accurate, reliable, and applicable.   Usually, critical appraisals look at 3 key areas that include: 1. Whether it is worth looking at the study’s results. 2. What the results are. 3. Whether the results are relevant to the patients under treatment.   Whether it is worth looking at the study’s results This part of the appraisal examines key areas that encompass: 1. Why the study was done. 2. What the research question was. 3. What study design type was used, and whether it was the most appropriate for entailed research question. 4. What the study characteristics are, and whether they are compatible with the entailed research question. 5. Whether the results are valid (presence of potential research biases and their impact on the results).   What the results are This part of the appraisal looks at different issues, including: 1. Whether the outcome measures used in the study are relevant and comprehensive. 2. What the size of the “results effect” is. 3. What the precision of the “results effect” is.   Whether the results are relevant to the patients under treatment This part of the appraisal looks at whether the study results could be generalized effectively for proper application in the current clinical practice. It looks at key issues like: 1. Whether similar definitions are applicable. 2. Whether a similar patient population is used. 3. Whether similar protocols can be followed. 4. Whether the health systems are similar.  

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