Need help? Consult this PICO handout and presentation slides.
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PICO is an acronym used for exploring clinical questions. It serves as a framework for evidence-based practice.
P (Problem/Population) |
I (Intervention) |
C (Comparison) |
O (Outcome) |
|
---|---|---|---|---|
Example 1 | Infants in the NICU | cup feeding | tube feedings | greater reported success with breastfeeding post-discharge |
Example 2 | men over age 65 | daily 30 minute exercise regimen | no exercise regimen | reduce the future risk of cardiac arrest |
Example 3 | women ages 25-40 | who take oral contraceptives | who use IUDs for contraception | greater risk for developing blood clots |
Example 4 | adults 65 years and older | influenza vaccine | no vaccine | influence the risk of developing pneumonia |
Search keywords using the Advanced Search.
STEP 1) Brainstorm Keywords: Pull keywords from your PICO questions. Think about synonyms. Use “or” in between synonyms in the search boxes.
Example: P = Accidental falls in hospitals, adults aged 65+ years
I = Walking aids, assistive devices
C = Non-skid footwear
O = Reduce fall risk
Now it's your turn to brainstorm keywords for your search.
NURS 310 - Activity 1: Brainstorm your keywords Write your PICO question: ___________________________________________________________________________ ___________________________________________________________________________
Write down potential keywords and synonyms for your intervention:
1st ______________________ or _______________________ or ____________________
2nd ______________________ or _______________________ or ____________________
3rd ______________________ or _______________________ or ____________________
If you have a comparison intervention, brainstorm keywords for it here:
______________________ or _______________________ or ____________________
STEP 2) Perform an Advanced Search using keywords. You may need to perform at least two searches: one search for the intervention and another search for the comparison intervention.
NURS 310 - Activity 2: Advanced Search in CINAHL
Perform an Advanced Search using your keywords.
How many results (yields, hits) did you initially get? ________________________
Now narrow on the left side using the Refine Results column. What did you select to refine results for your topic?
______________________________________________________________________________________________
______________________________________________________________________________________________
How many results (yields, hits) do you have now? _______________________
Email yourself potential articles you can use. Remember to select APA citation.
Search CINAHL Subject Headings to find controlled vocabulary used in the database. Then perform a subject heading search using your Search History.
STEP 1) Start a CINAHL Subject Heading search
Click on "New Search" to clear any previous search history.
Click on "CINAHL Subject Headings" located on the top blue navigation bar:
Type in one keyword. Make sure you're using Relevancy Ranked. Then click Browse.
Click on the keyword link to see an expanded list.
Review related terms and check off the words that best describe your keyword. I selected "Ambulation Aids" below. Click on the Scope icon for a definition of the term.
You'll see the blue Subheadings column on the right side of the page. For now, you can leave the default box for "Include All Subheadings" checked off.
You can also choose to select "Explode" (to expand) or "Major Concept" (only where the word is a major concept subject heading in an article) on the right side.
Then click the green Search Database button.
STEP 2) Repeat STEP 1 with another keyword.
Go back up to the top blue navigation bar, click on CINAHL Subject Headings and perform another CINAHL Subject Heading search. If you initially searched for an intervention (like I did above), then search for a keyword about your PICO problem or outcome. For example, I searched for accidental falls next.
STEP 3) Repeat STEP 1 with a third keyword (if necessary).
For example, I searched for hospital since my PICO population focused on patients in hospitals.
STEP 4) Combine Subject Headings in your Search History.
Under the Advanced Search boxes at the top of the page, click on the Search History link.
Now clear any words from the top three Advanced Search boxes. It may interfere with your search results.
You'll see all the searches you performed so far during your current CINAHL session.
Check off the CINAHL Subject Headings searches you created (STEPS 1, 2 and 3).
Then click on Search with AND button. This will combine all of your Subject Heading search results to get articles using the controlled vocabulary you selected in the database.
Click on View Results.
Then narrow on the left side by using the Refine Results column (by publication date, Academic Journals, etc.).
If you received no results, go back to the Search History page. Select a different search variation (select 2 instead of 3 terms) or perform another CINAHL Subject Heading search.
NURS 310 - Activity 3: CINAHL Subject Headings
Perform two-four CINAHL Subject Heading searches. Start with the keywords you brainstormed.
What CINAHL Subject Headings did you come up with? ___________________________________________________
_________________________________________________________________________________________________
__________________________________________________________________________________________________
Combine CINAHL Subject Heading in your Search History.
How many results (yields, hits) did you initially get? ________________________
Email yourself potential articles you can use. Remember to select APA format for your citation.
For the level of evidence, you want to determine the type of study design for each article.
See the Types of Study Design definitions on the right side of this Level of Evidence LibGuide (from Ascension Library Services).
How can you determine the type of study? Read the Methods/Methodology section of the article and compare it to the type of study design definitions.
Some article records in CINAHL will list the type of study. Look for the Publication Type line. Example:
For NURS 310 and NURS 412 PICO Papers, you CAN NOT use the article type Systematic Review or Meta-Analysis.