● Have we critically analyzed the literature? ● Have we cited and discussed study findings contrary to our perspectives? In the example about bladder training, researchers would use such words as “stroke,” with “bladder training” and “urinary incontinence” being typed as a subcategory under “stroke.” Researchers must decide on age parameters: if they are going to exclude any coexisting problems, such as Alzheimer’s disease; and if they are going to study both men and women. The search can be narrowed by asking the following questions (Polit & Beck, 2022): Assessing credibility of the literature Because many resources are now published exclusively on the Internet, it is vital to critique these resources. Here are some questions to ask to help in the critique of Internet resources (Polit & Beck, 2022): ● What are the author’s credentials? Are they listed? Are the credentials appropriate for the material they have written? ● Is the author’s contact information provided? ● Are references listed? Are they credible? Are they current? ● When was the website created? How and when is the site updated? ● Is any website sponsorship clearly stated? Funding sources must be identified. ● Does the website contain advertising? If so, is it separate from the scholarly material? ● Is information objective and free from bias? ● Does the website provide contact information if technical assistance is needed? ● Is a privacy statement available? Any information requested by users of the website should be protected by a privacy statement. Finding a search engine One of the first questions nurses should ask when embarking on a search for evidence in the literature is where can relevant research articles be found? The following are helpful search engines for sources of EBP nursing research articles: ● Agency for Health Research and Quality (AHRQ) : This agency is a free source of government documents for researchers: http://www.ahrq.gov ● The Cumulative Index to Nursing and Allied Health Literature (CINAHL) : This site provides indexing of nursing and allied health literature that covers a wide range of topics. Included in the database are nursing journals and publications, books, nursing dissertations, standards of practice, selected conference proceedings, book chapters, and audiovisuals: https://www.ebscohost.com/nursing/ products/cinahl-databases/cinahl-complete ● Cochrane Collaboration : This resource provides access to abstracts from the Cochrane Database of Systematic Reviews: http://www.cochrane.org ● EBSCO Host : EBSCO Information Services provides information from e-journals, e-books, and research databases: http://www.ebsco.com ● JBI EBP Database : Membership is required to access this resource. It provides recommended links and descriptions of levels of evidence of articles: http://joannabriggs.org/ Levels of evidence It is important to determine which level of evidence the research article provides when critiquing research studies. Levels of evidence are organized into a ranking system to describe the strength of the results measured in research studies. Level I is the strongest form of evidence and Level VII is the weakest (Melnyk & Fineout-Overholt, 2019): ● Level I : Evidence is gathered from a systematic review of all relevant randomized controlled trials (RCTs) or evidence- based clinical practice guidelines based on systematic reviews.
● Who are the patients to be studied? ● What is the problem? ● When does the problem occur? ● Why does it need to be studied?
Researchers can access search engines by using such terms as “bladder retraining in female stroke patients over the age of 65” and “urinary incontinence in female stroke patients over the age of 65”. This would limit the study to females of a certain age. If researchers wanted to study both men and women, the researcher would include the term “male” in the parameters or delete the term “female.” ● What is the purpose of the website? Is it primarily scholarly, informative, or entertaining? Scholarly sources are typically at least 5 pages long and usually longer. The articles usually have an abstract and a specific outline to the article: introduction (background), presentation of the problem, how the problem is going to be studied, findings, analysis, and recommendations. Scholarly web sources typically end in .edu or .org. Websites ending in .com and .gov are not typically the location to find scholarly articles. Google Scholar is a good place to start looking for information in databases if the researcher is not attached to a university and does not have access to their databases. Nursing consideration: Many websites have a link called “About Us”. This link generally describes the persons responsible for the site and those who contribute scholarly information. This description should include credentials and contact information. Nurses must always be aware of author credentials when conducting a literature review (Polit & Beck, 2022). ● National Library of Medicine and the National Institutes of Health MEDLINE and PubMed Resources Guide : This resource contains journal citations and abstracts for biomedical literature from around the world: http://www.nlm. nih.gov/bsd/pmresources.html ● ProQuest Nursing & Allied Health Source : Designed to meet needs of researchers at healthcare facilities and nursing and allied health programs at academic institutes, its database offers abstracting and indexing for thousands of titles and full-text dissertations: http://www.proquest.com/ products-services/pq_nursingahs_shtml.html ● PubMed : This site comprises more than 22 million citations for biomedical literature from MEDLINE: http://www.ncbi. nlm.nih.gov/pubmed ● Turning Research into Practice : This site provides a wide sampling of available evidence from a variety of free online resources: http://www.tripdatabase.com ● Virginia Henderson International Nursing Library : This service is free of charge and helps nurses to locate conference abstracts and research study abstracts. It is supported by Sigma Theta Tau International: http://www. nursinglibrary.org ● Level II : Evidence is gathered from at least one well- designed RCT. ● Level III : Evidence is gathered from well-designed controlled trials without randomization, a quasi-experimental study. ● Level IV : Evidence is gathered from well-designed case- control and cohort studies. ● Level V : Evidence is gathered from systematic reviews of descriptive and qualitative studies. ● Level VI : Evidence is gathered from a single descriptive or qualitative study.
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