• Evidence-based Practice Tutorial for Nurses from Penn State University Libraries. Includes basic PICO concepts, audio clips, and links to library and free-web sources for evidence.

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Scenarios wanted! Please add your favorites! [Click on "Easy Edit", above]

Information about each scenario can include, but need not be limited to:

• the case
  
• the PICO'd question
  
• type of question/preferred study design
• suggested search strategies
• teaching tips

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Case: You are a recent graduate of the School of Nursing and are being oriented to your new position on a cardiothoracic stepdown unit at another hospital. In hopes of improving patient outcomes, bringing down postoperative complication and mortality rates, and decreasing length of stay in the hospital, the unit is investigating changing its practices in order to improve glycemic control in cardiac surgery patients. There has been growing concern among nurses and physicians over the association between poor glycemic control and poor outcomes following cardiac surgery (in non-diabetic as well as diabetic patients). The nurse manager has asked you to do a literature search on the topic and give a presentation at the next in-service conference.

P heart surgery
I glycemic control
C
O improving patient outcomes, bringing down postoperative complication and mortality rates, and decreasing length of stay in the hospital
T therapy
T RCT

SEARCH Strategy:heart surgery AND (glycemic control OR "Blood Glucose"[MeSH] OR ("Hyperglycemia/diet therapy"[MeSH] OR "Hyperglycemia/drug therapy"[MeSH] OR "Hyperglycemia/nursing"[MeSH] OR "Hyperglycemia/prevention and control"[MeSH] OR "Hyperglycemia/therapy"[MeSH] ) OR "Insulin"[MeSH])
limit to: sys review, pub dates desired, nursing journals, age, etc

TEACHING Tips: cardiac surgery maps to thoracic surgery, which isn't really the topic, using heart surgery will map you to both thoracic and cardiac surgical procedures; go to the MeSH Database and type in glycemic to search for relevant terms

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Case: Find articles discussing patient safety issues related to hand off situations (shift changes, patient transfers, etc).

SEARCH Strategy: (CINAHL) (patient safety AND (hand off or handoff or shift change)) OR (MH "Patient Safety+" AND (MH "Shift Reports" OR MH "Transfer, Intrahospital"))

TEACHING Tips: Use combination of keywords and CINAHL headings to get at this topic, searching for hand off in the CINAHL heading Database won't give you anything so switch to shift change, searching for patient transfer will show you intrahospital transfers
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