AML: PubMed for Nurses

Open PubMed for Nurses in another browser window to work through this tutorial side by side.

Using Guide on the Side (GotS)

 This guide should be used simultaneously with the live website (on the right).

Use the arrows at the bottom to navigate the guide page by page.

The menu button (top right of guide) Menu button can be used to skip to any section of the guide.

Links to additional information appear throughout the guide.

Let's begin.

Disclaimer

Goals and Objectives

1 of 2By the end of this tutorial, learners should be able to:

1. Understand PubMed's scope and content.

2. Perform a simple subject search to find relevant material.

3. Apply PubMed filters.

4. Conduct a Clinical Queries search to find systematic reviews.

5. Find and use the Nursing Journals collection

 

Goals and Objectives

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This continuing nursing education activity has been approved by the Montana Nurses Association for .9 contact hours. Montana Nurses Association is accredited as an approver of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.

For more information regarding contact hours, please call Kathy Murray, 907-786-1611.

To receive a completion certificate, learners must answer all the questions posed throughout the tutorial.

What is PubMed?

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PubMed is a free online collection of article citations, often with abstracts, from the National Library of Medicine.  PubMed includes descriptions of more than 25 million articles in the biomedical literature.

Journal publishers decide whether the articles are available for free or at a cost.

Begin your PubMed search from the Alaska Medical Library's home page

PubMed Starting PointPubMed is the first link in the left column.

What is PubMed?

2 of 2Starting from the library's website, icons to full text articles paid for by the library or the State of Alaska are visible.  Links to full text that is freely available to all are also visible.  These links to free articles are on the upper right of the PubMed record. [Click on the image to make it larger]

Free Links

The Alaskan flag (red arrow) is shown when the article is free to anyone living in Alaska.

What is in PubMed?

Simple Subject Search

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Objectives:

1. Create a well-defined clinical question.

2. Identify the key terms in your question using PICO.

3. Execute a simple subject search.

Simple Subject Search

2 of 4Before opening a research tool, like PubMed, have a clear idea of the question you would like to answer. 

PICO is an acronym to help formulate a clinical question and guide your search for evidence.  Using this format can help find the best evidence available in a quicker, more efficient manner.

Open this PICOS Worksheet to help develop a search strategy.

Today we will apply PICO to this scenario to formulate a clinical question.

Simple Subject Search

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You have noticed that physicians in your office recommend exercise to patients age 65 and older who have high blood pressure.  You wonder if the patients will follow this recommendation after overhearing a patient tell his spouse that he does not know how exercise will help.

You are considering whether creating handouts and holding classes on the benefits of physical activity might encourage patients to exercise.

Using PICO, the Patient or Problem is Patients age 65 and older with high blood pressure.  The Intervention is Patient Education.  The Comparison is no patient education.  The Outcome is patient participation in exercise.

Simple Subject Search

4 of 4We can now develop the clinical question, "In patients age 65 and older with high blood pressure, does patient education compared to no patient education encourage exercise?"

Keywords

PICO can also help identify keywords that could be used.  The keywords for this question are:

  • high blood pressure
  • patient education
  • exercise

To perform a simple subject search, enter the key terms with no punctuation or operators.  Be as specific as possible.

Enter: high blood pressure patient education exercise

Notice that we are not including AND between the terms.  PubMed will do this automatically.

Automatic Term Mapping: Check Search Details

The results are displayed in a list.  Each entry lists the title, authors, name of the journal, date of publication, volume, issue, and page numbers.  Click on the title of an article to see additional information, including the abstract.

To see how PubMed interprets the search, view the Search Details in the right column.  Click See More to view the full Search Details.

Mapping

PubMed maps the search terms to Medical Subject Headings, also known as MeSH.  MeSH is a thesaurus of terms applied to articles in PubMed.  These subject headings describe the concepts covered in the articles.  MeSH improves your search by accounting for variations in language.

The Translation table shows that PubMed included

Translation

 "hypertension" along with "high blood pressure".  Both "patient education" and "exercise" are MeSH terms.  If your search term does not map to a MeSH term or PubMed does not translate it how you expected, try the search again using a synonym.

PICO Search

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Use this scenario to answer the following 4 questions.

An elementary school nurse has noticed an increase in unhealthy eating habits among the students in her school.  She is interested in beginning a health promotion program in her school to promote healthy eating.

Identify the PICO elements in this scenario.

 

 

Answer.

PICO Search

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Answer.  This question could be answered using either students OR schools.  Try both.

Conduct this search in PubMed

How many articles did you find?

PICO Search

3 of 3Check the search details to see how the search was mapped to MeSH. Tip: remember to click See more.

Which of the following are MeSH terms?

Translation Table for this Search.

 

Locating Filters

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Using filters can help narrow your search to the most relevant results.  PubMed's list of filters is in the left column of the results page.

Enter these search terms into the PubMed Search box:

patient education hypertension

How many articles did you get?

Locating Filters

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PubMed includes publications in the fields of veterinary medicine and clinical and basic science research.  It also includes journals from all over the world.  Knowing this, the first two filters to apply are Humans and English.  Notice that there is no filter for languages.  Click Show Additional Filters at the bottom of the left column.  Click Languages, Ages, and Publication date.

Now that these options appear in the left column, choose the appropriate options: English, Aged: 65+ years, and publication date that is no more than 10 years old.

How many articles remain?

Depending on the topic you are searching, the currency of the results may be more or less important.

Locating Filters

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Another useful filter is to select the type of journals that have published the articles.  Journal categories includes the option to limit to Nursing Journals.  These articles are written from the nursing perspective.

Apply this filter.

 

How many articles remain?

ALL the filters will be applied to your searches until you remove them.  To remove a filter, click on Clear to the right of the filter title.  All filters can be removed by clicking on Clear All at the bottom of the left column.

Exercise: Health promotion for healthy nutrition in schools

Returning to our earlier question, enter this in the PubMed search box: (schools OR students) health promotion nutrition

Use filters to limit results to articles published in the last 5 years in Nursing journals.  Limit the ages to 6-12 years.

How many articles did you find?

Clinical Queries

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Because PubMed is so large (over 25 million articles), it can be difficult to narrow your results to just those articles that are relevant to clinical questions.

The Clinical Queries were designed to help search the clinical literature and are useful when conducting evidence-based practice research. 

The Clinical Queries apply built-in search filters.  Click on Clinical Queries from the PubMed home page - found in the middle column under PubMed Tools.

Clinical Queries

2 of 4PubMed Clinical Queries contain three types of searches: Clinical Study Categories, Systematic Reviews, and Medical Genetics.  The rest of this tutorial will focus on the first two, which address evidence-based practice.

Open the Clinical Queries page and enter the following in the search box:

hypertension exercise aged

How many systematic review articles were found?

The Systematic Reviews filter displays systematic reviews, other reviews, and guidelines.  Systematic Reviews are useful in Evidence-Based Practice research because they evaluate the available evidence.

Clinical Queries

3 of 4The Clinical Studies column has two ways to adjust the search results: category or scope.

Clinical Study Categories

There are five study categories: Etiology, Diagnosis, Therapy, Prognosis, and Clinical prediction guides.  Change the category to each of these options and read the titles of the first five articles. 

Clinical Queries

4 of 4The Scope menu provides two options: Broad and Narrow.  A broad search retrieves more results, but some may not be very relevant.  The narrow search is more precise, so results will be more relevant, but some articles may be missed.  Try both. 

When the Category is Therapy, approximately how many fewer articles are found when the Scope is set to Narrow vs. Broad?

 

Exercise: Find systematic reviews on self care of diabetes among school age children

1. Select Clinical Queries from the PubMed homepage.

2. Enter self care diabetes children in the search box and click search.

3. Review the articles listed under Systematic Reviews.  Click See all to view all results in the normal PubMed display.

Find the article with the title "[Type 1 diabetes mellitus: evidence from the literature for appropriate management in children's perspective".  This article is written in which language?

Article titles enclosed with [square brackets] will be in a foreign language.  The abstract may be in English, but not the full text of the article.

Tips

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PubMed citations are displayed in Summary format, 20 at a time, "last in, first out," except results that retrieve a single citation, which will display the Abstract view. You can change the display for all or selected citations by selecting a new display format from the Summary link.

Summary View

Summary format: Short bibliographic citation.

Abstract format: Bibliographic citation plus abstract of the article and the first 5 Related Articles. Use also for links to full text.

After displaying your search results, view single records by clicking on the title of the article or mark a set of references by clicking on the boxes to the left of each citation. Click on the 20 per page link to increase the number of citations per page (up to 200).  Use the Sort by Most Recent to change the sort the order of the citations displayed, e.g., by journal title instead of date.

Tips

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Send To

Clipboard: Use the Send To link to place citations on the Clipboard, if desired, for later review. The Clipboard is a temporary holding file for all citations collected during your online session. The Clipboard will be lost after 8 hours of inactivity.

The Manage Filters link takes you to My NCBI, your personal space in PubMed where you can configure your results filters.

More information on how to search in PubMed is available in the freely available online guide.  The Find Full Text includes tips for finding articles, as well as how to print, save, and email the results of a PubMed search.

Tips

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Final question.

How many systematic review articles did you find when looking for whether nurses workloads lead to medication error?  

If you limit to the Nursing Journals collection, what happens?

The End

You have completed the PubMed for Nurses tutorial. 

You may want to review using My NCBI - this tool is used to set your preferences when searching in PubMed, allows saving searches and creating alerts for new articles, and permits creating Collections of articles on a particular clinical or research topic.

To get credit for this tutorial:

  • Students, include your name and email to kmurray10@alaska.edu
  • For practicing nurses, please be sure to include your name and email to receive your certificate of completion.

If you do not provide your email address on the next page:

  • Students will not receive credit for the assignment.
  • Practicing nurses will not receive a completion certificate.

Adapted from PubMed for Nurses Online Training, created by Megan Kellner.

Certificate

Please enter your name and email address to retrieve a copy of your completed quiz.

You can enter multiple email addresses separated by commas with no spaces. If you are doing this for a class, you may need to enter your instructor's email address also.