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Using CINAHL Ultimate's PICO Search Feature

Cochrane Library is a great place to find PICO questions. However, finding articles in Cochrane can be difficult if you already have a PICO question.

Instead, use CINAHL Ultimate to find articles related to your PICO question.

This quick guide will review how to search for a PICO question in CINAHL Ultimate from a librarian's point of view. You will see how one librarian starts, refines, and finalizes a search of this type.

For this example, the student provided this information about their PICO question:

P- Nurse burnout

I- self-interventions

C- work interventions

O- decreased burnout, staff retention, job satisfaction

Let's get started searching. Use the menu below to navigate quickly through the parts of this search.

Part 1: The First Search
Part 2: Evaluating the Search
Part 3: Finding an Article that's Not in the Database
Part 4: Using the Clues from Part 2 to Search Again
Part 5: Refining the Search Again

Part 1: The First Search

To start your search, open CINAHL Ultimate and click the PICOT search option (figure 1). Note: The T in PICOT stands for Time, which is usually optional.

Figure 1

first cinahl screen pointing to picot search

Once the form is open and you fill it out, click add to search, then click search again. See the filled-out form in Figure 2.

Figure 2

image of filled in PICOT search screen from CINAHL Ultimate

In this search, we didn't use full-text or peer-review limiters because we wanted to see our results first. The search only resulted in 49 articles that mostly failed to address the topic we wanted. It found articles on job burnout and reduced job satisfaction, but none addressed the interventions. The one article that fit some of our parameters was not full-text, so if we had narrowed it down, we would not have found it.

Part 2: Evaluating the Search

The resulting article has key clues that helped us think about the search differently (see Figure 3).

Figure 3

image of the results screen showing article with specific keywords highlighted

First, notice that this article uses the words self-care and improving, which suggests that we could try those words in our next attempt. Another clue is that this article came from Archives of Psychiatric Nursing, so we may want to include another database, APA PsycArticles, in a new search.

But first, let's see how we can locate this article outside of the CINAHL Ultimate database.

Part 3: Finding an Article that's Not in the Database

Figure 4

Before we start a new search, I want to click on the article title to view information about the article and the journal. Here's the link to the article so you can follow along as I explain the essential sections: https://research.ebsco.com/linkprocessor/plink?id=62dc95e1-2cdf-3b46-a98b-8759ea394733.

To access the article outside the database, use the DOI pictured at the bottom of Figure 4. The DOI is the Digital Object Identifier, which is assigned to articles so they are easier to find. Using this link, I found the article on the web for free.

Now, let's focus on the other information in Figure 4 and how it can enhance searches or create references.

The first thing you see is the article's full title, which is helpful for referencing.
Then, you see a list of authors. Each one is a link that will take you to other articles by that person. You also see little superscript numbers next to their names, leading you to their affiliation listed underneath.
The affiliation list corresponds to each author in the author list and tells you where they work or teach. This is helpful when evaluating the author's expertise and credibility.
The source section gives you the title of the journal along with the date of publication, volume, issue number, and page numbers. You will need this information when creating your references.
The Major and Minor Subjects list the major and minor areas the article covers. This is a good way to find new search terms and keywords for other searches. You can even click on the links to start a new search.
Finally, the Abstract is a summary of the article, which is a quick way to read the basics of the article to see if it will work for your paper.

Part 4: Using the Clues from Part 2 to Search Again

So now I'm going to focus on doing a new search. This Time, I will skip the PICOT search and do an Advanced Search instead.

Figure 5

image of CINAHL Ultimate Advanced Search feature

I will also click the database name and add APA PsycArticles to my search. The "1 more database" seen in Figure 6 is the APA PsycArticles database. So, I ran my search with the following terms: (burnout or retention or satisfaction) AND (nurses or nurse or nursing) AND (self care or "self care" or "self-care" or self interventions) AND (work interventions or employer interventions). Notice that I narrowed my search to peer-reviewed articles, but did not narrow it down by date. I always like to see everything when searching for my first new search.

Figure 6

image of advanced search

The search produced 17 results, most of which were not on target. One of the results was the one we found in Part 2. One other article worked, but unfortunately, it was from 2017 and was not within the required five-year time frame. See Figure 7.

Figure 7

article from 2017 with valid subject heading

Part 5: Refining the Search Again

Our search in part 4 was unsuccessful, but we found an older article we need for our paper. Figure 7 shows a Major Subject that might fit the parameters. Clicking on the "Prevention and Control" part of the major subject, our results look like this (Figure 8).

Figure 8

This is a pretty effective search in that it specifically searches for prevention and control of occupational stress, which we need. However, this is searching two databases (APA PsycArticles and CINAHL Ultimate) for the topic across all jobs/industries. Thus, you get the article in Figure 8 for anesthesia students.

Because we have close to 2000 results, we can narrow this search to see if we can find more articles. To do this, click on Advanced Search again.

Figure 9

image of Major Subject Search with profession limiters

Figure 9 shows the new search. As you can see, we're searching the same two databases, but we will add the profession (nurse, nursing, or nurses) in the second box. This search narrowed the results down to 977. Because of the number of articles, I also applied the Publication Date filter and selected "Past 5 Years," which reduced the results to 306 (Figure 10).

Figure 10

search results for Major Subject Search with profession limiters and past 5 year filter

After finding fewer results, the next step is to look through the results and see if the search was successful. This Time, the search produced more articles dealing directly with the topic.

After reviewing all the articles, I tried one final search to see if I got better results, see Figure 11.

Figure 11

Search Results

In this search, I added various forms of intervention to my advanced search. I also narrowed the search to the past 5 years. This produced 132 results, which were more on point than the rest of the articles I found.

Unfortunately, there are no articles that address this PICO question exactly, but that is not necessarily a bad thing. Not finding articles that fit exactly means that if you were doing this research as a professional nurse, you would add new information to the nursing discipline.