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Nursing - Forming Focused Questions Using PICO

Library resources for the Department of Nursing

You have already learned that PICO is a formula. When planning your search strategy, you again utilize the PICO formula. The intervention takes the center stage, as it is the FOCUS of the search.

Starting with the Intervention, you will know that the results list will address that concept at least in the title or abstract.

If you cannot find articles with that intervention, try using other terms with the same meaning. If that does not work, you may have found a gap in the evidence, but check with the librarian for additional help.

One thing to keep in mind is that databases are very different from Internet browsers such as Google. The database platform (the programming used to locate and display the content of the database) usually includes ways to search using boolean logic, a controlled vocabulary, and limiters such as Ages and Publication Types. Utilizing these features take some planning before beginning the search, but will result in a more focused, relevant retrieval. This will save you considerable time when evaluating the search results.

Where to Search

Can you find...



Evidence based research

Yes! The Clinical Queries page provides PubMed specialized searches. Search…

  • by clinical study category

  • for systematic review

  • for medical genetics

Yes! There is a limit on the Advanced Search screen for Evidence-based Practice.

Patient education / Health Promotion material

Yes!  There are subject headings [MeSH terms] for…

  • “patient education”

  • “health promotion”

  • other related concepts

Yes!   There are CINAHL subject headings for…

  • “patient education”

  • “health promotion”

  • other related concepts

Can you…

Save Searches

Yes!  The MyNCBI feature can save searches and citations.

Yes!  The MyEbsco feature can save searches.

Get email alerts

Yes!  with the MyNCBI feature

Yes!  with the MyEbsco feature

Export citations to AcademicWriter




Librarian Tips

Phrase Searching " "

When multiple words are placed  in a single search box, a database search engine will do one of two things--by default, the search engine will either:

1.  Search for those words as a phrase. Meaning it will search for them side-by-side, next to each other and in that exact order ONLY,


2.  Automatically place an implied Boolean `AND` between the words and search for each word separately. It will retrieve only articles that contain both words, including those that are next to each other...but in addition it will also retrieve articles where the words are found separately in different places within the article.

By default, most of the library databases will search for multiple words as a phrase. On the other hand Google and most online search engines will insert the implied AND between each word. To remedy this problem, try using double quotation marks around the phrase you want to search "infection control" and place a Boolean `AND` between words if you wish to search for them separately, "hand washing" AND "infection control." 


An asterisk can be used in many databases as a truncation symbol. With it your search will retrieve a root word with multiple endings: child* will find child, children, childhood, etc.

Parentheses ( ) 

Parentheses nest words so the database searches them in the right order:  “infection control” AND (handwashing OR “hand washing”) tells the database to look for the words in ( ) first and then to combine that set with "infection control."

When looking for books or articles try to narrow down your keywords. For example: search the terms hand washing AND infections. The results returned will have all of the terms hand washing and infections somewhere in the citation.  Look for the hyperlinked subject terms to lead you to more items with this same subject; for example Professional Compliance  AND handwashing are subject terms--Controlled vocabulary supplied by the database, MeSH. The results should be more exact  on your topic which means less searching.

Combine terms with AND, OR, NOT, NEAR:  

  • hand washing AND infection control → Narrow results (Reduces the number of search results by requiring both terms to appear in the article)
  • handwashing OR hand washing → Broad results (Expands the number of search results by expanding the possible matches to include either one or the other term, or both)
  • handwashing NOT soap → Narrow results (Reduces search results to omit references to articles with certain words that have nothing to do with your topic)
  • hand NEAR washing → Narrow results (Reduces search results by requiring two words to appear near one another in the articles)

Putting it all together...

Put it all together to make a sophisticated search: (handwashing OR hand washing) AND (infection control)