With a continuing increase in the volume of nursing information being published, there is a growing need to make that information accessible. One current directory of periodicals lists over 700 nursing journals and many more health care journals are potentially relevant (Ulrichs 2006). As we cannot read everything, we need to develop the information skills to identify and locate relevant documents when needed. There are some core information skills which can be applied across a range of publication formats and media.

Choosing the best sources is a skill acquired through familiarity with a range of nursing publications. For example, a pharmacopoeia might give sufficient information on a medication query; a review article summarising recent evidence-based research may be the solution to a clinical problem; guidelines for practice might be available on a reputable website. In other clinical and research contexts, there may be more complex problems to be solved and a more systematic search for information is needed. A literature review is conducted to create a picture of what is currently known about a problem situation and to identify what knowledge gaps may exist. Identifying pertinent studies, reviewing them and then clarifying the areas of further investigation all contribute to the development of research (Younger 2004).

Nursing information may be categorised according to the degree to which it is based upon empirical evidence from research or practice. Primary, research information derives mainly from original data collected and analysed in methodologically rigorous studies. Secondary information derives from authors presenting and discussing the work of others. Theoretical works contribute to other levels of knowledge building. Descriptive accounts and case reports may be valuable in presenting information on areas where there has been little or no formal research.

The impact of evidence-based medicine on nursing literature was noted by Morrisey and DeBourgh (2001), as was the subsequent drive to develop access to the literature among nurses. The growth of evidence-based practice has led to a clearer focus upon identifying specific types of scientifically sound studies in the literature. The study types concerned range from systematic reviews and randomised controlled trials to cohort and case studies. The Centre for Evidence Based Medicine at Oxford has a useful guide to the various levels of evidence in published research (Centre for Reviews and Dissemination 2005a) (Table 8.1).

Journals are now commonly published on the web, but searchers cannot rely on general web search engines to discover articles. Web search engines work well for general information but specialist bibliographic databases such as CINAHL (Cumulative Index to Nursing and Allied Health) and MEDLINE have been developed specifically to index journal articles. Human indexers evaluate the articles and add abstracts and subject information to aid the searcher in assessing the work described. Bibliographic databases are professional finding tools; however, they do not always include the complete full text of all articles indexed. Accessing the full text of articles is often another stage in the search process. Much will depend for instance upon whether an institution or a library has a subscription to a journal.

There are a significant number of nursing databases, each with a different coverage of nursing sources (Table 8.2). The journals included for indexing are selected by the database publishers; not all journals relevant to a particular sub-specialty or geographic area may be included in any one database. Morrisey and DeBourgh (2001) discuss the spread of nursing literature across medical, nursing and social science sources and they suggest that nurses must refine their literature search skills to improve effectiveness. Hek et al (2000) identified over 20 databases being used in some systematic reviews.

There is potential for some overlap between databases, but there may also be gaps; some databases will not index reports, books or theses. Newly published journals may publish on emerging issues but it may be some time before databases start indexing them. There are also access and subscription issues; many of the most important databases are offered by different vendors with various search interfaces and features. CINAHL for instance is available from publishers such as OVID, DIALOG and EBSCO.

The UK’s national gateway for nursing information, NMAP – Nursing, Midwifery and the Allied Health Professions (http://nmap.ac.uk), is a good source of information on health care resources.

Nursing dissertations are included in ProQuest’s Dissertations & Theses Database (http://www. proquest.com) and the Index to Theses (http://www.theses.com).

Searching is often an intuitive, iterative process with the results retrieved at each stage informing the steps used to proceed further. Searches on most systems can range from basic searches using a few keywords to more complex searches which use the many advanced search features. In the simplified record from CINAHL on the OVID system presented in Table 8.3 the words and phrases in the title, abstract and subject headings fields are the basis for successful search matches. If the system matches the search words with terms in article records, then these articles will be deemed to be relevant and will be presented in the results.