Midwives must ‘always practise in line with the best available evidence’ (Nursing and Midwifery Council (NMC), 2015a: 7) in order to provide safe and effective care. The purpose of the revised Code and revalidation is to ensure that midwives are basing their practice on the best available evidence thereby giving the public greater confidence in their fitness to practise and the quality of care they provide. Midwives will be required to undertake increased continuing professional development (CPD) (from 35 to 40 hours) and provide evidence of reflective practice (five reflective accounts) to maintain their professional registration (NMC, 2014; 2015a; 2015b). In reality, keeping up-to-date with developments and innovations in health can seem overwhelming, with a constant stream of research from across the world being published daily. Trying to search for, and access, the latest literature may seem an unrealistic expectation of busy midwives who are already juggling their work and home life.
Information overload?
Historically, midwives remained up-to-date by attending study days, reading journals and textbooks and practising according to national and local guidelines. With advances in technology, a wider range of resources has become available, such as online learning in the form of massive open online courses (MOOCs); open educational resources (OERs) and social media platforms (Power, 2014; Power and Coulson, 2015). Given that information is ubiquitous and plentiful, it can be even more difficult to access the quality literature and research that can help improve practice.
What are you looking for?
Table 1 shows some questions that are useful in framing a literature search and offering ideas on where to search.
| What is being looked for? | Information on breastfeeding and childhood obesity |
| What keywords can be used to search? | Breastfeeding, infant nutrition, obesity |
| Are there any other words that can be used? (consider medical terminology, abbreviations and alternative spellings) | Breastfeed, breastfed, infant feeding, health benefits, newborns |
| What type of information is needed? | Government guidelines and/or research from the UK |
An important strategy to successful literature searching is to keep it simple. Start with the main concept to look for relevant literature, then use other terms to help narrow the search. It may be difficult to obtain relevant results if only one keyword or phrase specific to the area of practice is used. Therefore, a few alternative keywords may yield positive results if the initial search does not prove fruitful. Use a few different terms, such as abbreviations, medical terminology, singular and plural spellings and lay terms in the search to ensure all possibilities are covered. This provides flexibility in order to adapt to find results. For example, searching for infant nutrition when looking for literature on the benefits of breastfeeding, will produce broader results.
Refining your search
Keywords or search terms can be combined using instructive words to help refine the search: AND, OR and NOT (Figure 1). This can help to focus and adapt the search depending on the results you get.
Using AND will only give results where both of terms are present. OR allows the search to be kept broad and to use terms that are synonymous with each other, for example, breastfeeding OR nutrition. Databases may also offer the option to exclude results from your search; this can be useful if results are obtained that were not intended. Therefore, prefacing the term with NOT will remove it from the search. It is also possible to do phrase searches to only provide results where the words that are used appear together. An example might be “infant nutrition”. The use of double quote marks acts as an instruction so results will only appear if the phrase is included in the text.
There is help available
Real world: The workplace
The literature searching strategies above should work for all types of search, whether looking for a book on a library catalogue, using Google or searching for research on a database. There is also help and support available through hospital libraries and professional organisations.
The Royal College of Midwives (RCM) has a library based in the Royal College of Obstetricians and Gynaecologists (RCOG) library in London. Although RCM members are welcome to visit the library, there is also plenty of support and resources available online (RCOG, 2015).
NHS employees can also access the hospital library resources. Full access to the print resources, as well access to the NHS core content can be obtained. The staff there can help with literature searching, critical appraisal training, send current awareness information and order resources through interlibrary loan. The NHS libraries can be a valuable support in helping keep up-to-date with current evidence in midwifery.
Web-based search engines
Table 2 lists web-based search engines that can give access to literature and research. The full text or just a reference and abstract may be obtained. If the full article is required, the local Trust or hospital library may be able to help with an interlibrary loan.
| NHS Evidence | https://www.evidence.nhs.uk/ |
| Trip Database | http://www.tripdatabase.com/ |
| Google Scholar | http://scholar.google.co.uk/ |
NHS Evidence or Evidence Search: Health and social care
NHS Evidence or Evidence Search is run by the National Institute for Health and Care Excellence (NICE) and allows searching through health and social care information on the internet, filtering out any commercial sites or blogs. It is also the gateway to the British National Formulary, British National Formulary for Children and NHS journals and databases. The search on NHS Evidence can be narrowed down according to areas of interest, types of information and sources. This means, rather than trying to access government policies on the websites, sources can be limited to gov.uk or the Department of Health (NICE, 2014).
TRIP database
The TRIP database is designed to allow users to quickly find high-quality research. It is colour-coded according to the quality of the evidence, with green being the best systematic reviews. The database can also be used to search for images and videos as well as patient information.
Google Scholar
Google Scholar is the ‘academic’ side of Google that searches the web for academic publications, books, theses and other resources. The number of results can, at times, seem overwhelming, but searches with keywords using the date range can narrow down the results. Google Scholar can identify a link to an institution with access to the resources and will link you through to the full text if it is available to you.
What next?
This article has outlined the revised professional requirements of maintaining registration in the UK according to the Code (NMC, 2015a) and revalidation (NMC, 2015b); given suggestions on how to access literature; provided a user-friendly step-by-step guide on good practice when searching for literature; and signposted some key resources, both real-world and web-based. If working within the NHS, the local Trust library can offer some one-to-one support. Resources can also be accessed through the RCM for members. The public expects high quality, evidence-based maternity services: there is an abundance of resources at your disposal to ensure they get it—give it a go!