intermediaries Developing and Evaluating Clinical Practice Guidelines: A Systematic Approach 5 have been called “an essential part of the health care team by allowing knowledge consumers to focus on the wise interpretation and use of knowledge for critical decision making, rather than spending unproductive time on its access and retrieval” (Homan, 2010, p. 51). The Cochrane Handbook for Systematic Reviews of Interventions points out the complexity of conducting a systematic literature review and highly recommends enlisting the help of a healthcare librarian when searching for studies to support locating studies for systematic reviews (Section 6.3.1; Higgins & Green, 2008). The team of librarian/searchers were given the topics, keywords, and suggested synonyms, as well as the evidence pyramid we agreed upon, and they were asked to locate the best available evidence for each broad area addressed in the following chapters. Search Strategies for Broad Topics The literature search begins with database selection and translation of search terms into the controlled vocabulary of the database if possible. The major databases for finding the best primary evidence for most clinical nursing questions are CINAHL (Cumulative Index to Nursing and Allied Health Literature) and MEDLINE. The PubMed interface to MEDLINE was used, as it includes added “unprocessed” records to provide access to the most recently published citations. For most topics, the PsycINFO database was searched to ensure capturing relevant evidence in the literature of psychology and behavioral sciences. The Cochrane Database of Systematic Reviews and the Joanna Briggs Institute’s evidence summaries (The Cochrane Collaboration; Joanna Briggs Institute) were also searched to provide authors with another synthesized source of evidence for broad topic areas. The AGREE II instrument was used as a standard against which we could evaluate the process for evidence searching and use in chapter and protocol development (AGREE Next Steps Consortium, 2009). Domain 3, rigour of development, Item 7, states: “The search strategy should be as comprehensive as possible and executed in a manner free from potential biases and sufficiently detailed to be replicated.” Taking a tip from the Cochrane Handbook, a literature search should capture both the subject terms and the methodological aspects of studies when gathering relevant records (Higgins & Green, 2008). Both of these directions were used to develop search strategies and deliver results to chapter authors using the following guidelines: n To facilitate replication and update of searches in all databases, search results sent to authors were accompanied by a search strategy: listing the keywords/ descriptors and search string used in each database searched (e.g., MEDLINE, PsycINFO, CINAHL). n The time period searched was specified (e.g, 2006–2010). n Categorical limits or methodological filters were specified. (Some examples are the article type: “meta-analysis” or the “systematic review subset” in Pubmed; the “methodology” limit in PsycINFO for meta-analysis OR clinical trial; the “research” limit in CINAHL.) n To facilitate replication and update of MEDLINE/PubMed searches, searches were saved and chapter authors were supplied with a login and password for a My NCBI account (National Center for Biotechnology Information, U.S. National Library of Medicine), linking to Saved Searches to be rerun at later dates. 6 Evidence-Based Geriatric Nursing Protocols for Best Practice The librarian then aggregated evidence in a RefWorks database and sent this output to all chapter authors to enhance their knowledge base and provide a foundation for further exploration of the literature. Limits, Hedges, and Publication Types Most bibliographic databases have the functionality to exploit the architecture of the individual citations to limit to articles tagged with publication types (such as “metaanalysis” or “randomized controlled trial” in MEDLINE). In CINAHL, methodological filters or “hedges” (Haynes, Wilczynski, McKibbon, Walker, & Sinclair, 1994) for publication types “systematic review,” “clinical trials,” or “research” articles are available. The commonly used PubMed “Clinical