NURS 6052 Discussion: Searching Databases Assignment

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library research

The Walden library, MEDLINE, and CINAHL Plus with full text were the three main databases I used for my information search. CLABSI was the first acronym I used for my PICO(T) investigation. Because CLABSI is the central concept and a well-known big problem in our hospitals, I have chosen to use the specific phrase. CINAHL Plus full text yielded roughly 512 results, while peer-reviewed yielded 455. The total number of results obtained from MEDLINE full text was 599. In these findings, I feel there were numerous publications and data to work with. I narrowed my search by focusing on the years 2013 to 2020, and the results were essentially the same. Searching employing Boolean expressions such as AND, OR, and AND, according to Skelly and Ecker (2010), can help focus results. I used AND to narrow down my information. When I searched for “prevention AND intervention” to lower CLABSI in hospitalized patients, for example, 52 peer-reviewed articles came up.

Techniques for improving the PICO(T) question’s rigor and effectiveness

First, I was specific by using CLABSI to improve the rigor and effectiveness of my PICO(T) investigation. The keyword’s precision produced the expected outcomes. Then I used database filters. According to UAMS (2020), researchers should use database filters to filter results in order to acquire evidence-based information. To effectively narrow my findings in the CINAHL database, I used advance search with the Boolean keyword, limiters such as full text, peer-reviewed, and between 2010-2020. My score was around 63, which is a decent start. Then, using the search widgets on the right side of the screen, I immediately obtained the complete texts of CINAHL Plus and MEDLINE Plus.

Introduction

This discussion focuses on my Clinical issue of interest, which is CLABSI, my PICO(T) statement, literature search results, and Strategies to increase the rigor and effectiveness of my PICO(T) question database search.

A central line is a catheter inserted through an internal jugular vein, subclavian, femoral, or peripheral vein that terminated in the proximity of the heart in the superior or inferior vena cava (Khalid et al, 2013). A central line-associated bloodstream infection (CLABSI) is a serious infection that occurs when germs (usually bacteria or viruses) enter the bloodstream through the central line (CDC, n. d.). CLABSIs are a preventable infection, yet it results in thousands of deaths each year and billions of added costs to the U.S. healthcare system (CDC, n. d.).

PICO(T) question

Would using the CLABSI bundle decrease the incidence of CLABSI cases in hospitalized patients throughout their hospitalization period? PICO(T) format is popularly used when it comes to formulating

NURS 6052 Discussion Searching Databases Assignment
NURS 6052 Discussion Searching Databases Assignment

questions in evidence-based practice. According to Melnyk et al (2019), a PICO(T) question should be formulated before starting literature research. Having a well-constructed PICO(T) question helps find the best available results.

References

Khalid, I., Al Salmi, H., Qushmaq, I., Al Hroub, M., Kadri, M., & Qabajah, M. R. (2013). Itemizing the bundle: Achieving and maintaining “zero” central line-associated bloodstream infection for over a year in a tertiary care hospital in Saudi Arabia. AJIC: American Journal of Infection Control41(12), 1209–1213. https://doi-org.ezp.waldenulibrary.org/10.1016/j.ajic.2013.05.028

Melnyk, B.M., Fineout-Overholt, E., Stillwell, S.B., & Willamsom, K. M. (2009).Evidence-based practice: step by step: Igniting a spirit of inquiry. American Journal of Nursing. 109(11), 49-52. Doi:10. 1097/01. NAJ.0000363354.53883.58. Retrieved from https://journals.iww.com/ajnonline/fulltext/2009/11000/Evidence_Based_Practice_Step_By_Step_Igniting_a.28.aspx

+Skelly, A. & Ecker, E. (2010). Conducting a winning literature search. Evidence-based spine-care journal, 1(1), 9-14.https://doi.org/10.1055/s-0028-1100887

University of Arkansas for medical science (2020). Developing a search strategy for primary literature. Retrieved from https://www.//libguides.uams.edu/evidence_based_medicine/acquiring

What are some of the things that healthcare providers are doing to prevent CLABSI? Retrieved from https://www.cdc.gov/hai/bsi/clabsi-resources.html

NURS 6052 Discussion: Searching Databases Assignment

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Read Also: Discussion: Where in the World Is Evidence-Based Practice

By Day 3 of Week 4

Post your PICO(T) question, the search terms used, and the names of at least two databases used for your PICO(T) question. Then, describe your search results in terms of the number of articles returned on original research and how this changed as you added search terms using your Boolean operators. Finally, explain strategies you might make to increase the rigor and effectiveness of a database search on your PICO(T) question. Be specific and provide examples. NURS 6052 Discussion: Searching Databases Assignment

As clinicians, the top priority is to provide safe, up-to-date patient care utilizing evidence-based practice. The PICOT stands for a formulated question in evidence-based practice to aid clinicians in clarifying a clinical issue while minimizing the time spent searching for relevant, valid evidence (Melnyk & Fineout-Overholt, 2018). The PICOT model (P: population of interest; I: intervention or issue of interest; C: comparison of interest; O: outcome expected; and T: time for the intervention to achieve the result) is the best approach for developing a research question (Melnyk & Fineout-Overholt, 2018). The clinical issue of interest is post-operative pain management in hip replacement patients for this discussion. Based upon this clinical issue, the PICOT question will be: “In adult patients with total hip replacements (P), how effective is pharmacological pain interventions (I) compared to nonpharmacological (C) in controlling post-operative pain (O) during the recovery time (T).

For this discussion post, the search engines utilized were the CINAHL Plus and PubMed database. My keyword search was hip replacement, which returned 16,739 results. This was before filtering the search by date of publication, evidence-based practice, excluding systematic reviews and meta-analyses, and using Boolean operators (Walden University, n.d.-d). After combining the proper search terms with the Boolean operator and utilizing the filters, the total number of studies retrieved from down substantially to 10 articles. At this point, the articles are exact to the desired terms anticipated.

To increase the rigor and effectiveness of the database search, some strategies utilized were to refine the search by setting limitations. Some limitations include using research to the current year, using publication year limiters, and using keywords such as post-surgical, pharmacological, and nonpharmacological interventions to ultimately narrow the results to obtain the desired PICOT question articles. Another strategy used was Boolean terms. Boolean terms connect your keywords to create a logical phrase that the database can understand (Walden University, n.d.-f ). Boolean terms help the researcher develop more precise and powerful searches with a higher percentage of desired, relevant results (Walden University, n.d.-f ).

References

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.

Walden University Library. (n.d.d). Evidence-based practice research: Joanna Briggs Institute search help. https://academicguides.waldenu.edu/library/healthevidence/jbisearchhelp

Walden University Library. (n.d.-f). Keyword searching: Finding articles on your topic: Boolean terms. http://academicguides.waldenu.edu/library/keyword/boolean

By Day 6 of Week 4

Respond to at least two of your colleagues on two different days and provide further suggestions on how their database search might be improved.

Thanks for sharing, Felisha.

om all of us, not just professionals. We must develop self-confidence in our ability to transform our life and stop relying on others to accomplish everything for us. Clinicians work with various populations, focusing on individual differences, healthy and unhealthy behavior, emotional health, restorative practices, and the prevention of mental diseases. As stated in the post, the primary duty of a clinician is to manage a sick individual to treat the symptoms of their condition. The physician can also evaluate the patient’s and their family’s reactions to the sickness and other social issues.

A PICOT inquiry identifies the terms that should be utilized to find the best knowledge to address a pressing clinical question. The PICOT question is the search approach, as described in the post. The search approach ensures a fair and efficient search. PICOT is a framework in the PubMed search engine that asks a person to think explicitly about different facets of what they wish to examine. When creating a PICOT question, it is essential to make sure it is clear and detailed regarding the research. PubMed is the leading repository for scientific publications and one of the most widely accessed resources globally, as it provides a publicly accessible search engine for MEDLINE and several other NLM resources.

CINAHL Plus is a search engine that delivers an enlarged version of the CINAHL Database, the comprehensive index to medical and supports health literature, nurses, health professionals, researchers, and students (Ali et al., 2021). On the other hand, PubMed is a search engine that supports retrieving information from scientific and biological sciences publications to enhance global and personal health. Using the additional filters option to improve these database search engines provides a considerably broader range of different article categories, including the stage of a clinical trial (Wishart et al., 2018). This menu allows you to choose from a variety of article types. They can be enhanced by allowing it to provide a more concentrated study on a specific topic.

References

Ali, S., Kleib, M., Paul, P., Petrovskaya, O., & Kennedy, M. (2021). Compassionate nursing care and the use of digital health technologies: A scoping review. International journal of nursing studies, 104161.

Wishart, D. S., Feunang, Y. D., Guo, A. C., Lo, E. J., Marcu, A., Grant, J. R., & Wilson, M. (2018). DrugBank 5.0: a major update to the DrugBank database for 2018. Nucleic acids research46(D1), D1074-D1082.

Hello Felisha, I enjoyed reading your post. I think your clinical issue of interest is a great topic. I spent several years working in an orthopedic postoperative unit, and I have had close interactions with patients who had hip replacements. Pain control was a major concern for these patients. Total hip replacement is often associated with a great amount of postoperative pain affecting recovery and rehabilitation (Tsinaslanidis et al., 2020). Total hip replacement is a well discussed topic, so I think it’s a good idea that you used bloorean operators to limit your search results. The mainstay of patients experiencing moderate to severe acute pain is opioid therapy. However, considering the risks of opioid use and the growing number of patients with opioid tolerance nonpharmacological measures have been growing in popularity (Czech et al., 2018). Nonpharmacological measures of pain control have been underestimated in the past, but they have been proven to be extremely effective. I think you chose a great research question. I also used CINAHL for my clinical issue of interest and I was able to great results with that database. Another database I used was Medline. I recommend MEDLINE in the future.

References

Tsinaslanidis, G., Tsinaslanidis, P., & Mahajan, R. H. (2020). Perioperative Pain Management in Patients Undergoing Total Hip Arthroplasty: Where Do We Currently Stand?. Cureus12(7), e9049. https://doi.org/10.7759/cureus.9049

Czech, I., Fuchs, P., Fuchs, A., Lorek, M., Tobolska-Lorek, D., Drosdzol-Cop, A., & Sikora, J. (2018). Pharmacological and Non-Pharmacological Methods of Labour Pain Relief-Establishment of Effectiveness and Comparison. International journal of environmental research and public health15(12), 2792. https://doi.org/10.3390/ijerph15122792

RE: Discussion – Week 4

My PICO subject involves post-operative pain management using a numerical pain scale over the use of the Critical Care Pain Assessment Tool ( CPOT) to minimize opioid use.  My question is will the implementation of a collective assessment approach in acute care nursing at the PACU, containing the Critical Care Pain Observation Tool (CPOT) and comparative pain score, decrease post-operative use of narcotics compared to the comparative pain scale alone? NURS 6052 Discussion: Searching Databases Assignment

I selection of search terms used to get posts, feedback and other information are as follows: Terms of research analgesia, post-operative analgesia, preventive analgesia, non-opioid, pain, post-operative, fentanyl, multimodal treatment, preoperative nursing, analgesia, vital signs, pain effect, pain scale, postoperative pain, preoperative care, surgical procedures, surgical treatment, and pain management.

I started using the Walden library, but even after removing all of the parameters, I’m still not getting any search results. I began by using Google Scholar, which I am quite familiar with. I began searching for only the top three results in the hierarchy of Meta-Analysis, Systematic Reviews, and Critically Appraised Topics because these are the three most reliable results and three of the four that can be filtered. My top three search topics were as follows: In relation to (The criteria is the search sentence and the type of review method) Analgesia-(Meta-Analysis- 166,000). (Meta-Analysis- 166,000). (Systematic Reviews-267,000, Critically Assessed Topics-13,500) (Meta Research-120,000), (Systematic Reviews-235,000), Primary Care Pain Assessment Method (Topic Objectively Appraised-19,000) Multi-model Pain Treatment-(46,300 Meta-Analysis) (Systemic-Reviews-57,500). (4,030 Critically Approved Topics).

I searched for only three types of review methods because they contain the most reliable information that my PICO question requires to be answered precisely. Depending on the type of research, I look for information from the evidence hierarchy in different places. If I’m looking for statistical evidence, I prefer Meta-Analysis. I investigated the Systemic Reviews that met my pre-specified eligibility criteria. The Critically Appraised Topics, in my opinion, are the most useful because they are brief summaries of findings that may be relevant to my area of interest because they focus on a specific issue (Polit, D.F., & Beck, C. T., 2017).

One piece of information I discovered was that the results of one meta-analysis indicated that the CPOT’s reliability and validity were acceptable. “Inter-rater reliability was supported by strong intra-class correlations ranging from 0.74 to 0.91. For criterion-related validity, significant associations were found between CPOT scores and both FLACC 0.87-0.92 and pain intensity Numeric Rating Scale Score 0.50-0.69 ” (Buttes, et al., 2015). A key point in my question has been that a comprehensive, multimodel analgesic regimen will not only provide the most comprehensive pain control, but will also reduce the need for opioids and thus the resulting side effects. R.H. Carlson (2015)

References

Buttes, P., Keal, G., Cronin, S. N., Stocks, L., & Stout, C. (2015). Validation of the Critical-Care Pain Observation Tool in Adult Critically Ill Patients. Dimensions of Critical Care Nursing,33(2), 78-81. doi:10.1097/dcc.0000000000000021

Carlson, R. H. (2015). Multimodal Pain Management Minimizes Need for Opioids. Oncology Times,37(9), 36-37. doi:10.1097/01.cot.0000465759.66907.be

Discussion: Searching Databases

 

RE: Discussion – Week 4

PICO(T) is a mnemonic used to describe the four elements of a good clinical question.  It stands for Patient/Problem, Intervention, Comparison, Outcome. Many people find that it helps them clarify their question, which in turn makes it easier to find an answer (Cooke, Smith, & Booth, 2012). My PICO(T) question is, In hospitalized inpatient psychiatric patients (P), how does forcing medication (I), compare with not forcing medication (C), effect quality of care (O), during the duration of the inpatient admission (T). A well-built PICOT question increases the likelihood that the best evidence to inform practice will be found quickly and efficiently (Stillwell, Fineout-Overholt, Melnyk, & Williamson, 2010). My original search yielded no results in any database.

I had to reduce my search terms quite a bit to yield a result of 57 articles. Not many were very relevant however one such article,  Forced medication in psychiatric care: Patient experiences and nurse perceptions, was adequately related to my original question.  My search terms were, psychiatric patients forced medication care. I searched  the databases EBSCO and CINAHL, both retrieved from the Walden University library.

Cooke, A., Smith, D., & Booth, A. (2012). Beyond PICO: The SPIDER tool for qualitative evidence synthesis. Qualitative Health Research, 22(10), 1435-1443. doi:10.1177/1049732312452938

Haglund, K., Von Knorring, L., & Von Essen, L. (2003). Forced medication in psychiatric care: Patient experiences and nurse perceptions. Journal of Psychiatric and Mental Health Nursing, 10(1), 65–72. https://doi-org.ezp.waldenulibrary.org/10.1046/j.1365-2850.2003.00555.x

Stillwell, S. B., Fineout-Overholt, E., Melnyk, B. M., & Williamson, K. M. (2010). Asking the clinical question: a key step in evidence based practice. A successful search strategy starts with a well-formulated question. American Journal of Nursing, 3, 58.

Walden University Library. (2020). Keyword searching: Finding articles on your topic: Boolean terms. Retrieved from http://academicguides.waldenu.edu/library/keyword/boolean

RE: Discussion – Week 4

Just as with searching for a new car, I wanted to develop a PICO(T) question and perform research that is meaningful not only to my future but also that resonates with some of my previous areas of experience. I of course want my research to be meaningful and evidenced-based.

I have worked with the adolescent psychiatric population ages 5-17 in outpatient and level one hospitals. There have been many interventions carried out with great success and others with very limited positive outcomes. I have transformed my clinical inquiry into a searchable question in order to search electronic databases step by step with efficiency which is as follows (Stillwell, Fineout-Overholt, Melnyk, Williamson (2010):

 

In Attention Deficit Hyperactive Disorder (ADHD) (Problem), how does diet (Intervention) compared to other treatments (Comparison) affect behavior and quality of life (Outcome) within the youth population (Time-Frame).

This will assist to develop and examine successful strategies that may increase the rigor and effectiveness of the most current evidence-based research. Specific examples include accessing search engines such as the Walden Library, Ebsco, and other scientifically reputable sites in order to get the most credible and value-rich material for evidenced-based research that I am looking for.

References

MD Anderson Library. (2020). Research guides: Evidence-based medicine: Searching techniques. MD Anderson Library Center. https://mdanderson.libguides.com/c.php?g=249812&p=2314759

Stillwell, S. B., Fineout-Overholt, E., Melnyk, B., & Williamson, K. M. (2010). Evidence-based practice, step by step: Asking the clinical question. AJN, American Journal of Nursing110(3), 58–61. https://doi.org/10.1097/01.naj.0000368959.11129.79

Walden University Library. (n.d.). Databases A-Z: Nursing. Retrieved October 4, 2019, from https://academicguides.waldenu.edu/az.php?s=19981