NURS 6052 Week 4 Discussion Searching Databases

NURS 6052 Week 4 Discussion Searching Databases

NURS 6052 Week 4 Discussion Searching Databases

              Evidence-based practice, also known as EBP, can be discovered in many different places, including journals, textbooks, databases, and so on. When conducting research, one must make certain that the information that they are looking for and evaluating comes from a reputable source. If credible resources are utilized, the evidence and study will have a greater potential to be held to a higher level. It is possible to acquire resources on your own or through places of employment or educational institutions. Unfortunately, policymakers continuously signal that dependable resources are required to ensure that patients are receiving the greatest patient care that is available from their healthcare providers; however, resources are not always available without constraints as required (Melnyk & Fineout-Overholt, 2018).

What is PICO(T)?

              The population of interest (P), intervention or issue of interest (I), comparison of interest (C), the outcome expected (O), and time for an intervention to achieve the outcome (T) is PICOT (Melnyk & Fineout-Overholt, 2018). PICOT questioning is a method of research that is utilized to identify the clinical evidence that is of the highest quality for use in practice. This is accomplished by conducting investigations in a manner that is both objective and productive (Ford & Melnyk, 2019). The researcher has the ability to employ a form of research known as PICOT questioning in order to reduce the outcomes of the evidential investigation to a more manageable level. The use of opioids in patients who are suffering from severe shortness of breath is an area of clinical interest that is both exciting and interesting.

—In patients that are suffering from severe dyspnea during end-of-life (P), can the use of opioids (I) be a beneficial intervention, compared to those not near end-of-life (C), to reduce the feeling of breathlessness (O), within a period of 2 weeks or less (T)?

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Research With and Without The Boolean process is a method that is utilized that inserts a variety of phrases (such as OR, AND, etc.) between the primary terms that helps to limit down the search results by processing them in a given order. This method is called the Boolean method (Library of Congress, n.d.). Within the Walden Nursing Library, a search for publications using the key phrases “opioids for dyspnea” resulted in the retrieval of 486 different articles. When searching for “opioids for dyspnea AND end-of-life AND morphine,” only nine articles were retrieved.

This was the result of employing the Boolean approach. When the primary search terms were altered to read “opiates for dyspnea AND morphine sulfate,” only one result was discovered. 313 articles were found when searching for “dyspnea OR breathlessness AND opioid use.” There were twenty publications discovered when the search terms “dyspnea OR breathlessness, AND opioid use, AND efficacy” were used. Last but not least, using the search terms “dyspnea OR breathlessness, AND opioid usage, AND end-of-life care,” 62 articles that are linked to this topic were found.ut the Boolean Process

Strategies for an Effective Database Search

When looking at the differences in the numbers that resulted from the searches that were carried out, it is obvious to see that the utilization of various words and the combination of these phrases can provide a variety of different results. When looking for particular publications, it is essential to be certain that the researcher is use the appropriate terminology in their search. When looking for particular articles that are associated with the administration of opioids during end-of-life care, there are quite a number distinct word combinations that can be searched for.

Some of these combinations include: The researcher ought to make use of combos that will bring about the most specific materials, for as employing “dyspnea OR breathlessness, AND opioid use,” in conjunction with “AND effectiveness” or “AND end-of-life care.” These two searches appeared to turn up a number of articles that would be useful in compiling information on the topic at hand. The researcher’s inability to obtain sufficient information, in addition to the aggravation that comes from having to read a large number of articles in order to amass a relatively small quantity of new information, can undermine the thoroughness of the investigation. The level of rigor can be maintained so long as the researcher makes it a point to keep in mind the vast number of papers that have been written on each and every subject. The researcher merely needs to keep up the pace and keep seeking until all of the relevant material is located and validated. 

References

Gallagher Ford, L., & Melnyk, B. M. (2019). The Underappreciated and Misunderstood PICOT Question: A Critical Step in the EBP Process. Worldviews on Evidence-Based Nursing16(6), 422–423. https://doi.org/10.1111/wvn.12408

Library of Congress. (n.d.). Search/browse help – Boolean operators and nesting. Retrieved December 21, 2021, from https://catalog.loc.gov/vwebv/ui/en_US/htdocs/help/searchBoolean.html

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

Click here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS NURS 6052 Week 4 Discussion Searching Databases:

This is a well-constructed PICO(T) question that clearly defines the patient population, intervention, comparison, outcomes, and, potentially, timeframe (Eriksen & Frandsen, 2018). The use of mobile health technology for managing anxiety is a growing trend, and it is interesting to see how it compares to traditional face-to-face therapy. By including a comparison group, this PICO(T) question addresses potential confounding variables and allows for a more accurate assessment of the effectiveness of the intervention. 

One factor that could be added to this PICO(T) question is a specific type of mobile health technology or app. It would be helpful to define the intervention being examined further, as many mental health apps are available with varying features and approaches. For example, specifying whether the app utilizes cognitive-behavioral or mindfulness techniques could impact the results and provide more specific information for clinicians and patients. 

I also believe it would be beneficial to consider the potential biases and limitations in this study design. Mobile health technology is relatively new, and there may be specific biases towards its use, especially in the management of mental health disorders. Some people may have access to more advanced technology or be more comfortable using it, leading to potential selection bias (Areàn et al., 2016). Therefore, addressing these biases and limitations in the study design and data analysis would be essential to ensure accurate and unbiased results. Overall, this PICO(T) question provides a solid foundation for investigating the effectiveness of mobile health technology for managing anxiety in adults. 

A Sample Answer For the Assignment: NURS 6052 Week 4 Discussion Searching Databases

Title: NURS 6052 Week 4 Discussion Searching Databases

Patient Outcomes Effected by Nursing Burnout

Patient outcomes are at the forefront of all healthcare organizations. We want the best for our patients and their families. As healthcare workers, this can be a challenge. With staffing shortages, and constantly changing work requirements, burnout is becoming more and more prominent. Exacerbated by the COVID-19 pandemic nursing burnout is a challenge we must overcome. Decreased work-related stressors such as workload, and time pressures, and increasing communication, and interpersonal relationships by having a more conducive work environment can minimize burnout in nursing (Afriyie, 2020).   This clinical issue must be addressed to prevent further deterioration of staff and patient outcomes (Canadas-DelaFuente et al., 2015). Overall, nursing burnout has negative implications for patient outcomes and healthcare organizations (Peirson, 2021).

Research Strategies

 I first had to develop a strategy for researching to find articles that did not include systematic reviews, this week’s resource section provided excellent explanations of the different types of research and where to go to find them. I did find that while searching different databases having fewer words helped with the search results. My original search term Nursing Burnout resulted in 45 articles to choose from, alternatively when using the term Patient Outcomes over 1600 articles populated. This made searching for my specific topic more challenging since there were only a few articles that had both specifications addressed. Some way to overcome these challenges is to speak the research engine’s “language” so to speak. I researched the topic of interest and utilized the word AND in addition to the second word in my topic of interest which narrowed down the amount articles to 40, which resulted in the best articles that addressed the complete topic in its entirety.

References:

Afriyie, D. (2020). Reducing work-related stress to minimize emotional labour and burn-out syndrome in nurses. Evidence-Based Nursing24(4), 141–141. https://doi.org/10.1136/ebnurs-2020-103321

Links to an external site.

Cañadas-De la Fuente, G. A., Vargas, C., San Luis, C., García, I., Cañadas, G. R., & De la Fuente, E. I. (2015). Risk factors and prevalence of burnout syndrome in the nursing profession. International Journal of Nursing Studies52(1), 240–249. https://doi.org/10.1016/j.ijnurstu.2014.07.001

Links to an external site.

Peirson, J. (2021). Staff burn-out has implications for organizational and patient outcomes: Would an open culture of support with structures in place prevent burn-out? Evidence-Based Nursing25(3), 99–99. https://doi.org/10.1136/ebnurs-2021-103437

When you decide to purchase a new car, you first decide what is important to you. If mileage and dependability are the important factors, you will search for data focused more on these factors and less on color options and sound systems.

The same holds true when searching for research evidence to guide your clinical inquiry and professional decisions. Developing a formula for an answerable, researchable question that addresses your need will make the search process much more effective. One such formula is the PICO(T) format.

In this Discussion, you will transform a clinical inquiry into a searchable question in PICO(T) format, so you can search the electronic databases more effectively and efficiently. You will share this PICO(T) question and examine strategies you might use to increase the rigor and effectiveness of a database search on your PICO(T) question.

To Prepare:

  • Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry.
  • Review the materials offering guidance on using databases, performing keyword searches, and developing PICO(T) questions provided in the Resources.
  • Based on the clinical issue of interest and using keywords related to the clinical issue of interest, search at least two different databases in the Walden Library to identify at least four relevant peer-reviewed articles related to your clinical issue of interest. You should not be using systematic reviews for this assignment, select original research articles.
  • Review the Resources for guidance and develop a PICO(T) question of interest to you for further study. It is suggested that an Intervention-type PICOT question be developed as these seem to work best for this course.

By Day 3 of Week 4

Post a brief description of your clinical issue of interest. This clinical issue will remain the same for the entire course and will be the basis for the development of your PICOT question. Then, post your PICO(T) question, the search terms used, and the names of at least two databases used for your PICO(T) question. 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.

It is true that all healthcare organizations aim at improving positive patient outcomes. At the same time, these facilities continuously work on promoting patient safety. Therefore, healthcare workers are expected to support their organizations to attain these objectives. However, attaining these admirations may be complicated to some healthcare professionals due to various challenges such as shortage of nurses and the constantly changing healthcare environments (Recio‐Saucedo et al., 2018). Nurse burnout and fatigue has also become a challenge to healthcare workers mandated with the duty of providing quality healthcare services to all (Arnold et al., 2021).

The COVID-19 pandemic escalated nurse burnout and fatigue since healthcare facilities were overwhelmed. The pandemic intensified research works since researchers wanted to understand the virus, mode of transmission, symptoms, and the impact on the patients and on healthcare.  Also, unreliable materials were published for various reasons including manipulation. However, with good searching process, people accessed peer-reviewed articles with accurate and reliable information that helps them to understand the pandemic and the state of healthcare.

References

Arnold, D. T., Hamilton, F. W., Milne, A., Morley, A. J., Viner, J., Attwood, M., … & Barratt, S. L. (2021). Patient outcomes after hospitalisation with COVID-19 and implications for follow-up: results from a prospective UK cohort. Thorax76(4), 399-401. http://dx.doi.org/10.1136/thoraxjnl-2020-216086

Recio‐Saucedo, A., Dall’Ora, C., Maruotti, A., Ball, J., Briggs, J., Meredith, P., … & Griffiths, P. (2018). What impact does nursing care left undone have on patient outcomes? Review of the literature. Journal of clinical nursing27(11-12), 2248-2259. https://doi.org/10.1111/jocn.14058

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.

Click on the Reply button below to reveal the textbox for entering your message. Then click on the Submit button to post your message.

Reply Quote

Clinical inquiry is the first process in Evidence Based Practice (EBP). It involves the clinical questioning of why and how something is done (Laureate Education (Producer), 2018). Health care is founded on the research that is derived from clinical inquiry. It is becoming prevalent to use clinical inquiry to challenge the status quo. When we want change, we first question how and why we need it. Before anything can be implemented safely into practice, it must first be proven through research to be effective and yield positive results. I decided my clinical inquiry will address the use of nonpharmacological interventions in mental health populations.

In order for nonpharmacological approaches to be perceived as reliable and trustworthy practice, it would first have to be supported by the evidence of its success. To help guide research, formulating the clinical inquiry in PICO(T) form gives a basis for keywords to use when searching databases (Melnyk & Fineout-Overholt (2018).  My clinical inquiry in PICOT form is as followed: In mental health populations, are nonpharmacological interventions just as effective as pharmacological interventions in yielding positive mental health outcomes during treatment process?

The data base I decided to use first was CLINAHL Plus with full text. I first started broad then added more words or phrases to narrow down the results.  The first word I looked up was “nonpharmacological interventions”. This gave me 532 results of nonpharmacological interventions in all specialties. Next, I decided to use the Boolean operator feature. Using Boolean operators assist with searching a combination of words by either retrieving records of all terms, records containing one or more terms or excluding records containing the term associated with NOT (Library of Congress, n.d). I continued with this method by now adding “AND mental health”. My results were now reduced to 21 results.  I decided to modify my search by adding “OR medication” to my search on top of the other two phases. To my surprise, results have now been broadened to 120,976 results.

Strategies to help strengthen my search would involve leniency to the terms used for mu search. Using a variation of phrases and words would help produce different results. I won’t use “OR” when trying to condense results since it will now possibly choose only one phrase instead of all phrases that were typed. Also, if I struggle to find supporting articles, I can look to changing the wording of my PICOT question. I can also try different data bases to see if different articles will appear.

Resources

Laureate Education (Producer). (2018). The Value of Clinical Inquiry [Video file]. Baltimore, MD: Author.

Library of Congress. (n.d.). Search/browse help – Boolean operators and nesting. Retrieved September 19, 2018, from https://catalog.loc.gov/vwebv/ui/en_US/htdocs/help/searchBoolean.html

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

Week 4 Top of Form

Searching Databases

When you decide to purchase a new car, you first decide what is important to you. If mileage and dependability are the important factors, you will search for data focused more on these factors and less on color options and sound systems.

The same holds true when searching for research evidence to guide your clinical inquiry and professional decisions. Developing a formula for an answerable, researchable question that addresses your need will make the search process much more effective. One such formula is the PICO (T) format.

In this Discussion, you will transform a clinical inquiry into a searchable question in PICO (T) format, so you can search the electronic databases more effectively and efficiently. You will share this PICO (T) question and examine strategies you might use to increase the rigor and effectiveness of a database search on your PICO (T) question.

To Prepare:

  • Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry.
  • Review the materials offering guidance on using databases, performing keyword searches, and developing PICO (T) questions provided in the Resources.
  • Based on the clinical issue of interest and using keywords related to the clinical issue of interest, search at least two different databases in the Walden Library to identify at least four relevant peer-reviewed articles related to your clinical issue of interest. You should not be using systematic reviews for this assignment, select original research articles.
  • Review the Resources for guidance and develop a PICO (T) question of interest to you for further study. It is suggested that an Intervention-type PICOT question be developed as these seem to work best for this course.

By Day 3 of Week 4

Post a brief description of your clinical issue of interest. This clinical issue will remain the same for the entire course and will be the basis for the development of your PICOT question. Then, post your PICO (T) question, the search terms used, and the names of at least two databases used for your PICO (T) question. 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.

The clinical issue of interest to me is mental health issues among adolescents due to the COVID-19 pandemic.  This subject interested me because having worked as a Psych/behavioral health nurse for over 2 years, I witnessed firsthand how the number of adolescent patients increased at our hospital.  I worked at a 20-bed inpatient behavioral health/psych facility and within a matter of months after COVID, we were getting twice as many adolescent admission packets than adult admissions.  In six months, the hospital went from 20 adolescents to a 50-adolescent inpatient facility.  

I started my search using the Walden library resource.  I started with the broad subject of mental health.  I narrowed my search result to adding adolescents to the search criteria.  I selected “peer-reviewed articles” and changed the years to include searches between 2016 and 2022.  I also included COVID-19 in the search criteria as well.  This narrowed the search result down to 495 articles which is a lot more manageable to go through rather than going through thousands of articles.  

I found a great article on this topic titled “The impact of COVID-19 on adolescents’ mental health.”  In this article, the author discusses that several studies show that emergency department visits for peds patients increased after the first lockdown.  The author also talks about the underlying causes of pandemic-induced distress, with social isolation and loneliness due to social distancing being the main culprit in increased anxiety, depression, self-harm, and suicidal ideation among this population.  

I will continue to read through the list of articles on this subject matter and the COVID-19 timeframe of the last year will develop my PICOT question.  I will also research how this pandemic over the last year has increased substance abuse among adolescents.  

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.

Click on the Reply button below to reveal the textbox for entering your message. Then click on the Submit button to post your message.

Clinical interest to form a PICOT is hand hygiene to prevent infection in health care setting and at home. Hand hygiene form the basis of all infections that occur. Hand hygiene is the single most important strategy for preventing and reducing the spread of microorganisms. (Gammon & Hunt 2020). After hand washing, drying is also crucial. This is whereby some of the microorganisms are wiped off. Also, the microbes may enter through skin which is not intact when the hands are wet.  Health care related infection have the greatest impact in morbidity and mortality rate in the community. (Sousa et al 2017). Safe practice prevents the spread of infection from one person to another. The infection can be spread from health care workers to patients and among the health care. Doctors contribute the highest number of infections transmitted from one patient to another. This is whereby they use one equipment many patients without cleaning it. For example, covid was spread rapidly because of poor hand hygiene.

When searching for articles that meet the criteria, it may be trick and cumbersome. The system needs specific words to bring out the required article. On the issue of had hygiene, I had to use specific words to be able to get relevant material. If you use general term, the articles that come up may be too many and you may not be able to get what you want.

Infection to occur, it must be a complete chain. The best way to prevent it is by breaking the chain. Example hand hygiene is one of the best ways to break it. It may look simple and easy but may be the greatest course of many diseases.

PICOT Question

 P represent the problem that we are discussing. In this case P is the issue of infection. Under this we are going to look at what causes the problem of infection and what population that is affected. “I”, this is whereby we identify way to prevent the issue of infection. this is where we found out that hand washing is the major ways to prevent infection from spreading. If followed we, the chain is broken. Therefore, infection if prevented from happening. “C” this is whereby we do comparison of hand washing with other option. For example, what will happen if no handwashing is done or what if someone uses hand sanitizer and wearing mask to prevent the spread of microbes. Finally, “T” this is the time it takes to spread the microbes and time to achieve the outcome of hand washing.

Bottom of Form

 MAIN POST DISCUSSION 

      Hospice care and providing optimal interventions to terminal patients and families are always the focus of an on-call RN for hospice patients delivering care for uncontrolled symptoms and emergent needs. Hospice is a service that individuals frequently are unaware that the best outcomes for the patient are provided when the patient is involved from six months out from the prognosis for their hospice journey. Usually, patients only consider hospice care during the final hour to control symptoms. The research and evidence-based interventions make a difference to these families and patients by broadening the understanding and appreciation of the essentialness of hospice. Interventions to control and provide quality during the final stage is the aim of my clinical question. 

PICOT 

In terminal dementia hospice patients, how does morphine compared to non-pharmacological approaches affect pain during the final stages of imminent death? 

     This is a common issue and debate between clinicians and practitioners regarding the best approach. It is very taxing and causes further hardships on family when a patient at the final days of approaching the end of their journey. When searching utilizing the Walden library search engines, I was challenged and struggled with receiving any results when I started to find credible scholarly articles that would benefit and answer my particular PICOT question. I then utilized Science Direct and was pleased to find articles using the population and intervention in my search engine first (Melnyk et al., p.69, 2010). I was not delighted with the results, for I obtained 11 results that were not specific enough toward my PICOT question or information that I could use. To limit the number of search items, I then placed a publication year from 2016- 2021, ensured all were full text and peer-reviewed original resources while utilizing Boolean /phrases. This limited my search to two resources and fine-tuned my attention and efforts. Using Boolean terms “helps to create more precise and powerful searches with a higher percentage of relevant results (Library of Congress, 2018).”

     I then decided to utilize the approach as suggested on our announcements page from our professor to focus on one concept and search broadly, and then add one concept at a time. It was necessary, as was mentioned, not to expect to see and have all of the aspects of the PICOT question answered and would require the assembly of using multiple articles to gather the data sought. There were times I would get frustrated as I changed my key searches and included or took away Boolean phrases using our assigned resources for recommendations. I was then brought to contact the librarian and found that chat messenger is available for scheduled allotted times but found it would be more efficient to email. I then sent the email and decided to wait for the librarian’s expertise response before changing my PICOT question,that I initially thought did not have enough data or research to use or find. With the expertise of the librarian, I was then faced with over 100 results and then had to apply what was learned in our readings to then limit the resources. I was determined to find this research, for I often wondered about the optimal interventions and did not want to throw in the towel and was glad I did not.

     To increase the rigor and effectiveness of a database search on my PICOT question in review limiting publication date, asking a librarian for assistance, utilizing Boolean phrases, and placing an advance search for full text and peer-reviewed articles assisted in the hunt as I discussed above. The CINAHAL Plus with Full-Text database was a massive aid and support of my questions, rigor, and effectiveness of my research. This “unfiltered database contains over 750 nursing and allied health-related journals, and indexes another 5,000” (Walden University Library, 2019). I was fortunate enough to gain some experience and access multiple databases. For example, out of the five articles that I found helpful, I used EBSCOHOST, SAGE journals, and Science Direct. I was unaware of how efficient looking up data and resources can be until this week’s module. I feel that there was a lot to gain and learn to enhance the materials provided to Walden students.

References

Library of Congress. (n.d.). Search/browse help – Boolean operators and nesting. Retrieved September 19, 2018, from https://catalog.loc.

     gov/vwebv/ui/en_US/htdocs/help/searchBool
     ean.html

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.-c). Evidence-based practice research: CINAHL search help. Retrieved September 6, 2019,

      from https://academicguides.waldenu.edu/library/healthevidence/

      cinahlsearchhelp

5 articles found for PICOT question:

Allen, W. (2020). Medical Ethics Issues in Dementia and End of Life. Current Psychiatry Reports22(6), 1–7.

Fischberg, D., Bull, J., Casarett, D., Hanson, L. C., Klein, S. M., Rotella, J., Smith, T., Storey Jr, C. P., Teno, J. M., & Widera, E. (2013).

       Five things physicians and patients should question in hospice and palliative medicine. Journal of Pain & Symptom Management,

       45(3),595–605.https://doi.org/10.1016/j.jpainsymman.2012.12.002

Shega, J. W., Hougham, G. W., Stocking, C. B., Cox-Hayley, D., & Sachs, G. A. (2008). Patients Dying with Dementia: Experience at the End of

      Life and Impact of Hospice Care. Journal of Pain and Symptom Management35(5), 499–507. https://doi.org/10.

      1016 /j.jpainsymman.2007.06.011

Verreault, R., Arcand, M., Misson, L., Durand, P. J., Kroger, E., Aubin, M., Savoie, M., Hadjistavropoulos, T., Kaasalainen, S., Bédard, A., Grégoire,

     A., & Carmichael, P.-H. (2018). Quasi-experimental evaluation of a multifaceted intervention to improve quality of end-of-life care and quality

     of dying for patients with advanced dementia in long-term care institutions. Palliative Medicine32(3), 613–621. https://doi-org.ezp.waldenulibrary.org/10.1177/026921631771958             

Whitehead, P. B., Gamaluddin, S., DeWitt, S., Stewart, C., & Kim, K. Y. (2021). Caring for Patients With Dementia at End of Life. American Journal of Hospice

     and Palliative Medicine®. https://doi.org/10.1177/10499091211046247

Response

This is insightful Sarah; hospice care is essential in the delivery of quality healthcare services. Hospice is a special kind of care that focuses on the quality of life for patients experiencing advanced and life-limiting illnesses and their caregivers (De Graaf et al., 2020). Hospice care often leads to the provision of compassionate care for patients in the last stages of incurable diseases so that they may live as fully and as comfortable as possible. The PICOT question is researchable; it is in line with the reading resources provided in the databases. To determine the ideal resources required, there is the need to use specific search phrases (Patel et al., 2020).

Also, identifying the years of publications ensures the identification of the current and relevant resources that can be applied in answering the PICOT question. Utilizing Boolean phrases and placing an advance search for full text and peer-reviewed articles are some other effective strategies that can be applied to facilitate the search for the relevant articles (Library of Congress, n.d).

References

De Graaf, E., van Klinken, M., Zweers, D., & Teunissen, S. (2020). From concept to practice, is multidimensional care the leading principle in hospice care? An exploratory mixed method study. BMJ supportive & palliative care10(1), e5-e5. http://dx.doi.org/10.1136/bmjspcare-2016-001200

Library of Congress. (n.d.). Search/browse help – Boolean operators and nesting. Retrieved September 19, 2018, from https://catalog.loc.gov/vwebv/ui/en_US/htdocs/help/searchBool ean.html

Patel, K., Caragea, C., Wu, J., & Giles, C. L. (2020, September). Keyphrase extraction in scholarly digital library search engines. In International Conference on Web Services (pp. 179-196). Springer, Cham.

https://link.springer.com/chapter/10.1007/978-3-030-59618-7_12

RE: Discussion – Week 4

COLLAPSE

My clinical topic of interest is “In patients with hypertension, how does receiving medication teaching compared to no medication teaching correlate to medication adherence and lowered BP?” I chose this topic because hypertension is a global issue and a majority of patients present with this health issue. In the hospital setting, 90% of my patients present with this comorbidity and are prescribed medications. 

When searching databases regarding this topic, I did find many helpful, pertinent articles. When deciding a topic, I knew there would be much research related to this topic of interest, considering how many individuals struggle with this health issue. According to the CDC, nearly half of adults in the U.S. have hypertension and only 1 in 4 of these adults diagnosed have 

Their condition under control (CDC, 2021). When researching, I included key words on EBSCOhost including hypertension, patient, education, teaching, medication, and outcomes. When typing in important words related to my topic, it narrowed the results to articles that were closely related to my topic which was helpful. Using Boolean terms helped to narrow down the articles as well. According to Walden University, Boolean terms “may involve telling the database to look for multiple terms or concepts at once, which will make your search more precise. Or it may involve searching for alternative terms that will bring back more results” (Walden University Library, n.d.)

Strategies I may use to increase the effectiveness of my research is to continue to use the most effective key words. I will also utilize filtering out irrelevant articles by narrowing down searches to English language, researched in the U.S., looking at recent article (2010-2021), etc (University of Leeds, n.d.).

References

CDC. (2021). High Blood Pressure. Retrieved from https://www.cdc.gov/bloodpressure/facts.htm

University of Leeds. (n.d.), Literature Searching Explained. Retrieved from https://library.leeds.ac.uk/info/1404/literature_searching/14/literature_searching_explained/4

Walden University Library. (n.d.). Keyword Searching: Finding Articles on your Topic: Boolean Terms. Retrieved from https://academicguides.waldenu.edu/library/keyword/boolean

Response

This is insightful. Hypertension is one of the major healthcare issues that require specialized attention. Most healthcare institutions/providers have different interventions that ensure the effective management of hypertension (Unger et al., 2020). Medication teaching is one of the interventions often applied by healthcare professionals to ensure effective outcomes in the treatment processes. The PICOT statement/question is, therefore, relevant in the field of medication. However, there is the need to consider support materials, including previous research papers, cases studies, as well as articles relevant to different cases of hypertension.

These materials can be acquired from the University’s database. While searching for the relevant sources of information, there is a need to apply the key phrase (Walden University Library, n.d). The entire topic of research can act as a key phrase that can yield the required outcomes. The search can also be specified by the year of publication to ensure only current and relevant research studies are applied as references (Papagiannopoulou & Tsoumakas, 2020).

References

Papagiannopoulou, E., & Tsoumakas, G. (2020). A review of keyphrase extraction. Wiley Interdisciplinary Reviews: Data Mining and Knowledge Discovery10(2), e1339. https://wires.onlinelibrary.wiley.com/doi/abs/10.1002/widm.1339

Unger, T., Borghi, C., Charchar, F., Khan, N. A., Poulter, N. R., Prabhakaran, D., … & Schutte, A. E. (2020). 2020 International Society of Hypertension global hypertension practice guidelines. Hypertension75(6), 1334-1357. https://www.ahajournals.org/doi/full/10.1161/HYPERTENSIONAHA.120.15026

Walden University Library. (n.d.). Keyword Searching: Finding Articles on your Topic: Boolean Terms. Retrieved from https://academicguides.waldenu.edu/library/keyword/boolean

Searching Databases.

When nerve signals between the bladder and the brain do not work effectively, it results in Overactive bladder (OAB). About 30% of men and 40% of women in the U.S. live with OAB (Urology Care Foundation,2020). A well-constructed PICOT question helps find the best evidence available to influence practice. The question should be formulated before starting a literature search (Melnyk, et al. 2009).

PICO(T) Question: Does the InterStim neuromodulator implant for the treatment of Overactive bladder really work by decreasing or even stopping urinary urgency and frequency?

To formulate questions in Evidence Based Practice, the PICO(T) format is used. PICO(T) is a mnemonic derived from:

  1. Population/Patient problem: Patients diagnosed with Overactive Bladder.
  2. Intervention: Insertion of a neuro modulator implant.
  3. Comparison: Alternative treatments such as Diet modification, Bladder training, use of Anticholinergic drugs, Kegel exercises, Hydrodistension of the bladder, Bladder Botox
  4. Outcome: Reduction of day and nighttime frequency as well as episodes of uncontrollable urgency.
  5. Time: (Time element is not always included): Trial implant for a week, if symptoms improve within a week, a permanent neuromodulator is implanted under the skin of the upper buttock and connected to the sacral nerve by way of a wire tunneled under the skin.

CINAHL Plus with Full Text and Medline with full text were the two databases used for the research.

MEDLINE with full text search:

Original Term: Overactive bladder. This resulted in 10,322 articles. I limited my search to articles within 11 years, only peer reviewed, full text articles When I added search terms using Boolean operators, it resulted in 3 articles.

CINAHL Plus with Full Text search:

Original Term: Overactive bladder resulted in 7,822 articles. When I added search terms using Boolean operators, it resulted in 12 articles.

One strategy to increase the effectiveness of a database search for a PICO(T) question is to be specific in using the keywords for your search. I had a difficult time initially finding information for treatments for Overactive bladder, using the InterStim treatment. I also learned that the search cannot be a long, broad search, however it should be disease specific and search using minimal words.  Also know the correct abbreviation of the keywords you want to use in your search, I attempted to use O.B. for Overactive bladder instead of O.A.B, and it yielded no results.

Reference

Library of Congress(n.d.). Boolean Operators and Nesting. Retrieved December 21, 2020 from https://catalog.loc.gov/vwebv/ui/en_US/htdocs/help/searchBoolean.html

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

Urology Care Foundation. (2020). What is Overactive bladder? Retrieved on December 21, 2020 from https://www.urologyhealth.org/urology-a-z/o/overactive-bladder-(oab)

Walden University Library. (n.d.-a). Databases A-Z: Nursing. Retrieved December 21,2020 from https://academicguides.waldenu.edu/az.php?s=19981

NURS 6052 Discussion: Searching Databases

When you decide to purchase a new car, you first decide what is important to you. If mileage and dependability are the important factors, you will search for data focused more on these factors and less on color options and sound systems.

The same holds true when searching for research evidence to guide your clinical inquiry and professional decisions. Developing a formula for an answerable, researchable question that addresses your need will make the search process much more effective. One such formula is the PICO(T) format.

In this Discussion, you will transform a clinical inquiry into a searchable question in PICO(T) format, so you can search the electronic databases more effectively and efficiently. You will share this PICO(T) question and examine strategies you might use to increase the rigor and effectiveness of a database search on your PICO(T) question.

To Prepare:

  • Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry.
  • Review the materials offering guidance on using databases, performing keyword searches, and developing PICO(T) questions provided in the Resources.
  • Based on the clinical issue of interest and using keywords related to the clinical issue of interest, search at least two different databases in the Walden Library to identify at least four relevant peer-reviewed articles related to your clinical issue of interest. You should not be using systematic reviews for this assignment, select original research articles.
  • Review the Resources for guidance and develop a PICO(T) question of interest to you for further study. It is suggested that an Intervention-type PICOT question be developed as these seem to work best for this course. 

By Day 3 of Week 4

Post a brief description of your clinical issue of interest. This clinical issue will remain the same for the entire course and will be the basis for the development of your PICOT question. 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.

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.

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 4 Discussion Rubric

Post by Day 3 and Respond by Day 6 of Week 4

To participate in this Discussion:

Week 4 Discussion


Module 3: Advanced Clinical Inquiry and PICO(T) Questions (Weeks 4-5)

Laureate Education (Producer). (2018). The Value of Clinical Inquiry [Video file]. Baltimore, MD: Author.

Due ByAssignment
Week 4, Days 1-2Read the Learning Resources.
Compose your initial Discussion post.
Week 4, Day 3Post your initial Discussion post.
Begin to compose your Assignment.
Week 4, Days 4-5Review peer Discussion posts.
Compose your peer Discussion responses.
Continue to compose your Assignment.
Week 4, Day 6Post two peer Discussion responses.
Continue to compose your Assignment.
Week 4, Day 7Wrap up Discussion.
Week 5, Days 1-6Continue to compose your Assignment.
Week 5, Day 7                       Deadline to submit your Assignment.

Learning Objectives

Students will:

  • Create an answerable research question using the PICO(T) question format
  • Apply effective search strategies to identify relevant peer-reviewed and systematic reviewed research
  • Analyze strategies to increase rigor and effectiveness of database searches for PICO(T) questions
  • Analyze levels of evidence in peer-reviewed research

Learning Resources

Note: To access this module’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

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

  • Chapter 2, “Asking Compelling Clinical Questions” (pp. 33–54)
  • Chapter 3, “Finding Relevant Evidence to Answer Clinical Questions” (pp. 55–92)

Davies, K. S. (2011). Formulating the evidence based practice question: A review of the frameworks for LIS professionals. Evidence Based Library and Information Practice, 6(2), 75–80. https://doi.org/10.18438/B8WS5N

Note: You will access this article from the Walden Library databases.

Library of Congress. (n.d.). Search/browse help – Boolean operators and nesting. Retrieved September 19, 2018, from https://catalog.loc.gov/vwebv/ui/en_US/htdocs/help/searchBoolean.html

Stillwell, S. B., Fineout-Overholt, E., Melnyk, B. M., & Williamson, K. M. (2010a). Evidence-based practice, step by step: Asking the clinical question: A key step in evidence-based practice. American Journal of Nursing, 110(3), 58–61. doi:10.1097/01.NAJ.0000368959.11129.79

Note: You will access this article from the Walden Library databases.

Melnyk, B. M., Fineout-Overholt, E., Stillwell, S. B., & Williamson, 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

Note: You will access this article from the Walden Library databases.

Stillwell, S. B., Fineout-Overholt, E., Melnyk, B. M., & Williamson, K. M. (2010b). Evidence-based practice, step by step: Searching for the evidence. American Journal of Nursing, 110(5), 41–47. doi:10.1097/01.NAJ.0000372071.24134.7e

Note: You will access this article from the Walden Library databases.

Walden University Library. (n.d.-a). Databases A-Z: Nursing. Retrieved September 6, 2019, from https://academicguides.waldenu.edu/az.php?s=19981

Walden University Library. (n.d.-c). Evidence-based practice research: CINAHL search help. Retrieved September 6, 2019, from https://academicguides.waldenu.edu/library/healthevidence/cinahlsearchhelp

Walden University Library. (n.d.-d). Evidence-based practice research: Joanna Briggs Institute search help. Retrieved September 6, 2019, from https://academicguides.waldenu.edu/library/healthevidence/jbisearchhelp

Walden University Library. (n.d.-e). Evidence-based practice research: MEDLINE search help. Retrieved September 6, 2019, from https://academicguides.waldenu.edu/library/healthevidence/medlinesearchhelp

Walden University Library. (n.d.-f). Keyword searching: Finding articles on your topic: Boolean terms. Retrieved September 19, 2018, from http://academicguides.waldenu.edu/library/keyword/boolean

Walden University Library. (n.d.-g). Keyword searching: Finding articles on your topic: Introduction to keyword searching. Retrieved September 19, 2018, from http://academicguides.waldenu.edu/library/keyword/searching-basics 

Walden University Library. (n.d.-h). Quick Answers: How do I find a systematic review article related to health, medicine, or nursing? Retrieved September 6, 2019, from https://academicanswers.waldenu.edu/faq/72670

Walden University Library. (n.d.-i). Systematic review. Retrieved January 22, 2020, from https://academicguides.waldenu.edu/library/healthevidence/types#s-lg-box-1520654

Required Media

Laureate Education (Producer). (2018). Searching the Evidence [Video file]. Baltimore, MD: Author.

The development of clinical guidelines to improve nursing practice is a rigorous process. Healthcare providers should utilize the most accurate sources of data that will enhance the effectiveness of the outcomes. Therefore, this paper explores the search strategy that will be used to obtain the data related to the proposed PICOT question.

PICOT Question

            The PICOT question that is appropriate for the identified clinical issue is:

In hospitalized elderly patients (P), does the use of hourly nursing rounds and call lights (I) reduce the rates of falls (O) when compared to normal routine of care (C) in a six-month period (T)?

Search Terms Used

            According to Melnyk and Fineout-Overholt (2018), search terms for a clinical inquiry question (PICOT) can be obtained by doing database search using the key words of the PICOT question. The keywords that were used in this research that relate to the PICOT question include falls, elderly patient falls, falls prevention, hourly nursing rounds and falls, call lights and falls, and nursing rounds and falls. The use of these keywords in selected databases yielded 59 articles. The number reduced to 30 when the search criterion was limited to peer-reviewed articles alone. The second search strategy that was utilized was the use of database-controlled vocabulary.

This approach entails the use of specific keywords such as nursing rounds and elderly patient falls to obtain the needed articles. The databases produce all the articles that contain these keywords, thereby, increasing the accuracy of the obtained results (Melnyk & Fineout-Overholt, 2018). The use of this approach resulted in 45 articles related to the PICOT statement. Despite the effectiveness of these methods, they have the weakness of producing a large number of articles that might not be relevant to the issue under investigation. Consequently, the use of Boolean operation search is appropriate.

            Boolean search is an effective approach to obtaining relevant research articles due to the accuracy of its results. The use of this approach allows for the searching of word combinations in a specified order (Stillwell et al., 2010). Often, combinations are used to increase the relevance and accuracy of the obtained resulted. For instance, Library of Congress (n.d.) recommend that Boolean OR expressions should be executed first, followed by AND or NOT expressions. The search can be done in either lower or upper cases. The use of this approach to searching articles yielded 16 articles that were related to the PICOT statement. Therefore, it became evident that the use of Boolean search is highly accurate when compared to the utilization of random search of key words in the PICOT statement.

Names of Databases

            A number of nursing databases were used in this research. They included CINAHL, Medline, Embase, and TRIP databases. These databases were considered effective for the assignment because they publish peer-reviewed content. The sources contained in them are also credible for use in generating information for evidence-based practice.

Search Results

            As shown above, the initial search that was undertaken using random search of the key words of the PICOT question yielded 59 articles. This number reduced to 30 when the selected articles were specified to peer-reviewed articles only. The use of database-controlled vocabulary yielded 45 articles while Boolean search resulted in 16 peer-reviewed articles related to the PICOT statement.

Strategies to Increase Rigor and Effectiveness of a Database Search on PICOT Question

            A number of strategies will be utilized to increase the rigor as well as effectiveness of the database search for the relevant literature in the PICOT question. One of them will be the use of many databases. According to Ho et al. (2016), the use of a combination of different databases has been shown to result in an increased proportion of studies alongside questions. Restricting the search of the relevant sources of data to a single database would lead to one missing many articles, hence, skewed results.

            The second strategy that will be utilized to increase the rigor and effectiveness of the database search on the PICOT question is limiting the period in which the appropriate articles were published. Often, evidence-based practice focuses on the use of the most recent, highly accurate clinical data in improving processes (Melnyk & Fineout-Overholt, 2018). This implies that recently published data should be utilized in coming up with new clinical guidelines. As a result, the search strategy for the articles on the PICOT question will be limited to articles that were published in the last five years. The use of this approach will increase the relevance of the findings to the current issues being reported in the clinical environments.

            The last strategy that will be utilized to enhance the rigor and effectiveness of the database search on the PICOT statement is ensuring that the articles only relate to nursing practice. Evidence-based practice applies to all areas of healthcare. However, it is important that nurses explore the need for clinical practices that relate to their professional practice (Ellis, 2019). The need for this focus is to promote professional growth and advancement. Therefore, the search for the needed resources will only be specific to nursing.

References

Ellis, P. (2019). Evidence-based practice in nursing. Learning Matters.

Ho, G. J., Liew, S. M., Ng, C. J., Shunmugam, R. H., & Glasziou, P. (2016). Development of a search strategy for an evidence based retrieval service. PloS one11(12).

Library of Congress. (n.d.). Search/browse help – Boolean operators and nesting. Retrieved June 14, 2020, from https://catalog.loc.gov/vwebv/ui/en_US/htdocs/help/searchBoolean.html

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

Stillwell, S. B., Fineout-Overholt, E., Melnyk, B. M., & Williamson, K. M. (2010). Evidence-based practice, step by step: Searching for the evidence. AJN The American Journal of Nursing110(5), 41-47.

PICOT questions form the basis of clinical inquiry with a significant focus on improving patient outcomes (Melnyk  & Fineout-Overholt, 2018). The implication is that a clinical issue is identified, and an appropriate question in the PICOT format is formulated (Nieswiadomy & Bailey, 2018). The chosen clinical issue is catheter-associated urinary tract infections (CAUTI) in the emergency department. CAUTIs are common in the emergency department due to the need to catheterize patients who come in for admission. CAUTIs lead to undesirable problems, such as longer hospital stays, and even more adverse outcomes, such as death, hence a need to prevent and properly manage them (Ohanian & Gaines-Hill, 2019).  An appropriate database search strategy is necessary when searching databases for appropriate evidence regarding clinical issues. For instance, one can start the search broadly with a concept or a word and add more specific keywords to the search process to narrow down on more appropriate evidence.

Using the Walden database search, a search was conducted starting with the word catheter-associated urinary tract infections. Nursing databases were specifically used during this search. The first search was general and yielded 46,800 results. However, most of these resources were irrelevant, so more words were added to help narrow the search. The word emergency department was added to the search, reducing the number of articles to 10,600 and making them more specific. This was made possible by using the Boolean operator “And” (Grove & Gray, 2018). After formulating the PICOT question, it is expected that more specific terms will be included in the search strategy to help narrow down the most appropriate articles or evidence. For instance, the search still does not include a possible intervention to be used in the emergency department to reduce the chances of patients getting CAUTI.

PICOT question: Among adult patients admitted to the emergency department, what is the efficacy of using CAUTI bundles as compared to normal practice in lowering the rates of CAUTI in 12 weeks?

References

Grove, S. K., & Gray, J. R. (2018). Understanding nursing research e-book: Building an evidence-based practice. Elsevier Health Sciences.

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

Nieswiadomy, R. M., & Bailey, C. (2018). Foundations of nursing research. 1073.

Ohanian, S., & Gaines-Hill, S. (2019). Reduction of CAUTI rates organization-wide begins in the Emergency Department. American Journal of Infection Control47(6), S37. https://doi.org/10.1016/j.ajic.2019.04.086

According to the Quigley and White (2013), anywhere from 3%-20% of patients admitted in the impatient setting with suffer from a fall at least once throughout their stay. Within the facility that I work in, patient falls have continued to rise throughout the past year alone. Unfortunately, not all falls result in just soreness that works it’s way out in a few days. Some of the injuries patients receive in result from a fall are more serious issues, such as fractures, uncontrolled bleeding, or brain bleeds that could result in death.

According to the CDC (2021), more than 95% oh hip fractures are caused by falling and 1 out 5 falls cause serious health injuries. Although effectiveness of each of the interventions determine on the patient population being targeted in the study and the statistics being used depend on the sample size, the beginning of my focus is on the order of effectiveness of interventions to help derive a protocol. 

To begin my search at Walden University Library (n.d), I searched “falls that occur in the inpatient setting”  which yielded 3,481 results. I then placed a filter so the results only included peer reviewed articles which provided 3,065 results. To narrow the results even more, I placed the search to only show articles within the years of 2018-2022. This yielded 990 articles. When looking through the articles, they included all kinds of inpatient places (ex: psychiatric, pediatric, tertiary care, etc). I then made my search more specific and searched “elderly falls in an inpatient setting and received 13 results. By starting out the search broad and narrowing if down, it allows for more precise articles to be reported for better quality of information. Clear and concise searches are the method I am going to use to have the most recent research available so I can implement the best fall prevention strategies for my patients. I also plan to further my research and use other reliable databases. 

According to Davies (2011), evidence based practice is used to answer a variety of questions. PICO(T) was made to help break down the parts of a questions to help find research easily. My PICO(T) question is: Are elderly patients who are admitted into the inpatient setting less likely to have a fall with the use of a bed alarm or other mechanical device compared to those who just have a fall risk assessment upon admission? 

 Centers of Disease Control and Prevention. (2021). Facts About Falls. 

          Retrieved from https://www.cdc.gov/falls/facts.html 

Davies, K. S. (2011). Formulating the evidence based practice question: A review of the frameworks Links to an external site. for LIS professionals. Evidence Based Library and Information Practice, 6(2), 75–80. https://doi.org/10.18438/B8WS5N

Quigley, P., White, S. (2013). Hospital-Based Fall Program Measurement and     

             Improvement in High Reliability Organizations. The Online Journal of   

             Issues In Nursing. 18(2). https://doi.org/10.3912/OJIN.Vol18No02Man05Links to an external site.

Walden University Library. (n.d.). Databases A-Z: Nursing Links to an external site.. Retrieved from 

https://academicguides.waldenu.edu/az.php?s=19981

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?

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 I still haven’t received any search returns even with all the parameters remaining. I started using Google Scholar which I am pretty familiar with.  I started searching for only the top three of Meta-Analysis, Systematic Reviews, and Critically Appraised Topics in the hierarchy because these are the three most reliable results and three of the four that can be filtered. My three top search topics got the following: On the subject of (The criteria is the search sentence and the type of review method) Analgesia-(Meta-Analysis- 166,000). (Systematic Reviews-267,000), Topic Critically Assessed-13,500) Primary Care Pain Assessment Method -(Meta Research-120,000), (Systematic Reviews-235,000), (Topic Objectively Appraised-19,000) Multi-model Pain Treatment-(Meta-Analysis-46,300), (Systemic-Reviews-57,500). (Topics Critically Appraised-4,030).

The reason I searched for only three types of review methods is that they contain the most reliable information that my PICO question needs to be answered with the greatest precision. Depending on the type of research that I am doing, it depends on where I look for the information from the evidence hierarchy. I look more towards the Meta-Analysis if I am looking for statistical evidence. I have taken a closer look at the Systemic Reviews that fit my pre-specified eligibility criteria. The most useful ones in my view are the Critically Appraised Topics, as they are brief summaries of findings that may be close to my area of concern as they concentrate on a particular issue (Polit, D.F., & Beck, C. T., 2017). 

Some of the information I found was that the result of one meta analyst outcomes indicated the CPOT’s reliability and validity was acceptable. “Strong intra-class correlations varying from 0.74 to 0.91supported the inter-rater reliability. Significant associations between CPOT scores and both FLACC 0.87-0.92 and pain intensity Numeric Rating Scale Score 0.50-0.69 were found for criterion-related validity” (Buttes, et al., 2015). A key point to my question has been that a comprehensive, multimodel analgesic regimen will not only provide the most complete control of pain but will also minimize the need for opioids and thus reduce the resulting side effects. (Carlson, R.H., 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

 Polit, D. F., & Beck, C. T. (2017). Nursing research: Generating and assessing evidence for nursing practice (10th ed.). Philadelphia, PA: Wolters Kluwer.

Rubric Detail

Select Grid View or List View to change the rubric’s layout.

Content

Name: NURS_6052_Module03_Week04_Discussion_Rubric

  • Grid View
  • List View
 ExcellentGoodFairPoor
Main PostingPoints Range: 45 (45%) – 50 (50%) Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources.   Supported by at least three current, credible sources.   Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.Points Range: 40 (40%) – 44 (44%) Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module.   At least 75% of post has exceptional depth and breadth.   Supported by at least three credible sources.   Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.Points Range: 35 (35%) – 39 (39%) Responds to some of the discussion question(s).   One or two criteria are not addressed or are superficially addressed.   Is somewhat lacking reflection and critical analysis and synthesis.   Somewhat represents knowledge gained from the course readings for the module.   Post is cited with two credible sources.   Written somewhat concisely; may contain more than two spelling or grammatical errors.   Contains some APA formatting errors.Points Range: 0 (0%) – 34 (34%) Does not respond to the discussion question(s) adequately.   Lacks depth or superficially addresses criteria.   Lacks reflection and critical analysis and synthesis.   Does not represent knowledge gained from the course readings for the module.   Contains only one or no credible sources.   Not written clearly or concisely.   Contains more than two spelling or grammatical errors.   Does not adhere to current APA manual writing rules and style.
Main Post: TimelinessPoints Range: 10 (10%) – 10 (10%) Posts main post by day 3.Points Range: 0 (0%) – 0 (0%)Points Range: 0 (0%) – 0 (0%)Points Range: 0 (0%) – 0 (0%) Does not post by day 3.
First ResponsePoints Range: 17 (17%) – 18 (18%) Response exhibits synthesis, critical thinking, and application to practice settings.   Responds fully to questions posed by faculty.   Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.   Demonstrates synthesis and understanding of learning objectives.   Communication is professional and respectful to colleagues.   Responses to faculty questions are fully answered, if posed.   Response is effectively written in standard, edited English.Points Range: 15 (15%) – 16 (16%) Response exhibits critical thinking and application to practice settings.   Communication is professional and respectful to colleagues.   Responses to faculty questions are answered, if posed.   Provides clear, concise opinions and ideas that are supported by two or more credible sources.   Response is effectively written in standard, edited English.Points Range: 13 (13%) – 14 (14%) Response is on topic and may have some depth.   Responses posted in the discussion may lack effective professional communication.   Responses to faculty questions are somewhat answered, if posed.   Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.Points Range: 0 (0%) – 12 (12%) Response may not be on topic and lacks depth.   Responses posted in the discussion lack effective professional communication.   Responses to faculty questions are missing.   No credible sources are cited.
Second ResponsePoints Range: 16 (16%) – 17 (17%) Response exhibits synthesis, critical thinking, and application to practice settings.   Responds fully to questions posed by faculty.   Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.   Demonstrates synthesis and understanding of learning objectives.   Communication is professional and respectful to colleagues.   Responses to faculty questions are fully answered, if posed.   Response is effectively written in standard, edited English.Points Range: 14 (14%) – 15 (15%) Response exhibits critical thinking and application to practice settings.   Communication is professional and respectful to colleagues.   Responses to faculty questions are answered, if posed.   Provides clear, concise opinions and ideas that are supported by two or more credible sources.   Response is effectively written in standard, edited English.Points Range: 12 (12%) – 13 (13%) Response is on topic and may have some depth.   Responses posted in the discussion may lack effective professional communication.   Responses to faculty questions are somewhat answered, if posed.   Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.Points Range: 0 (0%) – 11 (11%) Response may not be on topic and lacks depth.   Responses posted in the discussion lack effective professional communication.   Responses to faculty questions are missing.   No credible sources are cited.
ParticipationPoints Range: 5 (5%) – 5 (5%) Meets requirements for participation by posting on three different days.Points Range: 0 (0%) – 0 (0%)Points Range: 0 (0%) – 0 (0%)Points Range: 0 (0%) – 0 (0%) Does not meet requirements for participation by posting on 3 different days.
Total Points: 100 

Name: NURS_6052_Module03_Week04_Discussion_Rubric

Sample Response for NURS 6052 Wk 4 Discussion: Searching Databases

Jessica, 

Thank you for your post, you brought up a high point on Formulating a good clinical question. Evidence-based practice (EBP) is a requirement in the current health care practice to deliver the latest technological and scientific delivery of care (Melnyk, Fineout-Overholt, Stillwell, & Williamson, 2016). EBP is the product of asking the right questions through a systematic and rigorous process. In this “big data.” age, the right word or string of words can help sift thousands of information down to the core data that is essential to start research. As suggested by Walden University Library (n.d.-a), a topic that one likes should be a good starting point. 

 This is a process that is helpful to identify a researchable question is to identify keywords that form the question – population, intervention, comparison, outcome and time (PICO(T)) (Davies, 2015).  There are more steps than just identifying the population, comparison, and intervention in formulating a research question. One must dissect more the individual parts of the question. One must also ask specific questions (foreground) and broad (background) questions (Stillwell, Fineout-Overholt, Melnyk, & Williamson, 2015). The strategies that were used to achieve a thorough and successful search was first to start from a broad topic and narrowing it down to the specific desired topic. 

References 

Davies. K. (2015). Formulating the Evidence Based Practice Question: A Review of the  

Frameworks. Evidence Based Library and Information Practice, (2), 75. Retrieved from https://ejournals.library.ualberta.ca/index.php/EBLIP/article/viewFile/9741/8144 

Melnyk, B. M., Fineout-Overholt, E., Stillwell, S. B., & Williamson, K. M. (2016). Evidence- 

based practice: step by step: igniting a spirit of inquiry: an essential foundation for evidence-based practice. The American Journal of Nursing, 109(11), 49–52. https://doi-org.ezp.waldenulibrary.org/10.1097/01.NAJ.0000363354.53883.58 

Stillwell, S. B., Fineout-Overholt, E., Melnyk, B. M., & Williamson, K. M. (2015). Evidence- 

based practice, step by step: Searching for the evidence. The American Journal of Nursing, 110(5), 41–47. https://doi-org.ezp.waldenulibrary.org/10.1097/01. NAJ.00003720 71.24134.7e 

Walden University Library. (n.d.-a). Keyword searching: Finding articles on your topic: Decide  

on a topic. Retrieved from https://academicguides.waldenu.edu/library/keyword /decideonatopic 

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