NURS 6052 Wk 4 Discussion: Searching Databases

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PICO (T), which is a process that is commonly used in evidence-based practice to structure, ask, and answer a question as regards the health-related question, is often used in evidence-based nursing practice. It is also used in another evidence-based research. The P stands for a population which can be age, sex, and ethnicity; I stand for intervention that is done, the C is the comparison O is the outcome while T is the time frame for the study (Melnyk & Fineout-Overholt, 2015). It can be used for the etiology

NURS 6052 Wk 4 Discussion Searching Databases
NURS 6052 Wk 4 Discussion Searching Databases

of a disease process, interpretation of research, diagnosis regimen, and epidemiology of diseases. My PICO question is “In the emergency center, how does handwashing with soap and water reduces the risk of nosocomial infections compared to the use of hand sanitizer among healthcare workers within eight months?” The listing for the population, intervention, comparison, and the outcome are listed below: P- Health care workers in emergency centers

I- Handwashing with soap and water

C- Use of hand sanitizers

O- Reduce the risk of nosocomial infections

T- Six months

One of the problems of the health care system across the nation is a hospital-acquired infection. This affects healthcare workers, relatives, and patients. Nosocomial infections otherwise called hospital-acquired infections can only be acquired in healthcare facilities in NURS 6052 Wk 4 Discussion Searching Databases. The commonest of these infections are pneumonia and urinary tract infections. These infections affect the respiratory and  the genitourinary system as well as other systems if poorly treated or Complicated. Various organisms (micro and macro) are responsible for these infections. The commonest of the bacterial organism is the Pseudomonas aeruginosa because this organism can survive and adapt in a different type of habitat, which includes soil, water, sewage, and hospitals, hence made this opportunistic pathogen the commonest cause of nosocomial infection (Zaher Ali & Nusrat munitaz, 2015).

NURS 6052 Wk 4 Discussion: Searching Databases

The databases searched for NURS 6052 Wk 4 Discussion Searching Databases were PubMed, CINAHL, CINAHL & MEDLINE Combined Search in Walden Library. My search was narrowed down to search for peer review where I used a date range of 2015 to 2020 (5 years) to show the most recent articles in evidence-based practice. For PubMed, an advance search was utilized where the article was filtered to narrow down the search. The only articles that were filtered were the studies done on the human that was published between 2015-2020. Moreover, another strategy that I utilized is a feature of PubMed that is referred to as Clinical Inquiries. Clinical Inquiries provide the ideal answers to clinical questions: using a structured search, critical appraisal, authoritative recommendations, clinical perspective, and rigorous peer review. Clinical Inquiries deliver the best evidence for point-of-care use. Clinical Inquiries are designed to improve search results by linking the type of question (therapy, diagnosis, etiology, and prognosis) to a stored search strategy that retrieves the appropriate research methodology (Schardt, 2007). With the use of these techniques, there will be an improvement in the search results which will be used to find the important peer-reviewed articles. Immediately I added a filter and search with a term When I add my filters and search the terms “Hospital Acquired Infection” in the Walden Library, I got over 212 results. The University recommends that students should use Boolean terms to create a more precise search with more relevant results (Walden Library, 2020. Immediately I added the Boolean terms to my next search and got over 84,623 results. Furthermore, a study concluded that it is important to search with a minimum of three different databases to achieve approximately 90% of all important literature on the subject. In addition to this, a strategy to increase the rigor and effectiveness of a database search is to use alternative terms (Ho et al., 2016). However, to improve my search results, alternative terms such as “Nosocomial infection”, “Proper hand-hygiene” or Hand sanitizers” can be used to improve the chance of useful evidence-based research.

NURS 6052 Wk 4 Discussion Searching Databases References

Ho, G. J., Liew, S. M., Ng, C. J., Hisham Shunmugam, R., & Glasziou, P. (2016). Development of a Search Strategy for an Evidence Based Retrieval Service. PloS one, 11(12), e0167170. doi:10.1371/journal.pone.0167170

Melnyk, B. M., & Fineout-Overholt, E. (2015). Evidence-based practice in nursing & healthcare: A guide to best practice (3rd ed.). Wolters Kluwer, Philadelphia. ISBN- 13: 978-1-4511-9094-6.

Schardt, C., Adams, M., Owens, T., Keitz, S., & Fontelo, P., (2007). Utilization of the pico framework to improve searching pubmed for clinical questions. Retrieved from https://bmcmedinformdecismak.biomedcentral.com/articles/10.1186/1472-6947-7-16

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 Main Post NURS 6052 Wk 4 Discussion Searching Databases

The PICO(T) question I chose to search for my NURS 6052 Wk 4 Discussion Searching Databases was “In acute stroke patients with dysphagia, how does an oral care regimen help reduce aspiration pneumonia rather than no oral care regimen?” I chose this question because I have worked in a Stroke unit. The hospital that I work for has a very strict protocol regarding stroke care. One of the guidelines for stroke patients is to complete a bedside dysphagia screen by nursing staff. If the screen is failed, then the patient is to be kept NPO until Speech-Language Pathologist (SLP) can assess the patient. During this in-between time bedside staff is supposed to do oral care every two hours. However, I never see the staff be diligent in this manner. This makes me question the long-term outcomes related to good oral care versus little to none.

To start my search for NURS 6052 Wk 4 Discussion Searching Databases, I used the Walden University Library (n.d.) to search for the term “oral care.” This search went across a myriad of databases that have been acknowledged by the University’s Library. The term “oral care” was far too broad and listed over 53,000 results.

At this point, I knew it was time to use Boolean operators as explained by the Library of Congress (n.d.) to help narrow my search. I also chose to use one specific database: Cochrane Database of Systematic Reviews. I found this database by using the dropdown box in the list of databases to narrow my topic to “Nursing” (Walden University Library, n.d.). Melnyk and Fineout-Overholt (2018) praise this specific database for its rigorous study designs which lead to strong levels of evidence. I then searched using the Boolean operator of “stroke AND oral care.” This lessens to only one article which was published in 2006.

I figured just one outdated article was not enough for NURS 6052 Wk 4 Discussion Searching Databases, so I decided to do a new search using MEDLINE with Full Text. This time I used a “nesting” term “oral care (stroke OR dysphagia).” This led to 46 results ranging from 2002-2020. From this point I updated the publication date ranges from 2015-2020, which then decreased the results to 25 articles. Of these 25 articles, I found an article titled “Implementing oral care to reduce aspiration pneumonia amongst patients with dysphagia in a South African setting” (Seedat & Penn, 2016). The study compared two groups, both of which had oropharyngeal dysphagia: one with consistent oral care and one without routine oral care (Seedat & Penn, 2016). This study concluded that “a regimen of regular oral care and free water provision when combined with dysphagia intervention did prevent aspiration pneumonia in patients with oropharyngeal dysphagia” (Seedat & Penn, 2016).

NURS 6052 Wk 4 Discussion Searching Databases References

Library of Congress. (n.d.) Search/browse help-Boolean operators and nesting.

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.). Wolters Kluwer.

Seedat, J., & Penn, C. (2016). Implementing oral care to reduce aspiration pneumonia amongst patients with dysphagia in a South African setting. The South African Journal of Communication Disorders, 63(1). https://doiorg.ezp.waldenulibrary.org/10.4102/sajcd.v63i1.102

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

Main Post

My clinical interest topic is looking at healthcare-associated infections (HCAIs) in regards to nurse staffing.  HCAIs are infections that patients receive while receiving care in a healthcare facility.  They are a significant cause of illness and death leading to serious medical, financial, and emotional consequences (Health.gov, 2020).  In research, PICO questions are important because they add structure to what is being researched; this saves time and effort as more relevant research is retrieved (Davies, 2011).  The PICO question for my focus is: (P) patients that acquire HCAIs, (I) increased with understaffed nurse shifts, (C) adequate nurse staffing, (O) reduced infection rates.  This question is a foreground question as it specific and relevant to the specified issue comparing two interventions to see which is most effective (Stillwell, 2010a).

The first database that I used was CINAHL Plus with Full Text.  I searched for “staffing and healthcare-associated infections.” This only yielded me with 12 articles.  From the resources, I learned that Boolean operators consists of “AND”, “OR”, or “NOT” and can assist with searches by searching combinations of words or phrases (Library of Congress, n.d.).  I then added the Boolean operator “OR” and put in “HCAIs” and 309 articles came up.  Stillwell, Fineout-Overholt, Melynk, & Williamson (2010b), suggest placing limits on the search.  I placed limits by clicking on “peer-reviewed” and my search was reduced to 232 articles.  Then I set limits on the dates and requested research only from 2015-2020.  This took my articles to 118.

The second database I used was MEDLINE with Full Text.  This time I searched one key phrase at a time.  Searching for “healthcare-associated infections” gave me 5,764 articles. Once I added “AND staffing”, 44 articles appeared.  Then I added “OR HCAIs” and was given 143 articles.  I set the same limits with dates and “peer-reviewed” as the previous database.

Using Boolean operators, adding limits, and searching multiple databases are a few ways to add rigor and effectiveness to researching PICO(T) questions.  Melynk, Fineout-Overholt, Stillwell, & Williamson (2009), discuss the spirit of inquiry—having an ongoing curiosity about why things are done the way they are.  They state that interventions should pique curiosity about evidence supporting their use.  Evidence-based practice leads to the highest quality of care, better patient outcomes, and lower costs.

References

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

Health.gov. (2020). Health care-associated infections. https://health.gov/our-work/health-care-quality/health-care-associated-infections

Library of Congress. (n.d.). Search/browse help-Boolean operators and nesting. https://catalog.loc.gov/vwebv/ui/en_US/htdocs/help/searchBoolean.html

Melynk, 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.

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

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.

M,

Thank you for posting your PICOT question and further explaining what that acronym means to the question. Your PICOT question addresses a fundamental of daily work practice which is a defining characteristic of a professional (Booth, 2006).

When starting a research project, the number of results can truly be overwhelming. As you explained in your post, Boolean operators are a great resource in narrowing one’s search. Our next assignment requires that we find systematic reviews. Walden University Library (n.d.) explains that these types of articles have a high level of evidence but there are not as many of them. Thankfully, Walden University Library (n.d.) provides filtered databases like Cochrane Database of Systematic Reviews which is known for containing a higher amount of systematic reviews when compared to other databases like CINAHL Plus.

References

Booth, A. (2006). Clear and present questions: formulating questions for evidence-based practice. Library Hi Tech, 24(3), 355-368. https://doi-org.ezp.waldenulibrary.org/10.1108/07378830610692127

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

Database Searching Discussion

When you decide to buy a new car, you must first determine what is most important to you. If mileage and dependability are important to you, you will look for data that focuses on these factors rather than color options and sound systems.

 

The same is true when looking for research evidence to help guide your clinical investigation and professional decisions. Creating a formula for an answerable, researchable question that addresses your need will greatly improve the effectiveness of your search. The PICO(T) format is one such formula.

 

In this Discussion, you will convert a clinical inquiry into a searchable question in PICO(T) format, allowing you to more effectively and efficiently search electronic databases. You will discuss this PICO(T) question and strategies for improving the rigor and effectiveness of a database search on your PICO(T) question.

 

To Get Ready:

 

Examine the Resources and identify a clinical issue of interest that can serve as the foundation for a clinical investigation.

Examine the materials in the Resources section that provide guidance on using databases, performing keyword searches, and developing PICO(T) questions.

Search at least two different databases in the Walden Library based on the clinical issue of interest and using keywords related to the clinical issue of interest to identify at least four relevant peer-reviewed articles related to your clinical issue of interest. For this assignment, avoid using systematic reviews and instead choose original research articles.

Examine the Resources for ideas and develop a PICO(T) question of interest to you for further investigation. It is suggested that an intervention-type PICOT question be created because these appear to work best for this course.

 

By Week 4’s third day

 

Post a brief description of your clinical concern. This clinical issue will be the basis for the development of your PICOT question throughout the course. Describe your search results in terms of the number of articles returned based on your original research, and how this changed as you added search terms using your Boolean operators. Finally, discuss how you might improve the rigor and effectiveness of a database search for your PICO(T) question. Provide specifics and examples.

By Week 4’s Day 6

 

Respond to at least two of your colleagues on two different days and offer additional suggestions on how to improve their database search.

Hello Wendy,

Thank you for your response. Finding the right PICO question can be challenging and time consuming. I believe that the more you practice the easier it becomes. When you think about it the evidence-based movement started in 1992 with Dr Cochrane (Melny & Fineout-Overholt, 2019). It is still recent and making its way slowly into our culture. When formulating a clinical question remember that your intervention must lead to an outcome. Your comparison is usually an undesirable result. When you think about how the experience influence the outcomes think about how it influences the culture of health care. The PICO question is the most difficult step in the evidence-based research process. Taking the time to formulate clear questions will save you time later in the process.

References

Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing & healthcare: a guide to best practice. Fourth edition. Philadelphia: Wolters Kluwer.

Name: NURS_6052_Module03_Week04_Discussion_Rubric

Excellent Good Fair Poor
Main Posting
Points 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: Timeliness
Points 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 Response
Points 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 Response
Points 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.

Participation
Points 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