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NURS 6052 Discussion: Searching Databases

NURS 6052 Discussion: Searching Databases

NURS 6052 Discussion: Searching Databases

Nurses know that staffing ratios are an important piece of a puzzle that is needed to deliver quality patient care with the best possible outcome.  Staffing shortages could be a huge concern for facilities regarding patient safety.  The number of nurses available for patient care has shown to have a substantial effect on patient outcomes and safety (Dong et al., 2020).  It only seems logical that hospitals and care centers who do not have enough staff for the number of patients would struggle greatly.

When searching for “staffing ratios” under the Walden Library Database, “Nursing” was chosen from the drop-down menu and a list of databases related to nursing came up.  After selecting chosen database, the main topic of staffing ratios was entered the search bar along with “nursing” as the Boolean phrase.  Boolean operators help the researcher look for keywords in a specific order that can include terms or filter them out (Library of Congress, n.d.).  For example, when searching for just the term “staffing shortages,” 98 results were available.  When searching for  “staffing shortages” and “nursing,” narrowed down results indicated there were 118 available peer-reviewed articles in the correct date range.

Evidence-based practice lays the groundwork for nurses when it comes to providing sufficient care.  Evidence-based practice starts with curiosity or a question that asks what the best possible way is to complete a task (Fineout-Overholt, 2009).  The framework of a question used for evidence-based practice is PICO.  This clinical question guideline helps breakdown clinical questions (Davies, 2011). “P” aims to identify the patient problem or the primary problem.  In this case it would be inadequate nursing staff in healthcare facilities.  The “I” is the intervention.  For staffing ratios, the intervention would be adequate staffing ratios or lower nurse to patient ratios.  “C” is for comparison.  What is the main comparison?  Inadequate staffing ratios and higher nurse to patient ratios.  The “O” is for outcome.  What is the anticipated outcome?  This would be patient safety and quality of care.

NURS 6052 Discussion: Searching DatabasesSome strategies that might increase effectiveness of a PICO question search would be using the Boolean search terms and, or, and not to assist in ruling out unwanted key phrases or including more content in the search (Library of Congress, n.d.).  Researchers know that searching for topics results in numerous results and using the Boolean phrase search can help narrow down the search to one’s specific topic of choice.

References

Davies, K. S. (2011). Formulating the evidence based practice question: A review of the frameworks [Required Readings]. Walden University Blackboard. https://class.walden.edu

Library of Congress. (n.d.). Boolean operators and nesting [Required Readings]. Walden University Blackboard. https://class.walden.edu

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

Wang, L., Lu, H., Dong, X., Huang, X., Li, B., Wan, Q., & Shang, S. (2020). The effect of nurse staffing on patient‐safety outcomes: A cross‐sectional survey. Journal of Nursing Management, 28(7), 1758–1766. https://doi.org/10.1111/jonm.13138

RE: Discussion – Week 4

Searching Databases

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The ability to efficiently research databases is a useful tool for both students and professionals. In order for a nurse to do credible

Discussion Searching Databases
Discussion Searching Databases

research on a clinical topic he or she first needs to recognize the area of interest, then identify a PICO(T) question, which is Patient/Population, Intervention, Compare/Control, Outcome and Time/Type of study or question (Stillwell, et al 2010). The clinical issue of interest I have chosen to focus on is mental health nursing in rural settings. Research has shown that there may be a discrepancy in patient care for those suffering from mental illness in rural environments compared to those in a more urban setting Jensen, E. J., Wieling, & Mendenhall, 2020).

The PICO(T) question I would like to use for this issue is, “In patients suffering from mental illness, how does a rural facility, compared to an urban facility, affect patient care outcomes during the initial encounter?”

The primary databases I searched that produced the most relevant results were, APA PsycInfo, and Medline using the Walden University Library, each producing over 40 results when searching for keywords or phrases without Boolean operators. Quotation made a significant reduction in the number of results, for example, the phrase “barriers to rural mental health” only produced five total results with the Peer-Reviewed Scholarly Journals only filter on.

According to the Library of Congress, Boolean operators and Nesting help find keywords in a specific order. The use of Boolean operators dramatically reduced the overall number of results, greatly improving the relevance of the information found in the databases. I will continue to use this strategy to improve my search results, however using overly specific phrases, such as “urban vs rural mental health” produced zero results. The use of synonyms for previously used keywords also helped refine search results, such as substituting the word urban with city, or facility with hospital. I will continue to refine my research skills, testing various keywords and phrases related to my clinical issue of interest.

References

Jensen, E. J., Wieling, E., & Mendenhall, T. (2020). A phenomenological study of clinicians’

perspectives on barriers to rural mental health care. Journal of Rural Mental Health44(1),

51–61. https://doi.org/10.1037/rmh0000125

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

Stillwell, Susan, DNP, RN, Fineout-Overholt, Ellen, PhD, RN, FNAP, FAAN, Melnyk, Bernadette, et

al. (2010). Evidence-Based Practice, Step by Step: Asking the Clinical Question: A Key Step

in Evidence-Based Practice. AJN, American Journal of Nursing, 110, 58-61.

https://doi.org/10.1097/01.NAJ.0000368959.11129.79

RE: Discussion – Week 4

 As Intensive Care Nurse, more often, we use urinary catheters for our convenience. I have seen my fellow nurses keeping a patient’s indwelling catheters until the Charge Nurse starts asking why the patient still has the catheter. Last month, one of the travel nurses hooked the indwelling Foley catheter to suction. I chose this topic on CAUTI’s to create awareness and educate my fellow nurses on using the foley for shorter periods and how to use them. My PICOT question is,  ‘How can members of the healthcare team prevent CAUTI from occurring inpatient?’

I am using three different nursing databases using Boolean terms; my first search word is ‘Catheter-Associated Urinary Tract Infection.’ My second search word, ‘Catheter-Associated Urinary Tract Infection’ or ‘CAUTI,’ to find different ways to frame a concept, expand my search and increase results (Elson, 2020). My third search word, ‘Catheter-Associated Urinary Tract Infection prevention and ‘Evidence-based Practice’ to find different ways to frame a concept, expand my search, and increase results. ‘Catheter-Associated Urinary Tract Infections’ and ‘Evidence-Based Practice’ connect different concepts and limit my results. These terms will increase the rigor of my research and provide an accurate representation of the inpatient population studied in my research (Elson, 2020) .’I will be using CINAHL plus with full text, Medline with full text, and ProQuest nursing databases to conduct my research. My researched articles have been published in the last five years to remain updated on changing evidence.

According to CINAHL plus with full text, there are 403 researched articles using my first search word, 419 using my second search word, and 7articles using my third search word. My second research database is Medline with complete text; there were 512 researched articles using my first search term, 555 using my second search term, and two articles on my third. The third database I used was ProQuest; there were 288 articles using my first search term, 302 on my second, and ten on my third search term.  In conclusion, each time I was specific on my research terms using ‘Catheter-associated Urinary tract Infection prevention’ and ‘Evidence-Based Practice,’ the research articles were fewer.

References

CINAHL  Plus with full text, (2021)

https://web.s.ebscohost.com/ehost/search/advanced?vid=0&sid=57b1227c-937d-4bfc-9689-36f0af8bc211%40redis

Echevarria, Ilia, MS, MSN, RN, CCRN, CHES, NEA-BC, Walker, Susan & DrNP, RN-BC. (2014). To make your case, start with a PICOT question. Nursing, 44, 18-19. https://doi.org/10.1097/01.NURSE.0000442594.00242.f9

Elston, D. M. (2020). Getting the most out of online literature searches-More on Boolean logic. Journal of the American Academy of Dermatology, 82(2), 299–300. https://doi.org/10.1016/j.jaad.2017.11.005

MEDLINE with full text, (2021) https://web.s.ebscohost.com/ehost/search/advanced?vid=2&sid=57b1227c-937d-4bfc-9689-36f0af8bc211%40redis

PROQUEST, (2021)

https://www.proquest.com/nahs/results/F76D4A0500504442PQ/1?accountid=14872

Vicki Parker, Michelle Giles, Laura Graham, Belinda Suthers, Wendy Watts, Tony O’Brien, & Andrew Searles. (2017). Avoiding inappropriate urinary catheter use and catheter-associated urinary tract infection (CAUTI): a pre-post control intervention study. BMC Health Services Research, 17(1), 1–9. https://doi.org/10.1186/s12913-017-2268-2

. For years I have worked in the involuntary sector of mental health treatment and have struggled with the idea of forced medication administration. On one hand, as a health care provider, I understand that if medication is not being taken on a routine basis no improvement will be made which may lead to an escalation of mental health symptoms. On the other hand, I feel it is a traumatic experience to have medication forced on you by essentially a stranger and may lead to long-lasting effects such as post-traumatic stress disorder. Over the years I have witnessed miracles and complete turn arounds in patients who presented severely psychotic and met state hospitalization criteria, as a result of court-ordered forced medication treatment. If we logically think about it, a person in psychosis cannot make a coherent, informed decision to take medications thus by initiating forced injections for at least a few doses they may be able to clear up enough to understand the need for them to take oral medications.

I went to the Walden Library research databases, selected the Database A-Z, chose nursing as the subject, then chose the PsychINFO database.  In the search fields I used “psychiatric AND forced medication”, this returned with approximately 51 sources. Most of the sources were referencing forced medication as being a type of coercive technique often used in the psychiatric setting. In my opinion in order to get more specific sources you may have to revise your PICOT question to identify a more measurable outcome as quality of care can be vague. Clarification of “quality of care” such as “patient satisfaction”, “symptom management/improvement”, “successful medication compliance”, these are all more specific outcomes. Maybe by searching these outcome keywords more sources will be available; just a theory.

Please let me know what great information you find as to outcomes, I am very interested.

 

Walden University Library. (n.d.-a). Databases A-Z: Nursing. Retrieved June 27, 2020, from http://academicguides.waldenu.edu/az/php?s=19981

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.

Resources

Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.

WEEKLY RESOURCES

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.

*Library tip:

Walden Library recommends starting your search broadly with one concept or search word and adding more elements one at a time. Depending on your topic, the evidence will not necessarily address all the aspects of your PICO(T) question in one article. Select the most important concepts to search and find the best evidence available, even if that means assembling evidence from multiple articles.

Links to an external site. page, including Ask a Librarian

Quick Answers:

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.