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NURS-6052 Discussion: Searching Databases

NURS-6052 Discussion: Searching Databases

Walden University NURS-6052 Discussion: Searching Databases– Step-By-Step Guide

 

This guide will demonstrate how to complete the Walden University  NURS-6052 Discussion: Searching Databases  assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

 

How to Research and Prepare for NURS-6052 Discussion: Searching Databases  

 

Whether one passes or fails an academic assignment such as the Walden University  NURS-6052 Discussion: Searching Databases depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

 

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

 

How to Write the Introduction for  NURS-6052 Discussion: Searching Databases   

 

The introduction for the Walden University  NURS-6052 Discussion: Searching Databases is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

 

How to Write the Body for  NURS-6052 Discussion: Searching Databases   

 

After the introduction, move into the main part of the  NURS-6052 Discussion: Searching Databases  assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

 

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

 

How to Write the Conclusion for  NURS-6052 Discussion: Searching Databases   

 

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

 

How to Format the References List for  NURS-6052 Discussion: Searching Databases  

 

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

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Sample Answer for NURS-6052 Discussion: Searching Databases

I began the process by learning more about the ‘PICO-T’ phenomenon. It is an acronym for methodically breaking down what kind of information a good research question should ask, and it is important to ask questions this way because it represents a systemic breakdown of the components of a research issue (Stillwell et al., 2010). Medication errors and prevention are a particular interest of mine. I wasn’t sure how much I wanted to learn about medication errors. I thought it would be interesting to look into reconciliation, but I couldn’t narrow the results down to a specific intervention. I started by searching for’medication errors,’ which led me to a slew of references ranging from pediatrics to pharmacist involvement. I knew I didn’t want any pediatrics information. And it appears too complicated to ask to what extent pharmacist involvement affected medication errors.

Furthermore, when I checked that box, the results were minimal. Then it occurred to me: why not broaden the question to include all interventions? I looked through the Walden Library, PubMed.gov, and the Cochrane Library. All of this produced a plethora of results when I searched for medication error prevention policies. After all, that is my area of expertise. I suppose it is best to see where your colleges have already traveled before embarking on an entirely new experiment of study, right? As a result, I devised the following PICO-T question: What inpatient medication prevention policies have been shown to reduce medication errors in adult patients admitted for at least 24 hours? After reading the resources for this discussion/assignment, I wondered if this was too general or vague.

On ohsu.edu, there is a good breakdown of background versus foreground questions, as well as examples of questions that are either too generalized or specific enough to meet the PICO-T criteria (ohsu.edu, 2021). So I decided to expand my search and try to zero in on a specific intervention that was effective. Are electronic medical records more effective than handwritten records at reducing medication errors in adult hospital patients? What happened to my timetable? Is the phrase “hospital setting” implied? These are the questions I’m pondering. Then I realize I’m getting too hung up on this timeframe thing. But I think that’s a good PICO; I’m just not sure if the “handwritten” comparison is necessary. When I include it in my search criteria, my results suffer greatly. So, if I can avoid the comparison, I will.

References

(September 13, 2021) ohsu.edu. https://libguides.ohsu.edu/nursing/PICO (accessed September 20, 2021).

S. B. Stillwell, E. Fineout-Overholt, B. M. Melnyk, and K. M. Williamson (2010). Step-by-step evidence-based practice: A critical step in evidence-based practice is asking the clinical question. 58-61 in the American Journal of Nursing.

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Sample Answer 2 for NURS-6052 Discussion: Searching Databases

“Evidence-based practice questions center on real-world problems and issues.” The more pressing the question, the more important it is to place it in an EBP context.” Davies (2011) This week, I used the question “How do I prevent deep vein thrombosis in inpatientsover the age of forty?” to inform my PICO(T). I chose this topic because I work in a medical-surgical setting, but I previously worked on an acute rehabilitative floor where anticoagulation was a clinical priority for all of my patients. I still work with adults, the majority of whom are elderly, and many of them are not anticoagulated for a variety of reasons. I recently requested a rapid response for one of my patients,    who turned out to have bilateral pulmonary emboli, so this topic has piqued my interest more than ever. “P-patient or Problem: Who is the Patient?” Davies breaks down the elements of the PICO(T) inquiry for us. What are the patient’s most important characteristics?

What is the primary issue, disease, or co-occurring condition? I – Intervention: What is the primary intervention under consideration? C – Comparison: What is the main intervention in comparison? “What are the anticipated measures, improvements, or effects?” “When a nurse possesses a spirit of inquiry within a supportive EBP culture, she or he can routinely ask questions about clinical practice while care is being delivered,” Melnyk et al remind us. In the spirit of inquiry, I formulated the following from my initial question: (P) in patients over 40 at risk for deep vein thrombosis, (I) is an anticoagulant the most effective prevention (C) compared to physical therapy (O) in preventing deep vein thrombosis (T) while in the hospital.

“Boolean operators and nesting allow you to look for combinations of words or phrases that have been processed in a specific order” (Boolean Operators and Nesting, 2018). I searched “deep vein thrombosis prevention” in Walden’s library’s CINAHL database, which yielded 123 results. When I entered “in elderly patients” as my Boolean operator in the advanced search box, I received only three results, which are much easier to sort through than 123. When I am conducting research in online databases, I use several strategies to narrow down the results. One such strategy is to check the ‘peer-reviewed’ box, as I only want to use reliable research. I also select ‘only inpatients’ on occasion because I work in an inpatient setting.

Nesting and Boolean Operators (2018). The Library of Congress https://catalog.loc.gov/vwebv/ui/enUS/htdocs/help/searchBoolean.html

K. S. Davies (2011). A Review of the Frameworks for Formulating the Evidence-Based Practice Question 75-80 in Evidence-Based Library and Information Practice. https://doi.org/10.18438/B8WS5N

B. Melnyk, E. Fineout-Overholt, S. Stillwell, and K. Williamson (2009).

Evidence-Based Practice: Step by Step: Creating an Inquiry Spirit

doi: 10.1097/01.NAJ.0000363354.53883.58. AJN, American Journal of Nursing, 109 (11), 49-52.

S. Stillwell, E. Fineout-Overholt, B. Melnyk, and K. Williamson (2010).

Evidence-Based Practice, Step by Step: Finding Evidence

doi: 10.1097/01.NAJ.0000372071.24134.7e. AJN, American Journal of Nursing, 110 (5), 41-47.

Sample Answer 3 for NURS-6052 Discussion: Searching Databases

I’ve chosen ventilator-associated pneumonia as my clinical topic of interest (VAP). For four years, I worked in a neuro/medical ICU, and VAP prevention was a regular part of my daily nursing tasks. Ventilator-associated pneumonia affects 10% of ventilated patients and is a major cause of inpatient morbidity and mortality (Modi & Kovacs, 2020). VAP appears to be becoming more common over time, accounting for 22% of all hospital acquired infections in 2014. (Modi & Kovacs, 2020). Effective clinical research and evidence-based practice can have a significant impact on lowering VAP rates (Emparanza et al, 2015). Emparanza et al discovered that using evidence-based practice (EBP) in the clinical setting reduced the risk of death and lengthened hospital stays (2015).

I started with a background question when thinking about my PICO(T) question. “How do you prevent ventilator-associated pneumonia in intubated ICU patients?” was my background question. This question was designed to help provide a broader understanding of the subject. The PICO(T) method enabled me to develop a foreground question that aids clinical decision making by providing evidence (Stillwell et al, 2010). To address this issue, my PICO(T) question would be, (P) does the use of a ventilator care bundle (C) compared to not using a ventilator care bundle (O) reduce rates of ventilator associated pneumonia in ventilated patients in the ICU?

I began by searching the Walden Library for articles about VAP, which yielded 18,823 results. There were a lot of search results, and it was difficult to find articles about using ventilator bundles. I then Googled “ventilator care bundle to prevent ventilator-associated pneumonia.” This produced only seven results, which were reduced to six after I applied the peer-reviewed filter. I realized I needed to find a happy medium with my search question. I began by searching specific databases, first selecting CINAHL with full text and searching “ventilator care bundle,” which yielded 25 results produced between 2015 and 2021. Many of these findings are primary research sources. With the same filters, MEDLINE yielded 27 results with full text.

Using filters is one strategy for increasing the rigor and effectiveness of a database search. Filters such as peer-reviewed journals, a range of years that a journal was published, and full text improve the search’s efficiency. The use of Boolean operators in the search question aids in the creation of a query that a database can understand. The word “and” allows the database to find items that contain both keywords, “or” finds items that contain either keyword, and “not” excludes titles that contain that keyword.

References

Emparanza, J. I., Cabello, J. B., & Burls, A. J. (2015). Does evidence-based Practice improve patient outcomes? An analysis of a natural experiment in a Spanish hospital. Journal of Evaluation in Clinical Practice, 21(6), 1059–1065. https://doi.org/10.1111/jep.12460

Modi, A. R., & Kovacs, C. S. (2020). Hospital-acquired and ventilator-associated pneumonia: Diagnosis, management, and prevention. Cleveland Clinic Journal of Medicine, 87(10), 633–639. https://doi.org/10.3949/ccjm.87a.19117

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

What are boolean operators? What are Boolean operators? – Quick Answers. (n.d.). Retrieved September 21, 2021, from https://academicanswers.waldenu.edu/faq/72773.

Sample Answer 4 for NURS-6052 Discussion: Searching Databases

The Clinical Issue that interested me was “Overcrowding in the Emergency Room,” Overcrowding in the emergency department is a significant public health issue. It leads to a decline in the overall quality of health care, which includes, but is not limited to, higher waiting times, delays in diagnosis and treatment, more significant financial load, and general patient discontent, among other things (Akbar Baig, Muhammad, Mian, Asad, Najeeb, Fatima, & Shahzhad, Hira, 2015). The PICOT question that I have developed was Emergency Room patients + interventions to reduce overcrowding + Daily Operation + Patient Satisfaction

After entering Overcrowding as the first keyword in the CINAHL & MEDLINE Combined Search database, I received 2,068 hits, which I considered a significant search. Using the terms Emergency Room and Overcrowding in the investigation, the results were reduced to 616 hits; by including the word “solution” in the Boolean expression, the results were further reduced to 64 hits.

The purpose of developing a search strategy is to identify the pool of relevant citations on the topic. The quality of searches can be formally evaluated by recall and retrieval rates (Hempel, 2020).Strategies for enhancing the rigor and effectiveness of a database search include the following: knowing the nature and content of the databases being searched; Utilizing  Boolean Operators, Parentheses, Truncation, and Wildcard Symbols; Recognizing the Limitations of the Search Interface Used to Conduct the Literature Search. In the planning stage of any research project, the process of conducting an intensive and complete literature search is crucial (Spurlock, Darrell, 2019).

References

Akbar Baig, Muhammad, Mian, Asad, Najeeb, Fatima, & Shahzhad, Hira. (2015). Overcrowding in the emergency departments: Challenges and opportunities for improvement. Journal of Pakistan Medical Association, 65(12), 1344-1345.  https://advance-lexis-com.ezp.waldenulibrary.org/document/?pdmfid=1516831&crid=54613b69-5b87-48a6-8bee-7a5bb1ef96b0&pddocfullpath=%2Fshared%2Fdocument%2Fnews%2Furn%3AcontentItem%3A5HMS-M781-JD09-30CX-00000-00&pdcontentcomponentid=400876&pdteaserkey=sr0&pd

Hempel, S. (2020). How to look: Developing search strategies. In S. Hempel, Conducting Your Literature Review (pp. 37-48). Washington DC: American Psychological Association. doi:http://dx.doi.org.ezp.waldenulibrary.org/10.1037/0000155-004

Spurlock, Darrell. (2019, August). Searching the Literature in Preparation for Research: Strategies That Matter. Journal of Nursing Education, 58(8), 441-443. doi:DOI:10.3928/01484834-20190719-02

Sample Answer 5 for NURS-6052 Discussion: Searching Databases

My clinical issue of interest is the current staffing of inpatient acute psychiatric facilities. As any nurse who has ever done a rotation or worked in a hospital in the last decade will tell you, staffing correctly can make or break your day. Not only this but has a direct impact on patient care outcomes. At the facility that I work at, and other psychiatric facilities in my state, we are staffed based on numbers at the end of the previous night. So at midnight, whatever the patient count is, this is how we are staffed for the next day. Patients continue to admit throughout the night and through the next day, whether we have staff or not. There is no consideration put into the acuity of these patients. While most of our patients are inpatient with us due to increasing depression and suicide attempts, there are in fact patients who come to us severely psychotic, completely out of touch with reality, and some manic. This means that to help them, we are understaffed and struggling to give them the care they need. There are no current staffing laws at the state level to change this policy. “Formulating a clinical question in a systematic way makes it possible to find an answer more quickly and efficiently, leading to improved processes and patient outcomes” (Stillwell et al, 2010).

According to Melnyk and Fineout-Overholt, “Finding the right information in a timely way amid an overwhelming amount of information is imperative” (2019, p. 37). First I tried to search on the CINAHL database with just the words “staffing acuity”. This brought me to 120 results. I then always like to turn on the “peer-reviewed scholarly journals” and the “full text”. This brought me to about 101 results. To narrow this down further, I added after the “and” the word “psychiatric”. This brought my results down to 4. Using the word “and” in the search allows for the search to include more than the original words, making the search produce better results (Library of Congress, n.d.). My search is a difficult one as not much research has been done into psychiatric facilities staffing levels. I plan to also use the plans that have been used in multi-specialties hospitals, and relate them to psychiatric staffing needs.

Library of Congress. (n.d.). Search/browse help – Boolean operators and nesting. Retrieved September 20, 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.

Stillwell, S. , Fineout-Overholt, E. , Melnyk, B. & Williamson, K. (2010). Evidence-Based Practice, Step by Step: Asking the Clinical Question. AJN, American Journal of Nursing, 110 (3), 58-61. doi: 10.1097/01.NAJ.0000368959.11129.79.

Sample Answer 6 for NURS-6052 Discussion: Searching Databases

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.

Sample Answer 7 for NURS-6052 Discussion: Searching Databases

Clinical Issue of Interest

The complication of Hip and Knee arthroplasty especially in older patient from 65 years and up with elective surgery. The Enhance Recovery After Surgery (ERAS) approach aims to address issues including surgical stress and organ malfunction that slow postoperative healing. A multi-source and integrated clinical care pathway uses ERAS protocols, which is a set of evidence-based interventions, as part of its overall care plan. They stand for a comprehensive strategy aimed at minimizing surgical complications, cutting down on hospital stays, raising patient satisfaction, and quickening recovery (Kaye et al,. 2019). Postoperative complications and length of hospital stay are strongly influenced by pre-existing illnesses such organ failure, hypertension, chronic obstructive pulmonary disease, diabetes, and coronary artery disease ( Alan et al,. 2019).

Most importantly, my clinical issue of interest is: If not ambulating the first day of hip or knee arthroplasty (total replacement) and blood glucose check can lead to complication in elderly people?

PICO Question

P: Older adult 65 years and up with post-operative hip and knee surgery

I : Early ambulation and post-operative blood glucose control

C: Post operation early ambulation on the day of surgery to no ambulation

O: Reduction of complication, hospital stay and early recovery with ERAS protocol

(T): Accomplish year-end performance measures.

PICO Question developed

In Older adult aged 65 and above, if not ambulating on the first day of surgery with the nurse or physical therapy and not checking blood glucose, can it lead to postoperative complications?

Database Search

Two database were selected for my search: CINAHL and PubMed ; PubMed literature search terms used “ Enhanced recovery after hip and knee replacements” and received 104 search results while in CINAHL search term “ ERAS Orthopedic” and received 27 search result. Using the exact word in my search provided many articles to select from.

Strategies to increase the Rigor and Effectiveness of Database search

By enabling the electronic health documentation sidebar summary and daily-tracking skills that are intended to validate appropriate documentation on ERAS elements, the ERAS task at this organization specifically aims to boost actual data tracking. In both articles, it emphasizes the essential components of an improved recovery program and explained the clinical use of ERAS.

References

Jentons, Alatia S., “Enhanced Recovery after Surgery: Effectiveness of Real Time Data Tracking Tools” (2021). Master’s Projects and Capstones. 1266.
https://repository.usfca.edu/capstone/1266

Kaye, A. D., Urman, R. D., Cornett, E. M., Hart, B. M., Chami, A., Gayle, J. A., & Fox, C. J. (2019). Enhanced recovery pathways in orthopedic surgery. Journal of anaesthesiology, clinical pharmacology, 35(Suppl 1), S35–S39. https://doi.org/10.4103/joacp.JOACP_35_18

Gwynne-Jones DP, Martin G, Crane C. Enhanced Recovery After Surgery for Hip and Knee Replacements. Orthop Nurs. 2017 May/Jun;36(3):203-210. doi: 10.1097/NOR.0000000000000351. PMID: 28538534.

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

Sample Answer 8 for NURS-6052 Discussion: Searching Databases

In 2021, more than 107,000 Americans died from drug overdoses (FDA, n.d.). Today’s drug overdose crisis is multifaceted and has evolved beyond prescription pain medications. Illicit opioids, largely driven by fentanyl and heroin, have become key contributors. Naloxone is a safe medication that is widely used by emergency medical personnel and other first responders to prevent opioid overdose deaths (NIDA, n.d.). Naloxone can quickly restore normal breathing and save the life of a person who is overdosing. Improving Naloxone access and carrying to persons who inject drugs (PWID) may reduce overdose mortality associated with the influx of fentanyl and heroin in the market (Buresh et al., 2020).

Using the PICO(T) acronym (Stillwell et al., 2010), the following clinical question was developed: Among PWID and are participants in a syringe exchange program, how effective is the distribution of free Naloxone in reducing fatal overdoses during a time span of 12 months?

Database #1 Embase, had a PICO search tool which was helpful. After several attempts in adjusting the search words, I recovered 52,000 articles, then using the quick search mode with two – three words, I recovered approximately 17 articles, and these seemed to be most relevant to my research question. Database #2 CINAHL, required a little time to get the hang of using it and after several attempts, I was able to recover 1,797 articles related to my research question. Using the Boolean operator AND restricted the results and I found this to be unsuccessful, while using OR was helpful in providing articles for me to then go review and determine if they would be applicable to my research question.

Strategies I will use to increase the rigor of the database search will be experimenting with different words, phrases and trying different Boolean operators to obtain a series of articles that I am satisfied with.  Also, if time permits, I will try a different database or refine the search parameters even more. There were times where I felt frustrated during the database search, so taking a few minutes for a break, then coming back to resume my search is a helpful strategy as well!

 

Buresh, M., Gicquelais Id, R. E., Astemborski, J., Kirk, G. D., Mehta, S. H., & Genberg Id, B. L. (2020). Fatal overdose prevention and experience with naloxone: A cross-sectional study from a community-based cohort of people who inject drugs in Baltimore, Maryland. https://doi.org/10.1371/journal.pone.0230127

FDA’s Overdose Prevention Framework Aims to Prevent Drug Overdoses and Reduce Death | FDA. (n.d.). Retrieved March 19, 2023, from https://www.fda.gov/news-events/fda-voices/fdas-overdose-prevention-framework-aims-prevent-drug-overdoses-and-reduce-death

Naloxone for Opioid Overdose: Life-Saving Science | National Institute on Drug Abuse (NIDA). (n.d.). Retrieved March 17, 2023, from https://nida.nih.gov/publications/naloxone-opioid-overdose-life-saving-science

Stillwell, S. B., Fineout-Overholt, E., Melnyk, B. M., & Williamson, K. M. (2010). 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. https://doi.org/10.1097/01.NAJ.0000368959.11129.79

Sample Answer 9 for NURS-6052 Discussion: Searching Databases

I enjoyed reading your post and think that you have an excellent PICOT question. I admire your work as a labor and delivery nurse, helping moms safely through delivery, brining babies into the world! Discussing your PICOT question with your nursing leadership and colleagues will be essential in determining the answer to your question. 

The Cochrane Library is a great database to find high-quality systematic reviews and registered controlled trials related to your PICOT question (Cochrane Library n.d.).  We have access to the Cochrane database through the Walden University Library. When trying to find articles related to your PICOT question, I used the keywords pregnancy “and” induction of labour or labor “and “spontaneous labour or labor resulting in 393 search results. I selected a Cochran Review document written by Middleton et al. (2020) noted in the short abstract, the question, “Does a policy of inducing labour at or beyond 37 weeks’ gestation reduce risks for babies and their mothers when compared with a policy of waiting until a later gestational age, or until there is an indication for induction of labour? A randomized control study was conducted, and a summary of findings was provided between labour induction versus expectant management of infant /child outcomes (p. 4). The data was measured using the GRADE method, Grading of Recommendations Assessment, Development, and Evaluation. According to Melnyk and Overholt (2019), “GRADE provides a framework for specifying healthcare questions, choosing outcomes of interest and rating their importance, evaluating the available evidence, and bringing together evidence with considerations of values and preferences of patients and society to arrive at recommendations” (p. 243).  

Reference 

Cochrane Library. (n.d.). About the Cochrane Library. 

https://pregnancy.cochrane.org/pregnancy-and-childbirth-groups-trials-register

Melnyk, B.M., & Fineout-Overholt, E. (2018). Evidence- based practice in nursing &

 healthcare: A guide to best practice (4th ed.). Wolters Kluwer.   

Middleton, P., Shepherd, E., Morris, J., Crowther, C.A., & Gomersall, J.C. (n.d.) Induction of 

labour at or beyond 37 weeks’ gestation. Cochrane Database of Systemic Reviews, 7. 

Sample Answer for NURS-6052 Discussion: Searching Databases

The Clinical issue of interest is CLABSI. A central line is a catheter inserted through an internal jugular, subclavian, femoral, or peripheral vein that terminates near the heart in the superior or inferior vena cava (Khalid et al., 2013). A central line-associated bloodstream infection (CLABSI) is a severe infection that occurs when germs (usually bacteria or viruses) enter the bloodstream through the central line (CDC, n. d.). CLABSIs are preventable infections, resulting in thousands of deaths yearly and billions of added costs to the U.S. healthcare system. Central venous catheters (CVC) are often essential in the care of the critically ill patient. They allow the safe administration of intravenous medications that cannot be given peripherally, aid in the administration of intravenous fluid resuscitation, and help in monitoring hemodynamic parameters in the management of patients with syndromes such as septic shock, cardiogenic shock, decompensated heart failure, and pulmonary hypertension (O’Grady, 2017).

Literature search

The primary databases I searched for information were CINAHL Plus with full text, MEDLINE with full text, and the Walden Library. The initial term I used for the PICO(T) question was CLABSI. I used the exact term because CLABSI is the central concept and a known severe issue in our hospitals. With CINAHL Plus full text, the search result was about 512 and 455 for peer-reviewed. With MEDLINE with full text, the result was 599. These results were considerable numbers of articles and data to work. My filter search by narrowing down the years between 2013-2020, and the results came almost the same. Skelly Ecker (2010) finds that using Boolean terms such as AND, OR AND when researching can narrow down information. So, to narrow down the information, I used AND. For instance, to search for ‘prevention AND intervention’ to reduce CLABSI in hospitalized patients, the results were 52 peer-reviewed articles.

Strategies to increase the rigor and effectiveness of the PICO(T) question

To increase the rigor and effectiveness of my PICO(T) question, first, I was specific by using CLABSI. It produced needed results, being that the keyword was precise. Next, I used the database filters. UAMS (2020) agrees that to get evidence-based information, researchers should filter results using database filters. To filter the results in the CINAHL database by using advanced search with the Boolean term, limiters like full text, peer-reviewed, and between 2010-2020. The result was about 63, which would be reasonable to work. I also searched for articles by clicking on the search widgets on the right side for quick access to CINAHL Plus full text and MEDLINE Plus full text.

References

Khalid, I., Al Salmi, H., Qushmaq, I., Al Hroub, M., Kadri, M., & Qabajah, M. R. (2013). Itemizing the bundle: Achieving and maintaining “zero” central line-associated bloodstream infection for over a year in a tertiary care hospital in Saudi Arabia. AJIC: American Journal of Infection Control, 41(12), 1209–1213. https://doi-org.ezp.waldenulibrary.org/10.1016/j.ajic.2013.05.028Links to an external site.

Melnyk, B.M., Fineout-Overholt, E., Stillwell, S.B., & Willamsom, K. M. (2023).Evidence-based practice: step by step: Igniting a spirit of inquiry. American Journal of Nursing. 109(11), 49-52. Doi:10. 1097/01. NAJ.0000363354.53883.58. Retrieved from https://journals.iww.com/ajnonline/fulltext/2009/11000/Evidence_Based_Practice_Step_By_Step_Igniting_a.28.aspxLinks to an external site.

Bell, T., & O’Grady, N. P. (2017). Prevention of Central Line-Associated Bloodstream Infections. Infectious disease Clinics of North America, 31(3), 551–559. https://doi.org/10.1016/j.idc.2017.05.007

University of Arkansas for Medical Science (2020). Developing a search strategy for primary literature. Retrieved from https://www.//libguides.uams.edu/evidence_based_medicine/acquiringLinks to an external site.

What are some things healthcare providers are doing to prevent CLABSI? Retrieved from https://www.cdc.gov/hai/bsi/clabsi-resources.htmlLinks to an external site.