NURS 8114 Discussion: Search-Based Questions

I have chosen the self-care of nurses and how it affects patient outcomes as my quality improvement process.  Searching through the Walden Library is much like using PubMed or other university libraries I have used in the past. I like that it is through EBSCO.  I found in the past that EBSCO seems to provide a broader search result than some of the other search engines.  I entered self-care for the nurse into the search bar.  There were 4637 results.

Unfortunately, these results did not all fit what I needed.  In fact, many of them were not related to the nurse but to the patient and how the nurse’s education on self-care affected the patient outcomes.  This led me to reword my search phrase.

One of the results of lack of nurse’s self-care is burnout.  I entered self-care and nursing burnout into the search bar. This time I

received 96 results.  They were much more related to the topic.

This is still a large number of results. I changed it again to say nursing and burnout patient outcomes.  The result was six studies.  These studies included the rational, impact, Joint Commission view of burnout as a hot topic and proposed protocols for nurse self-care.  Each of these studies brought a different view of the impact of burnout.

Burnout can be directly related to the lack of self-care of the nurse.  Perhaps I need to restate my topic to include burnout instead of lack of self-care.  Although the result is the same, previous research would lead me to reword the topic.

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This exercise was quite beneficial in helping me understand how I need to proceed.  Is it common to have a change in topic this far into the process?  Is this accepted?  Is there a better way to work through the search engine than to reword the keywords and phrases entered?

Thank you for your post it is very interesting. I do not think you should change your topic as burnout is an outcome of lack of self-care. We cannot be effective care providers if we do not take care of ourselves. It is a good topic that certainly needs to be addressed. It will make a great practice problem.

I used CINHAL in the Walden library. I was able to find many current relevant articles on my critical question topic lack of reliable information on the covid vaccine causing vaccine hesitancy. I tried EBSCO and did not find as many articles. It probably is dependent on the site and which topic you are searching for.

In this week required reading Dang&Dearholt textbook the chapter searching for evidence was very thorough. That chapter has step by step instructions on how to narrow your search for better results. I really found it helpful and used it for my search. That chapter also has details on what the different sites: CINHAL, Medline, EBSCO and other resources are used for.

Keep searching for lack of self-care. You have a worthwhile subject. You can make a difference.

Sample Answer for NURS 8114 Discussion: Search-Based Questions

Evaluation of Literature Research

As cited in Discussion seven, I conducted a literature search formulated from the PICO model mentioned in Dang et al. (2021). The critical question is: For adult patients diagnosed with a severe mental illness (SMI) encountered by social determinants of health, does inter-professional collaboration improve accessibility to outpatient treatments and better health outcomes?  I utilized Walden’s Library via the academic portal to begin my research process. After analyzing the critical question, I found that Walden’s library via the academic portal is one of the most helpful tools made available for researching peer-reviewed articles. I began my literature review search through the nursing database using CINAHL (CINAHL (Cumulative Index to Nursing & Allied Health Literature) and MEDLINE combined search, which allowed me to gain access to thousands of peer-reviewed articles. CINAHL and MEDLINE are familiar search engines used in previous classes and my MSN degree program. I also utilized credible information obtained directly from the World Health Organization website and the most current publication, dated 2023. I am spending more time researching, reading, comparing, and discarding irrelevant articles that are not of high critical appraisal.

Search Strategies and Finding Relevant, Current Research

One article I researched under the CINAHL search tool was too broad, generating 25,167 findings for access to mental health. I added the word services; less than half of the articles specific to these keywords generated 10,301 articles. Narrowing the literature review to information supporting the critical claim was done by selecting health services under the subject heading and then selecting mental health services which generated 4,214 resources. After narrowing my search compared to utilizing CINAHL & MEDLINE Combined, 1754 articles were generated. The number of articles generated was not all relevant to my critical question.

Most of the time, I narrowed my search to peer-reviewed articles and rarely used book citations other than those offered in the course study. After narrowing my search for these peer-reviewed articles, I allocated 213 articles relevant to my practice question. Searching for the best articles relevant to my practice issue became daunting and disorganized. I also had to use the Boolean navigation to filter and apply more keywords relevant to my practice question. I had to create a system that would allow me to keep my literature review findings by categorizing them as the highest to lowest levels of evidence. I found 9 research articles ranging from level I to level V, of which four various ranges were used for discussion seven. Utilizing a more narrow search relevant to keywords worked best for me.

I purposefully synthesized a level V research article so that I could understand and compare the difference to highly rigorous literature relevant to my practice question. I also narrowed the expansion of the search engine for literature publications dated within the last five years, which allowed me to provide current knowledge. I became a little frustrated attempting to condense the amount of literature findings. However, three search fields are automatically populated, and I needed to narrow the research more by clicking on the plus sign located to the right of the last populated fields. After I figured out this simple task, allocating more relevant literature was easier, resulting in five populated fields. According to the readings of Dang et al. (2021), they suggested that the highest levels of research would provide the best critical appraisal when presenting the evidence-based practice (EBP) quality initiative (QI) research project.

Specifications of the Search Process, Concerns, and Question(s)

Overall, I have had positive experiences except for two articles not being accessible due to a broken link. When working within time constraints, my concern is the turnaround time that it takes for a librarian to answer questions or assist students in locating similar articles. Ask the Librarian is a great resource, but it requires me to work ahead of schedule to be able to use this service. Walden’s general search library database did not work best in my literature review search. One search engine requires the individual to enter the exact name of the titles of articles, books, and other pieces of work. However, there was an article that I wavered on the level of rigorous evidence being too low. I should have written the author’s name or subject header down, and that specific search engine would have saved time in allocating the article.

The other concern with using a general search and not using the filter options will exclude EBP case studies and some systematic reviews that would have been effective information to support my critical practice question. Utilizing the general research navigation and not keeping a proper ledger at the beginning of my articles and citations exhausted productive time that could have been used for other literature review findings. It was challenging trying to categorize the levels of the research articles when compared to Appendix H of the Synthesis Process and Recommendation Tool.  Question: My question is not about researching literature but trying to find additional resources or methods that will assist me with categorizing the literature review level of evidence. I may be overlooking a more specific way to approach Appendix H when it comes to categorizing the levels of evidence.

References

Dang, D., Dearholt, S. L., Bissett, K., Ascenzi, J., & Walen, M. (Eds.). (2021). Johns Hopkins nursing evidence-based practice: Model and guidelines (4th ed.). Sigma Theta Tau International.

Sample Answer 2 for NURS 8114 Discussion: Search-Based Questions

This research on inter-professional collaboration’s impact on adult patients with severe mental illness (SMI) and social determinants of health is commendable since it has utilized various resources to gather relevant literature. Secondly, using the PICO model and focusing on peer-reviewed articles from credible sources such as the World Health Organization and recent publications are essential steps in conducting a thorough literature review. Similarly, it is impressive how it has used specific search terms and filters to narrow down your results since by refining the searches using CINAHL and MEDLINE, the research can reduce the number of irrelevant articles and access a more focused set of resources. This is because it is essential to have a systematic approach to managing the literature review findings, and the effort in categorizing them based on evidence levels is commendable since organizing the articles from the highest to lowest levels of evidence helps you present a more cohesive and evidence-based argument.

However, regarding the concern about librarian assistance turnaround time, planning and using resources like “Ask the Librarian” is indeed beneficial, especially when there are time constraints. In addition, consider reaching out to peers or faculty members for suggestions on relevant articles or efficient search strategies. Additionally, to assist in categorizing the level of evidence more effectively, there is a consideration of exploring different critical appraisal tools or hierarchies specific to the research area. Some universities and organizations have customized frameworks that might align better with your study’s focus. Moreover, attending workshops or webinars on literature review and evidence synthesis can enhance your skills in evaluating and categorizing research articles.

Regarding the issue of using a general search and potentially missing out on valuable EBP case studies and systematic reviews, there should be a consideration of utilizing advanced search filters and specialized databases that focus on evidence-based practice. Tools like the Synthesis Process and Recommendation Tool’s Appendix H can be challenging at first, but attending workshops or consulting with research advisors can provide valuable insights into effectively using them.

Sample Answer 3 for NURS 8114 Discussion: Search-Based Questions

At the outset of every online search, the search results often tend to be excessively broad, making it challenging to pinpoint the most relevant information. To illustrate this, let us consider your own experience, where the initial search yielded an overwhelming 25,167 articles. To tackle this issue, you wisely took the initiative to refine and redefine your search parameters, aiming to narrow down your focus to the most credible sources.

Most search engines, thankfully, include sophisticated refining capabilities that allow users to specify specific criteria. These factors may include, among other things, the year of publishing and the document type. For example, a researcher can only choose to examine peer-reviewed papers directly connected to their research topic. This tailored technique considerably improves the search process’s efficiency and dependability. I agree with your comment that contacting a librarian can be time-consuming. When relying on the experience of a librarian, it is critical to approach them well in advance, allowing them enough time to provide the essential guidance before the individual assignment submission dates. By doing so, you respect the librarian’s workload and boost your chances of gaining useful insights and relevant resources to help you with your research.

In conclusion, utilizing search engine refinement features and proactive soliciting aid from librarians can considerably optimize the online research process, resulting in a more efficient and rewarding academic journey.