Searching Databases Develop your PICO(T) Question

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NURS-6052 week 4 Discussion: Searching Databases
For this discussion we are first developing your PICO(T) question. Try to use a topic that is important to you. From my experience, it is usually easier to use an intervention type question, but you can use any formats suggested in your textbook chapter 2, page 40, table 2.2 and there are some templates on page 44, table 2.2. Here is the intervention type format to use (if you like).

In_____________________(POPULATION) how does ______(Intervention) compared with _______(Comparison) affect ___________(Outcome) within______________________(time, optional).

Example: In acute care hospitalized patients (Population) what is the effect of using CHG caps on all central line ports (intervention) compared to current ports used (comparison) on rates of CLABSI (outcome…be sure it is measurable), over a 6-month period (time)?

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The second part of this discussion post is to describe your experience in your database searches. Chapter 3 in your textbook offers some great strategies or database searches. This can be a narrative description, or some students like to use a chart. Something like this:

Search terms using Boolean operators Database used Number of Hits Notes on any outstanding articles, what level of evidence were found
NURS-6052 week 4 Discussion: Searching Databases

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.

Be sure to include a reference page including all the resources you used for this discussion post.

Don’t forget these resources are available to help:

Essentials of Evidence-Based Practice: Library Tips NURS-6052 week 4 Discussion: Searching Databases

Library Course Guide for NURS 6052 with links to Library readings
Essentials of Evidence-Based Practice: Walden Library Tips

Library Course Guide for NURS 6052 with links to Library readings
Nursing Databases in the Walden Library – 15 recommended databases for scholarly research
Assignment Guide for Week 2 with recommended steps
Evidence-Based Practice Research Guide – includes help forming a PICOT Question, Evidence Types
Reliability & Validity – part of our Tests & Measures guide
Recorded Nursing Webinars – Introduction to Nursing Research in the Walden Library; Advanced Library Research
See also: Get Help – for library, writing, academic skills, and technical issues

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 NURS-6052 week 4 Discussion: Searching Databases.

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. NURS-6052 week 4 Discussion: Searching Databases
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. NURS-6052 week 4 Discussion: Searching Databases

Clinical Issue

The Clincial issue of interest i would like to research is the use of chlorhexidine for oral care on mechanically ventilated patients versus other types of routine oral care to prevent infection such as pneumonia. According to Nicolosi et al. (2014), a quasi-experimental study was performed using 0.12% chlorhexidine oral rinse 72 hours prior to cardiovascular surgery on mechanically ventilated patients to prevent ventilator associated pneumonia. The two groups included 150 patients each. Group two did not use chlorhexidine and had a 30% increase in VAP compared to group one.

PICO(t) Question

In acute care hospital ventilated patients how does chlorhexidine oral care compared to routine oral care affect pneumonia rates within 2 weeks.

Database Search

  1. I went to the Walden Univeristy Library and searched the Proquest Health and Medical Collection database. The keywords I used in the boolean boxes are: oral care, chlorhexidine and pneumonia. The search yielded 20 reaserch studies including quantitative, qualitative quasi-experimental studies. The research in scholarly in nature and evidence-based practice. According to Zand (2017), VAP is the number one infection for ICU patients and accounts for 9-27% of patients admitted to the ICU. VAP cost in the U.S is currently greater than two billion dollars.
  2. The second search was using the Walden University Library and the CINAHL & Medline Combined Search database. The keywords used in the boolean boxes were: chlorhexidine oral and pneumonia. I also used the advanced search option to include scholarly articles with lists of references. Here I found 15 articles of research that are quantitative, qualitative and reviews. NURS-6052 week 4 Discussion: Searching Databases The research articles are evidence-based practice and very informative. According to Oshodi & Bench (2013), the UK prefers chlorhexidine over other oral care to prevent VAP and decrease unwanted health care expenses.

Research Technique

When searching for research I plan on using additional databases in the Walden University library and other accredited organizations. Other ways to improve search results in Proquest and CINHAL would be to add additional keywords such as ventilator associated pneumonia, health care acquired pneumonia, ventilator oral care, and ICU infections. Keeping the words short help identify information in the research database. I would also like to explore other databases such as uptodate.com, this database does charge a yearly fee but has excellent research articles that are scholarly and use evidence-based practice.

Resources

Nicolosi, L. N., del Carmen Rubio, M., Martinez, C. D., Gonzalez, N. N., & Cruz, M. E. (2014). Effect of oral hygiene and 0.12% Chlorhexidine gluconate oral rinse in preventing ventilator associated pneumonia after cardiovascular surgery. Respiratory Care, 59(4) 504-509. https://doi-org.ezp.waldenulibrary.org/10.4187/respcare.02666

Oshodi, T. O., & Bench, S. (2013). Ventilator-associated pneumonia, liver disease and oral chlorhexidine. British Journal of Nursing, 22(13), 751-758. https://doi-org.ezp.waldenulibrary.org/10.12968/bjon.2013.22.13.751

Zand, F., Zahed, L., Mansouri, P., Dehghanrad, F., Bahrani, M., & Ghorbani, M. (2017). The effects of oral rinse with 0.2% and 2% chlorhexidine on oropharyngeal colonization and ventilator associated pneumonia in adults’ intensive care units. Journal of Critical Care, 40, 318-322. doi:http://dx.doi.org.ezp.waldenulibrary.org/10.1016/j.jcrc.2017.02.029

Sample 2

Discussion Week 4 Postpartum Depression

Clinical Issue of Interest

My clinical issue of interest is postpartum depression and the difference in screening women two weeks after giving birth versus six weeks after giving birth. NURS-6052 week 4 Discussion: Searching Databases There has been some debate at the practice I work for, that we are not catching a number of postpartum depression patients before their postpartum depression increases.

PICO(T)

In postpartum women, how does screening for postpartum depression at 2 weeks after birth compared with 6 weeks after birth, affect the overall outcome of the patient’s depression levels within the first 6 months after birth.

Database search

After forming my PICOT question based on my clinic issue of interest, I started my search on the Walden Library EBSCO discovery service using Boolean/phase: Postpartum Depression. Of course, that yielded 39, 884 articles so I narrowed my search by only peer-reviewed journal articles from the past 5 years. I added the Boolean/phase and EPDS to my search and this yielded 2,237. I searched MEDLINE with full text and CINAHL Plus with full text NURS-6052 week 4 Discussion: Searching Databases.

Strategies to Increase the Rigor and effectiveness of the database search

Some strategies that could increase the rigor and effectiveness of the database search would be to add other words to the boolean/phase and section and other keywords. Some other keywords would be other possible postpartum depression screening strategies. Forming the PICOT question helped with the keyword search.

References

Liu, H., & Yang, Y. (2021). Effects of a psychological nursing intervention on prevention of anxiety and depression in the postpartum period: a randomized controlled trial. Annals of General Psychiatry, 20(1), 1–7. https://doi- org.ezp.waldenulibrary.org/10.1186/s12991-020-00320-4

Long, M. M., Bennington, L., Cramer, R. J., Morgan, F. G., Wilkes, C. A., Fontanares, A. J., Sadr, N., Bertolino, S. M., & Paulson, J. F. (2020). Perinatal Depression Screening Rates, Correlates, and Treatment Recommendations in an Obstetric Population. Families, Systems & Health, 38(4), 369. https://doi- org.ezp.waldenulibrary.org/10.1037/fsh0000531 NURS-6052 week 4 Discussion: Searching Databases

Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer

Van der Zee-van den Berg, A. I., Boere-Boonekamp, M. M., Groothuis- Oudshoorn, C. G. M., & Reijneveld, S. A (2021). Postpartum depression and anxiety: a community-based study on risk factors before, during and after pregnancy. Journal of Affective Disorders, 286, 158–165. https://doi-org.ezp.waldenulibrary.org/10.1016/j.jad.2021.02.062

Wan Mohamed Radzi, C. W. J. B., Salarzadeh Jenatabadi, H., & Samsudin, N. (2021). Postpartum depression symptoms in survey-based research: a structural equation analysis. BMC Public Health, 21(1), 1–12. https://doi- org.ezp.waldenulibrary.org/10.1186/s12889-020-09999-2 NURS-6052 week 4 Discussion: Searching Databases

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