Reducing Hospital Acquired Infections via Hand Disinfection Discussion

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.

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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 materials offering guidance on using databases, performing keyword searches, and developing PICO(T) questions provided in the Resources.

Review the Resources for guidance and develop a PICO(T) question of interest to you for further study.

Post your PICO(T) question, the search terms used, and the names of at least two databases used for your PICO(T) question. Then, 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

Resources:

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.

Chapter 2, “Asking Compelling Clinical Questions” (pp. 33–54)

Chapter 3, “Finding Relevant Evidence to Answer Clinical Questions” (pp. 55–92)

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

Note: You will access this article from the Walden Library databases.

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

Note: You will access this article from the Walden Library databases.

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

Note: You will access this article from the Walden Library databases.

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. doi:10.1097/01.NAJ.0000372071.24134.7e

Note: You will access this article from the Walden Library databases.

https://catalog.loc.gov/vwebv/ui/en_US/htdocs/help/searchBoolean.html

https://academicguides.waldenu.edu/az.php?s=19981

https://academicguides.waldenu.edu/library/healthevidence/cinahlsearchhelp

https://academicguides.waldenu.edu/library/healthevidence/jbisearchhelp

https://academicguides.waldenu.edu/library/healthevidence/medlinesearchhelp

https://academicanswers.waldenu.edu/faq/72670

https://academicguides.waldenu.edu/library/healthevidence/types#s-lg-box-1520654

Examples of what my classmates are posting:

Trisha Carroll

Main Post Trisha Carroll

Discussion Main Post

PICO(T) Formula

A PICO(T) question uses a format or formula to develop research questions that are answerable. This formula assists in the evaluation of evidence, making the process easier and more straightforward (Melnyk, B. & Fineout-Overholt, E. 2018). To break it down P stands for population or patient problem this part of the formula answers the question of who is your patient? The I means intervention or what do you plan to do for the patient. The C stands for comparison, asking what is the alternative to your plan? O means outcome or what outcome do you seek? Finally, the T stands for time asking what is the time frame? (Lansing Community College Library, 2020). Nurses are encouraged to use this formula to create questions that will lead to better clinical care.

PICO(T) Question

Can healthcare providers decrease the overuse or misuse of antibiotics for treatment of urinary tract infections in the elderly through proper diagnostic testing versus improper testing within three months’ time?

Search Terms

When performing research it is important to use specific key search words. Some keywords used to create this PICOT question include urinary tract infection, elderly, and antibiotics. These keywords brought forth many useful articles that relate to the misuse of antibiotics in the elderly due to non-symptomatic bacteriuria. Bacteriuria is a chronic condition that often occurs within the elderly when bacteria in the bladder becomes colonized, yet does not cause negative signs and symptoms that are associated with a urinary tract infection. Alternative keywords used include bacteriuria and

Databases

CINAHL plus is a useful database in the research of healthcare issues (Walden University Library. n.d.). After using specific keywords 78 articles were found, at least half of these being relevant to this PICOT question. MEDLINE is another commonly used database to assist in healthcare-related research (Walden University Library. n.d.). After using the same key search words, 164 articles were found. Many of these articles were the same articles found through the CINAHL database. This database found multiple articles related to antibiotic resistance. After altering search words, another 173 articles were found through this database.

Boolean Operators

The use of Boolean operators assists a researcher by providing more focused and productive results. Boolean operators are simple words, they are used as conjunctions to combine or exclude keywords in a search. These operators help to narrow down search results to reduce time spent researching and scanning through databases (Library of Congress. n.d.)

Strategies

To help find more systematic reviews one can use filtered databases such as the Cochrane Database of System Reviews instead of unfiltered databases. When unfiltered databases are used there are additional limiters that a researcher can set that will refine the search to systematic reviews (Walden University Library. n.d.). Systematic reviews refine large quantities of data into a single document. Clinical decisions are summarized and clinical questions are reviewed through the analysis of specific criteria (Walden University Library. n.d.). Through the use of these strategies, articles can be found that are direct and related to the PICOT question above. These strategies will help to minimize the time spent researching and filtering through articles to find more relevant information.

References:

Lansing Community College Library. (2020). Nursing: PICOT. Retrieved on 3/17/20 from https://libguides.lcc.edu/nursing

Library of Congress. (n.d.). Search/browse help- Boolean operators and nesting. Retrieved on 3/17/20 from http://catalog.loc.gov/vwebv/ui/en_US/htdocs/searc…

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.

Walden University Library. (n.d.-c.). Evidence-Based practice research: CINAHL search help. Retrieved 3/17/20 from https://academicguides.waldenu.edu/library/healthe…

Walden University Library. (n.d.-c.). Evidence-Based practice research: MEDLINE search help. Retrieved 3/17/20 from https://academicguides.waldenu.edu/library/healthe…

Walden University Library. (n.d.-h.). Quick Answers: How do I find a systematic review article related to health, medicine, or nursing? Retrieved on 3/17/20 from https://academicanswers.waldenu.edu/faq/72670

Walden University Library. (n.d.-i). Systematic Review. Retrieved 3/17/20 from https://academicguides.waldenu.edu/library/healthevidence/types#s-lg-box1520654