NURS 6052 Discussion: Searching Databases Assignment

NURS 6052 Discussion: Searching Databases Assignment

NURS 6052 Discussion: Searching Databases Assignment

I agree with you that most adolescents experienced mental breakdown and psychological distress during the COVID-19 pandemic. Healthcare facilities received many teenagers with mental health complications. The restrictive measures such as closure of social and public amenities compelled these youngsters to stay lonely at their homes (Magson et al., 2021). However, to obtain credible and accurate materials to explain mental health issues among adolescents, locating the right platforms is important.

The Walden library resource is a genuine source of academic materials. However, navigating to the right reading materials is a process guided by the keywords. Walden library has many materials. Therefore, choosing wrong keywords may mislead someone to other sources (Ravens-Sieberer et al., 2022). Peer-reviewed articles are considered to be the best. Besides, using latest materials provide relevant and current information. Different results are obtained when searching for information about COVID-19. Hence, becoming more specific increases the accuracy of the process. Reading more articles on mental health issues among adolescents due to the COVID-19 pandemic increases clarity on the problem.

 

References

Magson, N. R., Freeman, J. Y., Rapee, R. M., Richardson, C. E., Oar, E. L., & Fardouly, J. (2021). Risk and protective factors for prospective changes in adolescent mental health during the COVID-19 pandemic. Journal of Youth and Adolescence, 50(1), 44-57.

Ravens-Sieberer, U., Kaman, A., Erhart, M., Devine, J., Schlack, R., & Otto, C. (2022). Impact of the COVID-19 pandemic on quality of life and mental health in children and adolescents in Germany. European Child & Adolescent Psychiatry, 31(6), 879-889.

Introduction

This discussion focuses on my Clinical issue of interest, which is CLABSI, my PICO(T) statement, literature search results, and Strategies to increase the rigor and effectiveness of my PICO(T) question database search.

A central line is a catheter inserted through an internal jugular vein, subclavian, femoral, or peripheral vein that terminated in the proximity of the heart in the superior or inferior vena cava (Khalid et al, 2013). A central line-associated bloodstream infection (CLABSI) is a serious infection that occurs when germs (usually bacteria or viruses) enter the bloodstream through the central line (CDC, n. d.). CLABSIs are a preventable infection, yet it results in thousands of deaths each year and billions of added costs to the U.S. healthcare system (CDC, n. d.).

PICO(T) question

Would using the CLABSI bundle decrease the incidence of CLABSI cases in hospitalized patients throughout their hospitalization period? PICO(T) format is popularly used when it comes to formulating

questions in evidence-based practice. According to Melnyk et al (2019), a PICO(T) question should be formulated before starting literature research. Having a well-constructed PICO(T) question helps find the best available results.

Literature search

The three 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 my PICO(T) question was CLABSI. I decided to use the exact term because CLABSI is the main concept and a known serious 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. I think these results were considerable numbers of articles and data to work with. I went on to filter my search by narrowing down the years between 2013-2020, and the results came almost the same.

Skelly & Ecker (2010) find that using Boolean terms such as AND, OR AND when researching can narrow down information. So, to narrow down my information, I used AND. For instance, I searched for ‘prevention AND intervention’ to reduce CLABSI in hospitalized patients, and 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 by using database filters. To really filter my results in the CINAHL database, I used advance search with the Boolean term, limiters like full text, peer-reviewed, and between 2010-2020. My result was about 63, which would be reasonable to work with. Moving on, 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.2013.05.028

Melnyk, B.M., Fineout-Overholt, E., Stillwell, S.B., & Willamsom, 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. Retrieved from https://journals.iww.com/ajnonline/fulltext/2009/11000/Evidence_Based_Practice_Step_By_Step_Igniting_a.28.aspx

+Skelly, A. & Ecker, E. (2010). Conducting a winning literature search. Evidence-based spine-care journal, 1(1), 9-14.https://doi.org/10.1055/s-0028-1100887

University of Arkansas for medical science (2020). Developing a search strategy for primary literature. Retrieved from https://www.//libguides.uams.edu/evidence_based_medicine/acquiring

What are some of the things that healthcare providers are doing to prevent CLABSI? Retrieved from https://www.cdc.gov/hai/bsi/clabsi-resources.html

NURS 6052 Discussion: Searching Databases Assignment

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.

Clinical Issue: Medication error is defined as “a preventable event that may cause or lead to inappropriate medication use or patient harm (Food and Drug Association, 2019). The Issue of medication error has proven its prevalence in the US as approximately one in every 5 medication doses given during hospitalizations are given in error (DataRay, 2002). To add to this, the Patient Safety Network revealed an alarming statistic that the median medication error rate during medication administration is 8%-25% (2021). With nurses being the gatekeeper of medication administration it is undeniable that we play a pivotal role in preventing medication errors as we are often times the last line of defense for our patients. Therefor my clinical issue of interest is to analyze the impact of employee engagement and motivation on medication errors caused by nurses within the clinical setting.

Clinical Question: Are nurses that are motivated through employee engagement less likely to make medication errors than nurses that are not engaged at work and are unmotivated?

P- medication errors caused by nurses

I- employee engagement

C- motivated versus unmotivated nurses

O- decrease in medication error

Databases Used and Results

I used the Embase database and initially searched for the phrase “nursing medication errors” which resulted in 6460 articles being populated with a few having relevance to my clinical interest. I also used the CINHAL Plus with full text database and searched for the same phrase and 251 articles populated as a result.

I then refined my searches on both databases using Boolean operators. The key words used were “nursing” AND “medication errors” AND “employee engagement”. Embase produced 3 articles only 1 of which was relevant to my clinical interest. CINHAL Plus also produced 3 articles, two of which was relevant. Further refinement was needed in the Embase database as I was not able to locate enough articles with relevance. I then had to use the key words “Medication” AND ‘Error” AND “Prevention” AND “nurses” in the Boolean operator to obtain more appropriate articles. I was then able to gather four articles for future use.

How to Increase Rigor and Effectiveness of Database Searches

One way to increase the rigor and effectiveness of  searches on the Embase database is to use the PICO option. There is an option on this database to insert the PICO information of the topic you would like to research and relevant articles will populate. Additionally, in CINHAL Plus searches can be refined by filtering the search options. I filtered my search to show peer reviewed articles and full text articles only. Lastly, I also found it synonyms useful to refine my searches. 

References

DataRay.(2002). Medication error statistics. Retrieved from: https://datarayusa.com/resources/stats/Links to an external site.

MacDowell, P., Cabri, A., and Davis, M. (2021). Patient Safety Network: Medication Administration Errors.Retrieved from: https://psnet.ahrq.gov/primer/medication- administration-errorsLinks to an external site.

Food and Drug Administration. (2019). Working to Reduce Medication Errors. Retrieved from: https://www.fda.gov/drugs/information-consumers-and-patients-drugs/working-reduce-medication-errorsLinks to an external site.

Walden University Library. (n.d.-c).Evidence-based practice research: CINAHL search helpLinks to an external site.. Retrieved September 6, 2019, from https://academicguides.waldenu.edu/library/healthevidence/cinahlsearchhelpLinks to an external site.

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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.

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By Day 3 of Week 4

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 examples. NURS 6052 Discussion: Searching Databases Assignment

Clinical issue of interest 

            My clinical issue of interest is nurse to patient ratios and how they relate to patient outcomes including length of stay, mortality, readmissions, and medical errors. This is a topic that is dear to all of us given the dramatic change of the staffing panorama across the country. It has become more challenging for hospitals to support adequate staffing given the already pre existing nursing shortage with the loss of full time staff to travel nursing and such. This is a multifaceted issue with many affecting factors but its dire effect on patient outcomes deserves to be analyzed so that the most appropriate ethical decisions can then be taken for both staff and patients. As discussed by McHugh et al. (2021), decreased nurse to patient ratios do not only improve patient outcomes but also aid in retaining staff due to the favorability of the working conditions. By providing nurses to adequate tools to render quality, ethical patient care, morale is then increased and working environment improves. Decreasing nurse turnover is a key factor to maintaining decreased patient ratios. 

PICOT question 

            Research of clinical significance must identify a legitimate issue with a valid research questions. In order to determine the best study design the question should be formatted in a precise manner. According to Lira and Rocha (2019), the PICOT acronym (Population, Intervention, Control, Outcome, and Time) encompasses all the ingredients needed for a research of question that will yield clinical significance. My PICOT question given my topic of interest is: For nurses in acute care settings if given decreased nurse to patient ratios , as opposed to increased, will lead to improved patient outcomes including decreased length of stay, mortality, readmissions, and medical errors. Two of the databases that yielded the most valuable research that was not a systematic or literature review were CINAHL and Proquest. 

Search Results/Use of Boolean Operators 

            As described by Bramer et al. (2018), the use of Boolean operators utilized correctly will yield for specific material to the issue in question and facilitate the research process. During my research process, when conducting a search using the term “nurse to patient ratios” and selecting dates from 2017 to current, peer reviewed journals, and full text available, 146 results This was using CINAHL plus with full text. The articles provided were of interest, value and validity. 

Research Strategies

            Graduate school has been challenging for me. It had been a while since I had completed my bachelors and I do not recall so much from my ADN program in terms of meaningful research and APA format. So all this has been of learning experience for me. I have found that using databases such as CINHAL, Medline, Pubmed, and Proquest will yield for meaningful articles. As well as selecting the dates of 2017 to current, peer reviewed , full text and currently avoiding the terms systematic and literature review will also help the search be of more rigorous research. 

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.

In evidence-based practice gathering data and scientific evidence coupled with clinical experience, interpret best practice methods. Clinical inquiry through research is a way to understand and evaluate interventions and outcomes. PICOT is an acronym to help you formulate a clinical question and guide your search for evidence, and using this format can help you find the best evidence available in a quicker, more efficient manner (Bonsall, 2015).  PICOT stands for P: patient, population, interest, I: intervention, exposure, C: comparison, O: outcome, T: time (Melnyk & Fineout-Overholt, 2019). After developing a PICOT question research will be conducted through appropriate databases to yield articles relevant to the PICOT question.

PICOT Question:

In nurses with less than five years of experience (P) what is the effect of a workplace bullying intervention program (I) on a reduction in the incidence of workplace bullying (O) compared with no intervention (C) within a one-year period (T)?

The databases used were the Cumulative Index to Nursing and Allied Health Literature (CINHAL) plus full text and Medline plus full text. The CINHAL database yielded nine articles using search terms “bullying,” “intervention,” and  “nurse.” The Medline database produced ten articles using search terms “bullying,” intervention,” and “nurse.”  After receiving the results, I added search terms, “support,” “solutions,” on top of “nurse” and “bullying,” and it yielded fewer results. 

Strategies I will utilize are; investigating database research, looking at the articles yielded, and finding keywords within and using them as Boolean operators. A few other strategies are brainstorming synonyms, expanding acronyms, and looking at subjects. Evidence-based practice is based on developing a PICOT question as a guide for research and part of clinical inquiry. Promoting clinical investigation in evidence-based practice allows scholars to understand and compartmentalize research processes to aid in successful navigation.

References

Bonsall, L. (2015, October). What is your question? Retrieved June 24, 2020, from https://www.nursingcenter.com/ncblog/october-2011/what-is-your-question

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

Hanrahan, K., Wagner, M., Matthews, G., Stewart, S., Dawson, C., Greiner, J., . . . Williamson, A. (2015). Sacred Cow Gone to Pasture: A Systematic Evaluation and Integration of Evidence-Based Practice. Worldviews on Evidence-Based Nursing, 12(1), 3-11. doi:10.1111/wvn.12072

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