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[ANSWERED] Post a brief description of your clinical issue of interest. This clinical issue will remain the same

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.

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.

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

Expert Answer and Explanation

Clinical Issue of Interest

My clinical issue of interest is pressure ulcers (PU). PU, also known as pressure sores, is a common condition in geriatric settings. It is a condition characterized by injury to the skin or an underlying tissue primarily due to consistent pressure being applied in one part of the body (Nadukkandiyil et al., 2020). According to statistics by the Agency of Health Care Research and Quality (AHRQ), it is estimated that over 2.5 million people suffer from pressure ulcers every year (AHRQ, 2014). Pressure ulcers are associated with several complications that affect the wellbeing of geriatric patients, some of which include severe pain, risk of serious skin infection, high cost of care, and unfortunately, at times, it can result in death. In fact, the same statistics by the AHRQ indicate that over 60,000 people in the United States die due to complications arising from pressure ulcers. As such my PICOT question is as follows;

In geriatric patients (P), does a pressure ulcer risk assessment (I) compared to no assessment (C) lead to a 10% reduction of pressure ulcer incidents (O) within three months (T)?

 Search Results 

Knowing the right places to look for evidence is essential when evaluating quality research to incorporate as part of the evidence in clinical settings (Laureate Education, 2018). One of the valuable resources in my search was the Walden library which provides access to different libraries specifically with nursing resources, including journals and guidelines (Walden University Library, n.d.-a). The two databases listed under the Walden library I used were CINAHL Plus with Full Text and MEDLINE with Full Text. In my initial search in the CINAHL Plus with Full-Text database, I searched for pressure ulcers which returned over 10,000 search results. However, by adding the Boolean operator “AND” then adding “geriatric care” as an additional search term, the results were sifted to 101. Using the Boolean operator “OR” resulted in more results.

Strategies for Rigor and Effectiveness

One of the strategies that I can employ to improve my effectiveness in the database search is to ask for the librarian’s help, especially in selecting the search terms to use. I noticed that the application of search terms might not be as direct as it sounds, and it requires some skill and experience, which the librarian will likely have. Another strategy is to identify and select a suitable database. Different databases have different articles they specialize in, and knowing the appropriate database to choose from can save time (Walden University Library, n.d.-g).

References

Agency of Health Care Research and Quality. (2014). Preventing Pressure Ulcers in Hospitals. https://www.ahrq.gov/patient-safety/settings/hospital/resource/pressureulcer/tool/index.html

Laureate Education (Producer). (2018). Searching the Evidence [Video file]. Baltimore, MD: Author.

Nadukkandiyil, N., Syamala, S., Saleh, H. A., Sathian, B., Ahmadi Zadeh, K., Acharath Valappil, S., Alobaidli, M., Elsayed, S. A., Abdelghany, A., Jayaraman, K., & Al Hamad, H. (2020). Implementation of pressure ulcer prevention and management in elderly patients: a retrospective study in tertiary care hospital in Qatar. Aging Male23(5), 1066–1072. https://doi.org/10.1080/13685538.2019.1670156

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

Walden University Library. (n.d.-g). Keyword searching: Finding articles on your topic: Introduction to keyword searching. http://academicguides.waldenu.edu/library/keyword/searching-basics

Peer response 1

Thank you for bringing up the discussion on pressure ulcers. Like you pointed out, pressure ulcers lead do enormous harm to the patient, including death. Individuals aged 64 and older living in nursing homes appear to be more likely to develop pressure ulcers. Pressure ulcers are wounds caused by persistent impact on the skin. (CDC, n.d.). Health care workers must commit to preventing pressure by providing excellent care to patients/residents, including but limited to frequent turns, educating and encouraging a healthy diet, mot allowing the patient to remain in moisture if incontinent, reducing stress to the bony area with pillows, and others. I work in the geriatric unit. Besides individual nurses’ assessments, we have a skin assessment team that assesses the whole skin of all patients every Thursday. This practice has produced some positive outcomes. The curiosity of the care for our elderly patient led to the clinical inquiry {(Melnyk & Fineout, 2018)

It is excellent to ask the Librarian for assistance when searching for articles, although people may feel they are swamped and try to avoid asking them questions. I also found CINAHL Plus with Full Text and MEDLINE with a beneficial database. (Walden University Library, n.d.)

References

Center for Disease and Prevention Pressure Ulcers Among Nursing Home Residents: the United States, 2004 Retrieved from

https://www.cdc.gov/nchs/products/databriefs/db14.htm

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

Walden University Library. (n.d.-g). Keyword searching: Finding articles on your topic: Introduction to keyword searching. http://academicguides.waldenu.edu/library/keyword/searching-basics

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