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.

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. 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.

student one:

PICOT Question: Will the community in the last stages of life (Population), benefit from a family/relatives training program (Intervention), in comparison to unguided home care (Comparison), when it comes to quality of health care delivery (Outcome), in a time frame of ten weeks (Time)?

Palliative care involves several divisions in the population. This group of chronically ill people may include children, young adults, and the elderly. Evidence-based solutions are those that have been used and established as successful and effective. A training program is a methodology used worldwide in several fields and sectors. For nursing, it is especially important to receive proper training and continue to receive it even after you are in the professional field because technology, knowledge, and communities are always evolving. For instance, on a journal article in Child: Care, Health and Development, the population at hand was “Looked after children and young people (LACYP).” In it, experts concluded that notwithstanding foster carers there are numerous different experts from various orders working with LACYP who may likewise profit by expanded preparing and backing, remembering staff for private units, social specialists, medical care experts, specialists, attendants, advisors, clinicians, educators, youth laborers and volunteers (for example free guests or coaches) (Everson-Hock, Jones, Guillaume, et. al, 2011).

In other articles and realms, the conclusion has been similar: there is a need for training in order for patients to receive the best quality of care. This is also the case for the article written in the Journal of palliative medicine, where the focus were Canadian homes where members were experiencing life-limiting conditions. Parental figures of canadians encountering a day-to-day restricting disease have been perceived as the foundation of the experts’ medical care framework, saving medical services dollars. Albeit numerous parental figures are glad to mind and get numerous awards from their kind consideration, others feel that they have practically nothing, assuming any, voice in taking on the providing care job. Evidence proposes that parental figure readiness is fundamental to limiting the negative effects of providing care. Not being trained is related with dread, tension, stress, and sensations of deficiency and vulnerability explicit to the guardian job (Williams).

Patients in the last period of life, mostly want to receive affection and die at home. Without the assistance of family parental figures that would be inconceivable for some patients. Family parental figures are characterized as: people who give any physical, enthusiastic and instrumental help to people with a life?limiting disease that they see as relatives. Family parental figures are frequently seriously associated with individual and enthusiastic consideration, and with family unit errands and the coordination of care. For example, in the United Kingdom, family guardians give care a middle of 69 hr every week in the last three months of life. The significant work that family parental figures give may bring about both positive and negative encounters. Nurses are in an extraordinary situation in essential medical care to help family guardians (Becqué, Rietjens, van der Heide & Witkamp, 2020).

In total, results were great, and I got several examples and cases. To improve, and narrow down the search, one strategy would be to start by narrowing down the palliative care population I will be focusing on. Others will include: Choosing search terms (palliative care, home care, training programs, etc), Searching with keywords (palliative, training, independent care, etc), Searching for exact phrases, Using truncated and wildcard searches, Searching with subject headings, and Using Boolean logic.

References

Becqué, Y. N., Rietjens, J., van der Heide, A., & Witkamp, E. (2020). The effectiveness of a nurse-led intervention to support family caregivers in end-of-life care: Study protocol for a cluster randomized controlled trial. Journal of advanced nursing, 76(5), 1266–1272. https://doi.org/10.1111/jan.14326

Everson-Hock, E. S., Jones, R., Guillaume, L., Clapton, J., Goyder, E., Chilcott, J., . . . Swann, C. (2011). The effectiveness of training and support for carers and other professionals on the physical and emotional health and well-being of looked-after children and young people: A systematic review. Child: Care, Health and Development,38(2), 162-174. doi:10.1111/j.1365-2214.2011.01247.x

Williams A. M. (2018). Education, Training, and Mentorship of Caregivers of Canadians Experiencing a Life-Limiting Illness. Journal of palliative medicine, 21(S1), S45–S49. https://doi.org/10.1089/jpm.2017.0393

student two: In an era of high technology and the ever-changing realm of healthcare, acknowledging and coping with uncertainty is more crucial than ever. Uncertainties increase healthcare professionals’ stress and effects of burnout and may be a potential threat to patients’ safety. The key to successful patient care for any healthcare professionals is staying informed and as up-to-date as possible on the latest best practices and evidence-based. Looking for the correct answers are complex; however, for you to be successful in searching for answers, understanding how to formulate a clinical question properly is essential to effectively begin the evidence-based practice process (Melnyk & Fineout-Overholt, 2018).

Since I work in Cardiology, I will be posing a question about the effect of drinking more than two cups of coffee a day for patients who have underlying cardiac disease using the PICOT format. Stillwell et al. (2010) noted that formulating a clinical question systematically makes it faster to get the answers effectively, leading to improved processes and a better patient outcome. So, here is my question using a PICOT format; For patients who have underlying cardiac disease, how does the consumption of only two cups of coffee a day reduces the risk of developing atrial fibrillation compared to patients who consumes more than two cups of coffee a day within five years time frame? Following the PICOT format; P stands for the population, which refers to patient’s with underlying cardiac disease; I stands for intervention which refers to coffee consumption of two cups a day; C stands for Comparison, which refers to the consumption of two cups of coffee a day versus consumption of coffee more than two cups a day; O stands for the outcome which refers to the reduction of the risk of developing atrial fibrillation; T stands for time which refers to the time frame for achieving the goal of not having atrial fibrillation within five years.

I went to Walden Library and the search engines that I utilized were CINAHL PLUS and ProQuest Central databases:

1. I typed in the keyword atrial fibrillation, which populated 88 192 results and 35 460 from the ProQuest database.
2. When I narrowed down my search using the filters for full text, peer-reviewed, date range from 2016 to 2021 and added the keyword coffee or caffeine, the streamlined search the result was 4, 804, and 17,957, respectively.
3. I added the keyword cardiac disease and added five years, I also included the Boolean search parameter and it gave me 5 475 from the CINAHL PLUS database and 2 789 from ProQuest Central.

It is challenging and sometimes frustrating to search for an article online. The inclusion of Boolean operators is vital to refine your search (Walden University Library, n.d.f.). When searching for an article, I used other strategies to break down the topic into keywords, and I added more keywords in the search box as I narrowed down my search. And also, look up an alternative term; for example, I added OR caffeine as an alternative word in the search bar for coffee.

References

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)

Stillwell, S. B., Fineout-Overholt, E., Melnyk, B., & Williamson, K. M. (2010). Evidence-based practice, step by step: Asking the clinical question. AJN, American Journal of Nursing, 110(3), 58–61. https://doi.org/10.1097/01.naj.0000368959.11129.79

Walden University Library. (Keyword searching: Finding articles on your topic: Boolean terms. Retrieved September 19, 2018, from http://academiaguides.waldenu.edu/library/keyword/…