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ANSWERED!! Post your PICO(T) question, the search terms

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 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.

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.

Readings

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.

Library of Congress. (n.d.). Search/browse help – Boolean operators and nesting. Retrieved September 19, 2018, from https://catalog.loc.gov/vwebv/ui/en_US/htdocs/help/searchBoolean.html

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.

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.-c). Evidence-based practice research: CINAHL search help. Retrieved September 6, 2019, from https://academicguides.waldenu.edu/library/healthevidence/cinahlsearchhelp

Walden University Library. (n.d.-d). Evidence-based practice research: Joanna Briggs Institute search help. Retrieved September 6, 2019, from https://academicguides.waldenu.edu/library/healthevidence/jbisearchhelp

Walden University Library. (n.d.-e). Evidence-based practice research: MEDLINE search help. Retrieved September 6, 2019, from https://academicguides.waldenu.edu/library/healthevidence/medlinesearchhelp

Walden University Library. (n.d.-h). Quick Answers: How do I find a systematic review article related to health, medicine, or nursing? Retrieved September 6, 2019, from https://academicanswers.waldenu.edu/faq/72670

Expert Answer and Explanation

Searching Databases

The PICOT Question

Perioperative outcomes are a major factor that affects the perceptions held by patients on helpful surgical procedures. With reported cases of poor postoperative outcomes, many patients who are scheduled to undergo surgery usually shy off opting to consider other forms of treatment which in some cases end up not being helpful. The application of the ERAS pathway has been hailed to be useful in improving the postoperative outcomes of patients who have undergone a surgical procedure (Chiu et al., 2018). However, the implementation of this pathway is far from the ideal levels. It is for this reason that a clinical inquiry to find out the efficacy of the ERAS pathway in improving postoperative outcomes was conducted. The PICOT question used in the inquiry reads as follows, ‘In patients undergoing general surgery does the ERAS pathway as compared to the standard care assist to improve postoperative outcomes one week after the surgical procedure?

In this case, the postoperative outcomes can be measured by assessing the length of hospital stay, pain scores, and the intensity scale of postoperative nausea and vomiting (PNOV)

P – patients who have undergone general surgery,

I– ERAS pathway

C – standard pathway

O – shorter hospitalization period, lower pain scores, and decreased intensity of PNOV.

T – one week after the surgical procedure.

Search Terms and Databases Used for the PICOT Question

One of the steps of embracing an evidence-based approach is by conducting a thorough inquiry on a clinical issue to inform the implementation of a practical solution. To collect evidence, a search for valid and reliable research literature is encouraged (Melnyk et al., 2009). However, this process may not be as simple as it seems given the numerous articles available on different clinical issues. That is why the use of search terms in reliable article databases can prove useful.

There are several databases that could be used to search for information regarding health topics. Since this specific problem involves the use of the ERAS pathway, nursing databases are the most suitable for searching for this kind of information. The Cochrane Database of Systematic Reviews database is the first candidate, as it is known to have a vast collection of nursing articles. MEDLINE was also used in this search as it contains articles with a broad range of medical topics. Also, both databases are easily accessible from the Walden University Library. The search terms used included the ERAS pathway, ERAS program, ERAS intervention, and postoperative outcomes.

Search Results in Original Search and After Adding Boolean Operators

In the original search, the search results had a broad range of articles that could be crucial in getting much of the background information about the topic in question. For example, in the MEDLINE database, after searching using the keywords “ERAS” a total of 8,235 articles were returned. The articles returned from the Cochrane database were 32 systematic reviewed articles. Because of the number of articles returned, the use of Boolean operators also proved to be useful. Some of the Boolean operators as listed by the Library of Congress, include “AND”, “NOT” or “OR”. After adding Boolean operators, the search was more refined. For example, after searching for “ERAS pathway OR ERAS program” the results from Cochrane narrowed down to 6 while in MEDLINE, they reduced to 312

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

Strategies to Increase the Rigor of a Database Search on my PICOT Question

Among the strategies that can be used to improve the rigor of a database is searching more than one database. While it is likely that much of the information from searching one concept in two databases will be the same, it is always likely that one database could have an additional influential finding. Another strategy is combining the search using Boolean operators, which helps to have a broader or narrower search depending on the intentions of the researcher. Also, for one to improve the rigor of a search in a database, it is crucial that they constantly revise their search strategy if they realize that one is not giving the desirable results (NCBI Resource Coordinators, 2018).  Most importantly, researchers should have information about some of the basic database rules that could have a large implication on their findings. For example, if a database requires that a researcher performs the search using a specific search strategy, employing that search strategy could likely help to reveal more outcomes of the database.

References

Chiu, C., Aleshi, P., Esserman, L. J., Inglis-Arkell, C., Yap, E., Whitlock, E. L., & Harbell, M. W. (2018). Improved analgesia and reduced post-operative nausea and vomiting after the implementation of an enhanced recovery after surgery (ERAS) pathway for total mastectomy. BMC anesthesiology18(1), 41. https://doi.org/10.1186/s12871-018-0505-9

NCBI Resource Coordinators (2018). Database resources of the National Center for Biotechnology Information. Nucleic acids research46(D1), D8–D13. https://doi.org/10.1093/nar/gkx1095

Library of Congress. (n.d.). Search/browse help – Boolean operators and nesting. Retrieved September 19, 2018, from https://catalog.loc.gov/vwebv/ui/en_US/htdocs/help/searchBoolean.html

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

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

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