[ANSWERED 2023] Review the materials offering guidance on using databases, performing keyword searches, and developing PICO(T) questions provided in the Resources

Written By: Dan Palmer, RN

Review the materials offering guidance on using databases, performing keyword searches

Review the materials offering guidance on using databases, performing keyword searches

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

Alternative Answer

PICOT – Searching Database

Database searches can be difficult mainly when a person does not have the correct search word for a clear question that needs to be addressed. The use of PICOT questions can help researchers understand the problem, the expected outcome, and the different keywords that can be used to identify the needed articles (Lira & Rocha, 2019).

The PICOT question identifies the desired population and the intervention that would be required against the comparison or existing measurement. the component also addresses the expected output and desired timeframe that the issue would be addressed. This paper will analyze the different components required for searching a database and locating the desired evidence (Lira & Rocha, 2019). The PICOT question to be used is, “in the nursing unit (P), how does the use of personal protective equipment (I) compared to the use of nurse education (C) help prevent exposure to COVID-19 (O) during their stay at the facility (T)?”

Search Terms and Database

To acquire the different evidence to support the question, the main search term used include “personal protective equipment,” “PPE,” “COVID-19,” and “nursing.” These questions are important since they can be used to offer details concerning the different aspects of nursing and its overall implementation. the terms were used independently while others were combined to make meaningful statements that can be used as a phrase (Nibbelink & Brewer, 2018).

The phrases were selected from the PICOT question since they are the main components of the question and what needs to be addressed. To acquire results that are based on the nursing profession, nurse-centric databases. The two main databases used were the CINAHL and Good Scholar (Hopia & Heikkilä, 2020). The CINAHL database is purely based on peer-reviewed nursing articles and the information collected from the website can be used to offer reliable evidence to be applied in practice. Google Scholar on the other hand is a broad database and offers a wide array of multidisciplinary articles. Google Scholar is efficient for articles that comprise different keywords or combines information from multiple disciplines.

During the search, the databases proved different results with each keyword and there was a need to refine or combine the keywords in an offer to acquire a relevant article. For instance, searching “personal protective equipment” alone did not yield the desired results. However, combining the phrase with the keywords “nursing” and “Covid-19” more relevant results.

While the number of outcomes reduced with the increase in the keywords, they were increasingly relevant and met the criteria needed by the PICOT question. For instance, searching “personal protective equipment” in Google Scholar returned about 1,140,000 results but the results reduced to 296,000 when using the search phrase “personal protective equipment in nursing during COVID19”

Strategies to Increase Rigor and Effectiveness

Different strategies can be sued to ensure that the outcome of the database leads to the attainment of desired results. To begin with, a researcher can decide to ensure that they set the date to a more recent timeline so as to only obtain the current and relevant materials (Daniel, 2019).

The advanced search components allow for the researcher to set whether they need only books or journals or they want specific articles. The other strategy to use is to select the keywords needed to match the desired outcome, the search string needs to be able to meet the needed outcome and ensure that all the relevant words are included.

References

Daniel, B. K. (2019). Using the TACT framework to learn the principles of rigour in qualitative research. Electronic Journal of Business Research Methods17(3), pp118-129.

Hopia, H., & Heikkilä, J. (2020). Nursing research priorities based on CINAHL database: A scoping review. Nursing Open7(2), 483-494.

Lira, R. P. C., & Rocha, E. M. (2019). PICOT: Imprescriptible items in a clinical research question. Arquivos Brasileiros de Oftalmologia82, 1-1.

Nibbelink, C. W., & Brewer, B. B. (2018). Decision‐making in nursing practice: An integrative literature review. Journal of Clinical Nursing27(5-6), 917-928.

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FAQs

What strategies you might make to increase the rigor and effectiveness of a database search?

To increase the rigor and effectiveness of a database search, you can employ various strategies to refine your queries and optimize the search process. Here are some strategies you can consider:

  1. Define Clear Objectives:
  2. Use Boolean Operators:
    • Use Boolean operators (AND, OR, NOT) to combine or exclude keywords in your search. This can help you narrow down or broaden your search results.
  3. Use Truncation and Wildcards:
    • Employ truncation () and wildcard (?) symbols to capture variations of a word. For example, “comput” will retrieve results for “computer,” “computing,” etc.
  4. Specify Fields:
    • If the database allows, specify the fields in which to search (e.g., title, author, abstract). This can help you target your search to specific aspects of the documents.
  5. Limit by Date Range:
    • Restrict your search to a specific date range to ensure that you get the most recent and relevant information.
  6. Utilize Filters:
    • Take advantage of filters provided by the database, such as publication type, language, or document type, to refine your results.
  7. Understand Controlled Vocabulary:
    • Many databases use controlled vocabularies or subject headings. Learn and use these terms to improve the accuracy of your search.
  8. Review Search Syntax:
    • Familiarize yourself with the specific syntax rules of the database’s search engine. Some databases may have unique syntax requirements.
  9. Explore Advanced Search Options:
    • Utilize advanced search options provided by the database to access more specific and targeted search features.
  10. Combine Keywords and Phrases:
    • Combine relevant keywords and phrases to create more complex and focused search queries.
  11. Search Multiple Databases:
    • If applicable, search multiple databases to broaden your scope and increase the likelihood of finding comprehensive information.
  12. Check Synonyms and Related Terms:
    • Include synonyms and related terms in your search to ensure you capture all relevant information.
  13. Review and Refine:
    • Regularly review your search results and modify your search strategy based on the information you find. This iterative process can improve the effectiveness of your search.
  14. Use Citation Chaining:
    • Once you find relevant articles, review their references and the articles that cite them. This can lead you to additional valuable sources.
  15. Seek Help from Librarians or Experts:
    • If you’re struggling with your search, consult with librarians or subject matter experts who can provide guidance on effective search strategies.

What’s a Picot question?

A PICO(T) question is a framework used in evidence-based practice and clinical research to formulate a focused and answerable research question. The acronym PICO(T) stands for:

  1. P: Patient/Population/Problem:
    • Describes the population or the patient group being addressed in the question. This could include specific characteristics such as age, gender, health condition, or other relevant factors.
  2. I: Intervention:
    • Specifies the intervention or exposure being considered. This could be a treatment, diagnostic test, therapy, or any other relevant factor that is applied to the patient population.
  3. C: Comparison:
    • Describes the alternative to the intervention. This could be another treatment, placebo, no intervention, or a different approach that is being compared to the intervention of interest.
  4. O: Outcome:
    • Identifies the outcome or result that you are interested in measuring or observing as a result of the intervention. This could include clinical outcomes, patient satisfaction, or any other relevant measure.
  5. T: Time (Optional):
    • In some cases, “T” is added to the acronym to represent the time frame over which the intervention and outcomes are being observed.

An example of a PICO(T) question could be:

“In adult patients with hypertension (P), does the use of medication A (I) compared to medication B (C) result in a greater reduction in blood pressure (O) over a 12-week period (T)?”

The PICO(T) framework helps researchers and healthcare professionals structure their questions in a way that facilitates the search for relevant evidence and the critical appraisal of research studies. It is commonly used in the development of research questions for clinical studies and systematic reviews.

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