Discussion: Searching Databases/NURS 6052

Searching Databases
The development of clinical guidelines to improve nursing practice is a rigorous process. Healthcare providers should utilize the most accurate sources of data that will enhance the effectiveness of the outcomes. Therefore, this paper explores the search strategy that will be used to obtain the data related to the proposed PICOT question.

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PICOT Question
The PICOT question that is appropriate for the identified clinical issue is:
In hospitalized elderly patients (P), does the use of hourly nursing rounds and call lights (I) reduce the rates of falls (O) when compared to normal routine of care (C) in a six-month period (T)?
Search Terms Used
According to Melnyk and Fineout-Overholt (2018), search terms for a clinical inquiry question (PICOT) can be obtained by doing database search using the key words of the PICOT question. The keywords that were used in this research that relate to the PICOT question include falls, elderly patient falls, falls prevention, hourly nursing rounds and falls, call lights and falls, and nursing rounds and falls. The use of these keywords in selected databases yielded 59 articles. The number reduced to 30 when the search criterion was limited to peer-reviewed articles alone. The second search strategy that was utilized was the use of database-controlled vocabulary. This approach entails the use of specific keywords such as nursing rounds and elderly patient falls to obtain the needed articles. The databases produce all the articles that contain these keywords, thereby, increasing the accuracy of the obtained results (Melnyk & Fineout-Overholt, 2018). The use of this approach resulted in 45 articles related to the PICOT statement. Despite the effectiveness of these methods, they have the weakness of producing a large number of articles that might not be relevant to the issue under investigation. Consequently, the use of Boolean operation search is appropriate.
Boolean search is an effective approach to obtaining relevant research articles due to the accuracy of its results. The use of this approach allows for the searching of word combinations in a specified order (Stillwell et al., 2010). Often, combinations are used to increase the relevance and accuracy of the obtained resulted. For instance, Library of Congress (n.d.) recommend that Boolean OR expressions should be executed first, followed by AND or NOT expressions. The search can be done in either lower or upper cases. The use of this approach to searching articles yielded 16 articles that were related to the PICOT statement. Therefore, it became evident that the use of Boolean search is highly accurate when compared to the utilization of random search of key words in the PICOT statement.
Names of Databases
A number of nursing databases were used in this research. They included CINAHL, Medline, Embase, and TRIP databases. These databases were considered effective for the assignment because they publish peer-reviewed content. The sources contained in them are also credible for use in generating information for evidence-based practice.
Search Results
As shown above, the initial search that was undertaken using random search of the key words of the PICOT question yielded 59 articles. This number reduced to 30 when the selected articles were specified to peer-reviewed articles only. The use of database-controlled vocabulary yielded 45 articles while Boolean search resulted in 16 peer-reviewed articles related to the PICOT statement.
Strategies to Increase Rigor and Effectiveness of a Database Search on PICOT Question
A number of strategies will be utilized to increase the rigor as well as effectiveness of the database search for the relevant literature in the PICOT question. One of them will be the use of many databases. According to Ho et al. (2016), the use of a combination of different databases has been shown to result in an increased proportion of studies alongside questions. Restricting the search of the relevant sources of data to a single database would lead to one missing many articles, hence, skewed results.
The second strategy that will be utilized to increase the rigor and effectiveness of the database search on the PICOT question is limiting the period in which the appropriate articles were published. Often, evidence-based practice focuses on the use of the most recent, highly accurate clinical data in improving processes (Melnyk & Fineout-Overholt, 2018). This implies that recently published data should be utilized in coming up with new clinical guidelines. As a result, the search strategy for the articles on the PICOT question will be limited to articles that were published in the last five years. The use of this approach will increase the relevance of the findings to the current issues being reported in the clinical environments.
The last strategy that will be utilized to enhance the rigor and effectiveness of the database search on the PICOT statement is ensuring that the articles only relate to nursing practice. Evidence-based practice applies to all areas of healthcare. However, it is important that nurses explore the need for clinical practices that relate to their professional practice (Ellis, 2019). The need for this focus is to promote professional growth and advancement. Therefore, the search for the needed resources will only be specific to nursing.
References
Ellis, P. (2019). Evidence-based practice in nursing. Learning Matters.
Ho, G. J., Liew, S. M., Ng, C. J., Shunmugam, R. H., & Glasziou, P. (2016). Development of a search strategy for an evidence based retrieval service. PloS one, 11(12).
Library of Congress. (n.d.). Search/browse help – Boolean operators and nesting. Retrieved June 14, 2020, from https://catalog.loc.gov/vwebv/ui/en_US/htdocs/help/searchBoolean.html
Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.
Stillwell, S. B., Fineout-Overholt, E., Melnyk, B. M., & Williamson, K. M. (2010). Evidence-based practice, step by step: Searching for the evidence. AJN The American Journal of Nursing, 110(5), 41-47.

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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.

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.