Searching Databases – NURS 6052 Discussion
Discussion – Week 4
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. 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.
Click on the Reply button below to reveal the textbox for entering your message. Then click on the Submit button to post your message.
9 months ago
Mary Bemker-page WALDEN INSTRUCTOR MANAGER
RE: Discussion – 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.
Have a great week!
Dr. B.
9 months ago
Albert Hatcher
RE: Discussion – Week 4
According to (Melnyk & Fineout-Overholt, 2019), “the purpose of the PICOT question is to guide the systematic search of healthcare databases to find the best available evidence to answer the question.” My clinical issues of interest in Violent Patients in the Emergency Room: How do it affect healthcare workers, particularly nurses? Being a nurse with the job of rounding the hospital to help prevent and de-escalate violent patients, I noticed that nurses are burnt out from dealing with aggressive patients. (Bermudez, 2021) states that “implementation of evidence-based practices is an expectation in healthcare and nursing, requiring knowledge and understanding of evidence-based practice (EBP) and research.” I have found that ED nurses encounter the most psychotic and disorderly patients. These nurses are punched, kicked, spat on, and verbally abused every day. These encounters never get reported, and several of my co-workers have resigned because they are afraid or burned out.
To find information on my clinical issue, I chose CINAHL plus with full text because it gives you articles on nursing, and at the top, it allows me to choose more databases, so I added Medline with full text. According to (Library of Congress, n.d.), “Boolean operators and nesting help you search for combinations of words or phrases processed in a specified order.” I typed in violent patients, giving me 23,742 different articles to choose from, so I narrowed down my results using the Boolean/Phrase. I entered the emergency room in the second box and shortened the results to 303 different search results. I went over to the left side and clicked on full text and peer-reviewed scholarly journal articles from 2017-2022, which left eighty-six articles on my clinical issue. I narrowed my search results even further by typing nurse in the third box, narrowing my results to only fourteen full texted, peer-reviewed articles.
References
Library of Congress. (n.d.). Search/browse help – boolean operators and nesting: Lc catalog (library of congress). Library: Library of Congress. Retrieved March 20, 2022, from https://catalog.loc.gov/vwebv/ui/en_US/htdocs/help/searchBoolean.html
Bermudez, N. (2021). Formulating Well-Written Clinical Practice Questions and Research Questions. NURSING & HEALTH SCIENCES RESEARCH JOURNAL, 4(1), 70–82. Retrieved March 20, 2022, from https://doaj.org/article/18d1b84020f34a0e84f0ef483e3413a4
Melnyk, B., & Fineout-Overholt, E. (2019). Evidence-based Practice in Nursing & Healthcare (4th ed.). Wolters Kluwer.
9 months ago
Chaquita Nichols
RE: Discussion – Week 4
Albert,
I hate that you and your coworkers have to go through that with patients, especially when you are trying to help them. Even though some patients are not aware of their actions, many of them are and that is exceedingly difficult to deal with. Sometimes these situations of how we are treated do not get reported because it has seemed to become the norm. But when these situations are reported, what is being done about it? My issue of interest was recruitment and retention of nurses. It is easy to get nurses in the facility, but how do you keep them there, especially new graduates? You mentioned they left due to burnout which could also be caused by not having a dedicated support system. This also adds to the nursing shortage. I am glad that you chose this topic because it makes others aware of what nurses go through and that they are not alone. Sachdeva et. al. (2019) noted, “violence against emergency department (ED) staff causes significant physical and mental distress which affects work productivity and patient care” (p.179).
Yes, I do agree that using Boolean operators helps with the searching process. Something that I did not know about was using quotations around phrases you want to see in articles together. You can also put quotation marks around phrases so the database will know to keep is as a phrase and not use the words individually (Walden University Library, n.d.).
Sachdeva, S., Jamshed, N., Aggarwal, P., & Kashyap, S. R. (2019). Perception of Workplace Violence in the Emergency Department. Journal of emergencies, trauma, and shock, 12(3), 179–184. https://doi.org/10.4103/JETS.JETS_81_18
9 months ago
Chaquita Nichols
RE: Discussion – Week 4
Author: Chaquita Nichols Date: Thursday, March 24, 2022 6:00:43 AM EDT Subject: RE: Discussion – Week 4
Albert,
I hate that you and your coworkers have to go through that with patients, especially when you are trying to help them. Even though some patients are not aware of their actions, many of them are and that is exceedingly difficult to deal with. Sometimes these situations of how we are treated do not get reported because it has seemed to become the norm. But when these situations are reported, what is being done about it? My issue of interest was recruitment and retention of nurses. It is easy to get nurses in the facility, but how do you keep them there, especially new graduates? You mentioned they left due to burnout which could also be caused by not having a dedicated support system. This also adds to the nursing shortage. I am glad that you chose this topic because it makes others aware of what nurses go through and that they are not alone. Sachdeva et. al. (2019) noted, “violence against emergency department (ED) staff causes significant physical and mental distress which affects work productivity and patient care” (p.179).
Yes, I do agree that using Boolean operators helps with the searching process. Something that I did not know about was using quotations around phrases you want to see in articles together. You can also put quotation marks around phrases so the database will know to keep is as a phrase and not use the words individually (Walden University Library, n.d.).
Sachdeva, S., Jamshed, N., Aggarwal, P., & Kashyap, S. R. (2019). Perception of Workplace Violence in the Emergency Department. Journal of emergencies, trauma, and shock, 12(3), 179–184.
Walden University Library. (n.d.-g). Keyword searching: Finding articles on your topic: Introduction to keyword searching. Retrieved September from September 19, 2018, from https://academicguides.waldenu.edu/library/keyword/searching-basics
9 months ago
Mary Bemker-page WALDEN INSTRUCTOR MANAGER
RE: Discussion – Week 4
You have a topic that is of interest to many in the healthcare field, and I can understand the high results in your literature search in spite of the terms you used to narrow the findings to a specific relationship. In addition to accessibility, do you think there are any other area to consider when considering treatment? IF so, what could be done to include that factor(s)?
8 months ago
Albert Hatcher
RE: Discussion – Week 4
Dr. B., most of my patients come to the hospital for treatment, whether voluntary or IVC’d; we only get them past the acute mental breakdown. The patient is either discharged to an inpatient facility or discharged home without any resources. No one follows up with mental health patients after discharge to see how they are doing, and most of our mental health is homeless. We do not provide a holistic treatment for mental health patients, and the cycle continues with admission after admission because they usually stop taking their medications. Patients tell me that they come to the hospital because they can afford their medications or have no transportation to doctor appointments. We need housing for these patients and someone who can help them find jobs for those who can work. According (Tiderington et al., 2020), “having a job provides a pathway to social integration and recovery often begins with securing stable housing, with the pursuit of employment deferred or postponed either by the individual or the program until this basic need can be met.” I feel that if we do not treat a patient’s whole state of well-being, we will never truly help the patient.
References
Tiderington, E., Henwood, B. F., Padgett, D. K., & Tran Smith, B. (2020). Employment experiences of formerly homeless adults with serious mental illness in housing first versus treatment first supportive housing programs. Psychiatric Rehabilitation Journal, 43(3), 253–260. Retrieved March 25, 2022, from https://doi.org/10.1037/prj0000391
8 months ago
Mary Bemker-page WALDEN INSTRUCTOR MANAGER
RE: Discussion – Week 4
Thank you so much for the added information.
Dr. B.
9 months ago
Adetokunbo Oluwatuyi
RE: Discussion – Week 4
Hello Albert,
I can easily tell that you pick this issue out of experience once I read what you picked. There was no need for me to read the further sentences once I saw that topic due to how broad it is and untalked about. I know it must be very exhausting to deal with patients with different type of reactions that usually have similar outcomes/meanings. I know you guys suffer the most with this because it is stated that the highest incidences reported are from paramedics, emergency departments, and inpatient psychiatric facilities. In 2016, health care workers made up 69% of all reported workplace violent injuries, according to the Bureau of Labor and Statistics. (Pitts & Schaller, 2021)
Hoping you or any of your coworkers don’t raise your voice or adopt confrontational body language, such as crossed arms or entering the patient’s space. (Dealing with aggressive patients, 2020) It is understandable that the patient is unbearable but sadly it would make it worse if you go their level.
Pitts, E., & Schaller, D. J. (2021, July 12). Violent Patients. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK537281/#:~:text=Verbal%20threats%20include%20statements%20of,to%20consider%20the%20potential%20etiology.
Dealing with aggressive patients. (2020). Medicalprotection.org. https://www.medicalprotection.org/uk/articles/dealing-with-aggressive-patients
9 months ago
hope Davis
RE: Discussion – Week 4
As nurses, our job is to save lives and provide services to our communities. Nevertheless, unfortunately, we are caught up in the crossfire of violence and abuse from the people we are willing to give aid to. According to an online article, “Nearly 50% of emergency physicians say they have been assaulted, In addition, 70% of emergency room nurses report being hit or kicked on the job. So what is the solution? (Budd, 2020)”.
Unfortunately, health care workers, specifical nurses, have to go through this kind of abuse. I am sorry that some of your co-workers had to resign due the burnout. However, 70% of nurses going through this behavior is ridiculous. As you stated in your post, most of the aggressive behavior nurses encounter in the emergency department is not reported; I would hate to know the accurate statistics of the percentage of nurses encountering this.
CINAHAL is to go when trying to research a topic. Make sure to narrow down your topic to specifics, so you can find the information you are looking for. I used CINAHL plus with full text, and I got the information I needed.
Walden University Library, n.d.).
references
Budd, K. (2020, February 24). Rising violence in the emergency department. AAMC. Retrieved March 25, 2022, from https://www.aamc.org/news-insights/rising-violence-emergency-department
9 months ago
Kehinde Tade
RE: Discussion -Response 1 Week 4
Hi Albert,I enjoyed your post; your topic is very interesting. You can also use Boolean operators to narrow down your result. My results were more focused and productive results for finding databases on my topic for PICO(T) question. The benefit of Boolean operators improves the findings of searches, which in turn helps millions who surf the web every day (papiewski,2015).
An approach that I recently discovered that increases the effectiveness of database search is the use of truncation. Truncation shortens a word to its root and allows for the location of additional research about the subject. Another critical strategy for improving the accuracy of database searching includes subject headings. The difference between subject headings and keywords or phrases is that keywords are found within the text of the resource. In contrast, subject headings locate all the available material on that subject (Melnyk & Fineout-Overholt, 2019).
References
Melnyk, B.M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing and healthcare: A guide to best practice. (4th ed.). Wolters Kluwer
Papiewski,J.(2017,April 25).Advantages &disadvantages of Boolean logic.Sciencing.Retrieved June26,2020,from https://sciencing.com/advantages-disadvantages-boolean-logic-12115642.html
9 months ago
Stacy Hinson
RE: Discussion – Week 4
Albert,
It is such a shame that people feel it is ok to treat others in that way. Civility has really has taken a backseat in this new world of instant gratification. Public health cited it as a world wide problem not just something we are seeing in America (Vento et al., 2020). This has become “an international emergency that undermines the very foundations of health systems and impacts critically on patient’s health” (Ullah, 2020). Lack of ccommunication seems to be one of the major triggers across this study by Vento (2020).
Another source you may want to look at for your research is the Government websites to evaluate what legislation is pending regarding this subject.
Reference:
Vento, S., Cainelli, F., & Vallone, A. (2020). Violence against healthcare workers: A worldwide phenomenon with serious consequences. Frontiers in Public Health, 8. https://doi.org/10.3389/fpubh.2020.570459
Ullah, N. (2020). The world after Covid -19. COVID-19 Pandemic Update 2020, 248–253. https://doi.org/10.26524/royal.37.25
Ullah, N. (2020). The world after Covid -19. COVID-19 Pandemic Update 2020, 248–253. https://doi.org/10.26524/royal.37.25
8 months ago
Crystal Anderson
RE: Discussion – Week 4
Albert,
I enjoyed reading your post this week, interesting topic. I have worked in the Emergency room as a nurse and have encountered several violent patients before. I have seen many coworkers come and go over the last 5 years due to being burnout related to workplace violence. I found a website by doing a google search https://www.aamc.org/news-insights/rising-violence-emergency-department. This website had a lot of useful information on workplace violence. I also found out that in 2019 the U.S. House of Representatives passes the Workplace Violence Prevention for Health Care and Social Service Workers Act which will require employers to investigate incidents and provide training to employees (116th Congress, 2019). I also found an article that used qualitative research to describe key narratives regarding the relationship between clinician burnout and agitated patients becoming physically restrained (Wong, et al., 2022); I thought his could be useful information regarding your clinical issue. Again, good post! I look forward to learning more on your topic as the weeks go on.
Reference
116th Congress. (2019). H.R.1309-Workplace Violence Prevention for Health Care and Social Service Workers Act. https://www.congress.gov/bill/116th-congress/house-bill/1309
Wong, A., Sabounchi, N., Roncallo, H., Ray, J., & Heckman, R. (2022). A qualitative system dynamics model for effects of workplace violence and clinician burnout on agitation management in the emergency department. BMC Health Services Research. https://doi.org/10.1186/s12913-022-07472-x
8 months ago
Claudia Paz
RE: Discussion – Week 4
Hi Albert,
I have friends that work in the ED and they also experience this same problem. Many nurses are burned out and feel so disrespected. Worst of all, nurses feel that no one in management is standing up for them. I am glad you have chosen a topic that can shed light and awareness about what ED nurses go through.
In searching for articles, I also like to use CINAHL because it has a vast amount of articles related to my topic. To use CINAHL, a person must have a library subscription in order to access journals, articles, books, and other content pertaining to nursing and health care related issues (Melnyk & Fineout-Overholt, 2019, p.81). CINAHL seems to be one of the most used database because it has a large amount of content to offer the reader.
Medline is my second go-to researchable database that I use. It is a widely used and popular database that includes content pertaining to medicine and health (Melnyk & Fineout-Overholt, 2019, p.80).
In addition to narrowing down your search, the boolean operators allow the researcher to locate articles using a combination of words or phrases (Library of congress, n.d.).
Reference
Library of Congress. (n.d.). Search/browse help – boolean operators and nesting: Lc catalog (library of congress). Library: Library of Congress. Retrieved March 25, 2022, from https://catalog.loc.gov/vwebv/ui/en_US/htdocs/help/searchBoolean.html
Melnyk, B., & Fineout-Overholt, E. (2019). Evidence-based Practice in Nursing & Healthcare (4th ed.). Wolters Kluwer.
9 months ago
Britny Ray
RE: Discussion – Week 4
Questions are the fuel behind evidence based practice(EBP), if there were no questions then EBP would be pointless (Davies, 2011). EBP questions focus on real world problems health care professionals face. The clinical issue I chose to address was how effective sequential compression devices are in preventing blood clots in patients. Blood clots are formed from patients experiencing vein thromboembolism(VTE). In the hospital setting, VTE is one of the core measures the facility must meet for accreditation. Surgery, certain medications, prolonged immobilization, obesity, heart failure, and cancer increase the risk of developing VTE (Bohnenkamp et al., 2020).
When doing an original search on my clinical interest, I first searched in the primary search box “sequential compression devices”. This search result gave me 568 results, with articles containing “sequential compression devices” within the title. Next, I used the database CINHAL with Medline and utilized the boolean operators. I searched “sequential compression devices” in the first box and then “venous thromboembolism” in the second box and received 77 results. I realized then that it needed to be arrowed down to peer reviewed full text only and it only dropped to 76 results.
Strategies that I may utilize during my research for my clinical interest and not being to broad when utilizing the search bar for articles. For example, when I only entered “sequential compression devices” in the first box and “blood clot prevention” in the second box I received no results. Another way I could have done it is by putting quotation marks around “blood clot prevention”. Putting quotation marks around phrases tells the database to search for these words as a phrase and not as individual words (Walden.edu, 2022).
References
Bohnenkamp, S. (2020). The Role of Interprofessional Practice in Sustainability of a Sequential Compression Devices Project. MEDSURG Nursing, 29(5), 315–319.
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.
Library of Congress. (n.d.). search/browse help – Boolean operators and nesting. Retrieved March 23, 2022, from https://catalog.loc.gov/vwebv/ui/en_US/htdocs/help/searchBoolean.html
9 months ago
April Williams
RE: Discussion – Week 4
Discussion Post #1
Hello Britny,
Thanks for your information. The discussion on usage of sequential compression devices in preventing blood clots is a great topic. Blood clots whether post-surgical or in hospitalized patient is major area to address among hospitalized patients. I found it interesting your initial search yielded over 500 articles. Given this topic has some many implications for healthcare and touch so many areas in healthcare, it is important to have a general idea how you may consider narrowing this topic.
As a certified wound care nurse, I am required to have a high level of base knowledge about my topic. What I have found challenging is by knowing so much about my topic has almost become a barrier in my assessment of the research that disagrees with my knowledge base. A second barrier is using the PICO(T) question as a search query to get my expected answer. There is research that suggest using the PICO(T) method as a search strategy may have an affect on the quality of literature search (Eriksen and Frandsen, 2018). I am finding it best to conduct the searches using the Boolean operators to either expand or narrow a topic in order to expand my knowledge base rather than searching for the answer (Library of Congress, n.d.).
Like many healthcare providers, my organization provides easy access to journals and evidence-based research articles as well as employs a librarian which is responsive to their commitment to deliver evidence-based care to patients and provide clinicians the support and tools to engage in evidence-based practice (Melnyke et al., (2009).
References
Eriksen, M. B., & Frandsen, T. F. (2018). The impact of patient, intervention, comparison,
outcome (PICO) as a search strategy tool on literature search quality: a systematic
review. Journal of the Medical Library Association : JMLA, 106(4), 420–431.
https://doi.org/10.5195/jmla.2018.345
Library of Congress. (n.d.). Search/browse help – Boolean operators and nesting.
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
8 months ago
Adetokunbo Oluwatuyi
RE: Discussion – Week 4
Hello Britny,
As you stated EBP is a very important practice that most if not all of nurses/professional need to know. As we know it is is applying or translating research findings in our daily patient care practices and clinical decision-making. Also Using EBP means abandoning outdated care delivery practices and choosing effective, scientifically validated methods to meet individual patient needs. (What Is Evidence-Based Practice?, 2021)
You also stated blood clot prevention as one of your search terms which is important that always must be taken seriously. It has killed over 100,000 people every year in the United States. This is more than the number of deaths caused by AIDS, motor vehicle collisions and breast cancer combined. (Manfuso, 2019) It can also affect other activities in life which can make a person’s life really restricted.
What is Evidence-Based Practice? (2021). Utah.edu. https://accelerate.uofuhealth.utah.edu/improvement/what-is-evidence-based-practice
Manfuso, J. (2019, July 25). How Do I Prevent Blood Clots? Hopkinsmedicine.org. https://www.hopkinsmedicine.org/armstrong_institute/improvement_projects/infections_complications/VTE/patients.html
8 months ago
Cory Legan
Response # 1
Hi Britny,
I believe that as healthcare professionals, we must always approach our practice with curiosity. Evidence-based practice is constantly changing with the discovery of new information (Walden University, LLC. (Producer), 2018). However, sometimes these changes don’t happen unless someone questions them. As nurses, we are often very busy and become task oriented, such as applying sequential compression devices. I do this for almost every surgical patient on my unit. I’m looking forward to learning more about this subject and the results of your research. Taking the time to research helps us stay current with evidence-based practice, in order to guide our clinical decisions (Melnyk & et al., 2009).
References:
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, LLC. (Producer). (2018). Searching the Evidence [Video file]. Baltimore, MD:
Author.
9 months ago
Janelle McEwen
RE: Discussion – Week 4
Ventilator-associated pneumonia (VAP) is considered the most common hospital acquired infection seen in critical care settings and leading cause of death in Intensive Care Units (ICU) (Buterakos et al., 2022). VAP is considered one of the most common hospital acquired infections seen in ICU among mechanically ventilated and intubated patients, with the number of cases exponentially rising at the peak of the COVID-19 pandemic since > 80% of patients admitted to ICU required invasive mechanical ventilation (Maes et al., 2021). Thus, prevention of VAP in the ICU is a critical component of care and a patient safety initiative and health care quality indicator. The Institute of Health Improvement (IHI) recommended the implementation of the VAP bundle for the care of artificially ventilated patients in 2004, with the presumption that the guidelines would decrease the odds of VAP (IHI, n.d.). The clinical issue focuses on the efficacy of VAP care bundle (VCB) in addressing the rising cases of ventilator-associated pneumonia among critically ill patients. My PICOT (population, intervention, comparator, time) states that: is VCB superior than usual care in reducing VAP cases among mechanically ventilated and/intubated patients in ICU six-months after implementation?
In order to identify articles that support my PICOT question, I performed an advanced search of Embase and CINAHL Plus databases through the Walden University Library (n.d.). The following Boolean phrases (‘ventilator-associated pneumonia OR VAP’) AND (‘ventilator’) AND (‘care’ AND bundle) AND (‘critically ill patients OR mechanically ventilated OR intubated patients). The search was limited to peer-reviewed articles published in the English language between 2017 and 2022 with available full texts. The initial search without the Boolean operators led to two articles in the CINAHL Plus database, which increased to five when Boolean operators were added. Contrastingly, the initial search without the Boolean operators yielded 129 articles in the Embase database, which were trimmed down to 21 articles when the Boolean operators were applied.
In addition to utilizing the filters available on the database and Boolean operators that both accelerates and limits the search to the most relevant results, I will also search more relevant databases, like PubMed and Cochrane Library to increase the rigor and effectiveness of the database search (Library of Congress, n.d.). Searching in a combination of databases has been shown to answer a higher proportion of questions. A single database search is known to be inadequate for systematic reviews as the non-inclusion of missed trials would influence the results of the meta-analysis (Ho et al., 2017).
References
Buterakos, R., Jenkins, P. M., Cranford, J., Haake, R. S., Maxson, M., Moon, J., Rice, B., & Sachwani-Daswani, G. R. (2022). An in-depth look at ventilator-associated pneumonia in trauma patients and efforts to increase bundle compliance, education and documentation in a surgical trauma critical care unit. American Journal of Infection Control, 000, 1–6. https://doi.org/10.1016/j.ajic.2022.01.029
Ho, G. J., Liew, S. M., Ng, C. J., Shunmugam, R. H., & Glasziou, P. (2017). Development of a search strategy for an evidence based retrieval service. PLoS ONE, 11(12), 1–14. https://doi.org/10.1371/journal.pone.0167170
IHI. (n.d.). Ventilator-associated pneumonia. http://www.ihi.org/Topics/VAP/Pages/default.aspx
Library of Congress. (n.d.). Search/browse help – Boolean operators and nesting. https://catalog.loc.gov/vwebv/ui/en_US/htdocs/help/searchBoolean.html
Maes, M., Higginson, E., Pereira-Dias, J., Curran, M. D., Parmar, S., Khokhar, F., Cuchet-Lourenço, D., Lux, J., Sharma-Hajela, S., Ravenhill, B., Hamed, I., Heales, L., Mahroof, R., Solderholm, A., Forrest, S., Sridhar, S., Brown, N. M., Baker, S., Navapurkar, V., … Conway Morris, A. (2021). Ventilator-associated pneumonia in critically ill patients with COVID-19. Critical Care, 25(1), 1–11. https://doi.org/10.1186/s13054-021-03460-5
Walden University Library. (n.d.). Databases A-Z: Nursing. https://academicguides.waldenu.edu/az.php?s=19981
9 months ago
Britny Ray
RE: Discussion – Week 4
Hey Janelle,
This was a great choice of a clinical issue of interest. I am pretty sure this is one of the biggest interest with everything going in the world today. While reading up on Ventilator Associated pneumonia bundles I learned what things consist in a bundle. For example in Sri Lanka they reported using head elevation, chlorhexidine mouth care, stress ulcer prophylaxis, heat and moisture exchangers, early weaning, and hand washing as part of their VAP bundle (Juneja et al., 2011). Another suggestion for when you continue your research is including parenthesis around phrases. For the greatest precision, use parentheses ( ) to group portions of complex Boolean expressions in the EXPERT option of Keyword Search, this allows terms inside the parenthesis to be processed first (Library of Congress, n.d.).
References
Juneja, D., Singh, O., Javeri, Y., Arora, V., Dang, R., & Kaushal, A. (2011). Prevention and management of ventilator-associated pneumonia: A survey on current practices by intensivists practicing in the Indian subcontinent. Indian Journal of Anaesthesia, 55(2), 122–128. https://doi.org/10.4103/0019-5049.79889
Library of Congress. (n.d.). Search/browse help – Boolean operators and nesting. https://catalog.loc.gov/vwebv/ui/en_US/htdocs/help/searchBoolean.html
9 months ago
Janelle McEwen
RE: Discussion – Week 4
Britny, thank you for your reaction. I concur with you that ventilator-associated pneumonia infections are a major concern to global public health currently following the exacerbations caused by SARS-COV2 virus (Buterakos et al., 2022). I was just looking into the application of parentheses to improve rigor and effectiveness of literature search, and I think I should have included in my main post as a challenge because I did not really understand how it operates (Walden University Library, n.d.). Did you know most databases give AND precedence over OR, meaning terms linked with AND will be searched before those linked with OR, no matter the order they appear in your search (University of Hawai’i at Manoa, n.d.). Thus, using parentheses will override the search precedence in any database.
References
Buterakos, R., Jenkins, P. M., Cranford, J., Haake, R. S., Maxson, M., Moon, J., Rice, B., & Sachwani-Daswani, G. R. (2022). An in-depth look at ventilator-associated pneumonia in trauma patients and efforts to increase bundle compliance, education and documentation in a surgical trauma critical care unit. American Journal of Infection Control, 000, 1–6. https://doi.org/10.1016/j.ajic.2022.01.029
University of Hawai’i at Manoa. (n.d.). Parentheses – Boolean operators . https://guides.library.manoa.hawaii.edu/c.php?g=105358&p=684347
Walden University Library. (n.d.). Connect keywords – Keyword searching: Finding articles on your topic. https://academicguides.waldenu.edu/library/keyword/boolean
9 months ago
Mary Bemker-page WALDEN INSTRUCTOR MANAGER
RE: Discussion – Week 4
You did a great job overall explaining your area of interest and explaining how you addressed your search. I know that when I look at a topic, it is important that I consider a variety of perspectives. I do much research in relation to burnout, moral distress, and compassion fatigue. When looking at the topic it is important to consider a variety of factors. Burnout, for example, is definitely a factor associated with compassion fatigue. Knowing that, one is then able to expand the search to articles that include the desired information (burnout) while accessing articles that may not appear when just the initial term is identified. Another factor linked to this process is to use synonyms in a search. Because the journal editor or the author chooses the words by which an article i referenced, they may say compassion instead of empathy. If one was searching by empathy, the article would not pop up even thought it could be appropriate.
Dr. B.
8 months ago
Crystal Anderson
My Response #2
Janelle,
Good post this week. I almost wrote on this clinical issue because I feel like it is a great topic. I just started working in the ICU almost two months ago. There are 5 ways to prevent ventilator-associated pneumonia which are minimizing ventilator exposure, provide excellent oral care, coordinate subglottic suctioning, maintain optimal positioning plus encouraging mobility, and to ensure adequate staffing (Botely, et al., 2017). The number one goal of our unit where I work is to minimize ventilator exposure by using Bipap or CPAP machines but if must be on the ventilator then the goal is to minimize the number of days the patient is on the ventilator. Also, where I work patients that are on the ventilator must receive oral care every two hours with Chlorhexidine gluconate with provided mouth care kits. My unit when someone is on a ventilator the patients primary nurse and Respiratory therapist must perform spontaneous breathing trails. According to the Oncology Nursing Society the PICOT question is a consistent “formula” for developing answerable searchable questions that results in an effective literature search that yields the best, most relevant information (Oncology Nursing Society, 2018). Again, good post I look forward to learning more about your clinical issue!
Botely, E., Yakusheva, O., & Costa, D. (2017). 5 Nursing strategies to prevent ventilator-associated pneumonia. American Nurse Today, 12(6):42-43. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5706660/#__ffn_sectitle
Oncology Nursing Society. (2018). Writing a PICOT Question. https://view.ons.org/HbJUaA
9 months ago
Matthew Cluderay
RE: Discussion – Week 4
My clinical issue of interest is the use of the CIWA scale when treating patients with alcohol or benzodiazepine withdrawal syndrome. Specifically, the effectiveness of the CIWA scale against other therapies like phenobarbital, cost of care, length of hospital stays, and nursing assessment. The purpose of the PICOT question is to guide the systemic search of healthcare databases to find the best available evidence to answer the question (Melnyk & Fineout-Overholt 2018). The start of any research begins with finding an answerable question and then finding the relevant information. Finding relevant information starts with formulating a well-defined question (Davis 2011). Search results need to be manipulated by the researcher to find the best information. In my case, searching the keyword “CIWA” yields almost 900 articles. The use of Boolean operators helps search for specific words and key phrases to find the data that will reflect the most appropriate results for a clinical question (Library of Congress n.d.). When adding the Boolean term “or” and including effects, impact, and consequences; the total number of related search results drops to 274. When filtering for only peer-reviewed articles between the years 2016 and 2022, the total drops to 93. Strategies that can be used to further narrow search results require some tinkering. Replacing or adding different search parameters affects the outcomes. Searching CIWA and “length of hospital stay” only leaves 9 total articles to review. If one is having a hard time finding a new journal, opening one article will provide a list of terms that can be used to provide parameters for another search. One tip I’ve found when looking into CIWA is omitting commonly used words and phrases into the search field or using the Boolean phrases to filter out common phrases if necessary.
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.
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. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.
9 months ago
Albert Hatcher
RE: Discussion – Week 4
Hello Matthew, as a behavioral rounding nurse, I deal with any behavioral including alcohol withdrawal. I agree that the Clinical Institute Withdrawal Assessment (CIWA) does not always work as effectively as other medications like phenobarbital and Geodon. (Tidwell et al., 2018) states that “patients who received phenobarbital had significantly shorter stays in the intensive care unit than those who received therapy CIWA.” I do believe that Ativan works well along with other medications. The hospital where I work uses CIWA protocol, but if Ativan is ineffective, we give Haldol, Zyprexa, or Geodon to help the patient with aggression. Phenobarbital is prescribed as a last resort after all those medications are attempted first. We can give up to four doses of 30 mg to equal 120mg for those patients going through bad alcohol withdrawals. If this does not work, I recommend that the doctor come up to see the patients so that they can transfer the patient to ICU for a Percedex drip.
You should be able to find information on whether CIWA is the most effective treatment for ETOH withdrawal. Most doctors are afraid that they will become over sedate the patient, so they start with the CIWA protocol and advance with other medications depending on the patient. According to (Melnyk & Fineout-Overholt, 2019), “foreground questions posed using PICOT format offer a sound framework to construct the systematic search required to gather the body of evidence needed to guide practice.” I wish you luck and hope that you will find a much-needed solution through evidence-based research other than the CIWA protocol.
References
Melnyk, B., & Fineout-Overholt, E. (2019). Evidence-based Practice in Nursing & Healthcare (4th ed.). Wolters Kluwer.
Tidwell, W. P., Thomas, T. L., Pouliot, J. D., Canonico, A. E., & Webber, A. J. (2018). Treatment of alcohol withdrawal syndrome: Phenobarbital vs CIWA-AR protocol. American Journal of Critical Care, 27(6), 454–460. Retrieved March 23, 2022, from https://doi.org/10.4037/ajcc2018745
9 months ago
Mary Bemker-page WALDEN INSTRUCTOR MANAGER
RE: Discussion – Week 4
You bring forth a point many of us has when conducting a search. We haaave a very specific area of interest, and there is little published on it. The strategies you utilized are sound, and it is always a plus to have them work for us. When I was doing my dissertation, I searched so many data bases, that it was estimated over three million articles were under review. I had no luck with finding any information on my topic.
I was forced to look at parallel topics (adult females for adolescent females, adolescent treatment not based on gender, etc). While that was a sound reason for conducting the specific research project I had chosen, it was difficult finding the literature support as a foundation.
Dr. B.
9 months ago
hope Davis
RE: Discussion – Week 4
I enjoyed reading this post, and It is incredible how CIWA protocols are so different. After graduating from nursing school, I worked in a hospital for a few months, transferred to in-house rehabilitation hospitals for a while, and started travel nursing in corrections. I never had to deal with CIWA patients while working in the hospital. As a correction nurse, I deal with behavioral health-specific CIWA and COWS. The CIWA protocol in the corrections place I work for is standard. Patients get diazepam for three days. First day TID, send day BID, and third day HS with Meclizine 25mg for 3days TID and loperamide 2mg TID for 3days. These patients are in the infirmary while getting CIWA therapy for 5days, and then after detox therapy is complete, they are sent to the general population.
It is essential to use PICOT while researching for evidence-based solutions. According to an online article, ” PICOT format is a helpful approach for summarizing research questions that explore the effect of therapy (Riva et al., 2012) .”
When searching for information to use while writing about the clinical issue of interest, it is always essential to narrow down the topic so one can get the accurate and specific information needed for the assignment. CIWA is a broad topic, and I am glad you used strategies to narrow it down to a specific topic.
references
Riva, J. J., Malik, K. M. P., Burnie, S. J., Endicott, A. R., & Busse, J. W. (2012, September). What is your research question? An introduction to the picot format for clinicians. The Journal of the Canadian Chiropractic Association. Retrieved March 25, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3430448/
8 months ago
Janelle McEwen
RE: Discussion – Week 4
Matthew, I must commend you on your choice of the PICOT question given that alcohol and substance abuse is a pandemic that calls for a research focus. Embase is one of electronic databases that offers researchers a chance to use the PICO elements as the keywords for searching for literature. I inserted your PICO elements into the search area and results were zero articles; however, when I searched “CIWA scale” alone, it yielded 272 entries (Embase, n.d.). I identified Steel et al. (2021) in my second search which sought to evaluate the frequency of Clinical Institute Withdrawal Assessment for Alcohol-Revised (CIWA-Ar) monitoring among ICU patients with alcohol withdrawal syndrome (AWS) and variation in CIWA-Ar monitoring across patient demographic and clinical characteristic. The results of the study showed that CIWA-Ar monitoring was used inconsistently in ICU patients with AWS and completed less often in those who were intubated or identified as Black. I am looking forward to reading your EBP throughout the course. Good luck!
References
Embase. (n.d.). Retrieved March 26, 2022, from https://www.embase.com/#advancedSearch/resultspage/history.1/page.1/25.items/orderby.date/source.
Steel, T. L., Giovanni, S. P., Katsandres, S. C., Cohen, S. M., Stephenson, K. B., Murray, B., Sobeck, H., Hough, C. L., Bradley, K. A., & Williams, E. C. (2021). Should the CIWA-Ar be the standard monitoring strategy for alcohol withdrawal syndrome in the intensive care unit? Addiction Science and Clinical Practice, 16(1). https://doi.org/10.1186/S13722-021-00226-W
9 months ago
Mary Bemker-page WALDEN INSTRUCTOR MANAGER
RE: Discussion – Class Meeting Scheduled
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Dr. B.
9 months ago
Marissa Ludwig
RE: Discussion – Week 4
My clinical issue of interest involves the chronic issue of nurse understaffing. Inadequate staffing negatively affects both nurse and patient safety as well as patient outcomes (Lasater et al., 2020). Medical errors are one of the top causes of preventable deaths and injuries, and nurse understaffing plays a role in the increase of errors and adverse events. Nurse understaffing has always been an issue in the healthcare industry, but lately, the understaffing has been exacerbated by the COVID-19 pandemic that began in 2020 (Andel et al., 2022). PICOT is an acronym used for developing a clinical question. PICOT stands for patient population, issue of interest, comparison issue of interest, outcome, and time (Stillwell et al., 2010). My PICOT question for my clinical issue is “In nurses working in hospitals (P), how does nurse understaffing (I) compared to adequate nurse staffing (C) influence the occurrence of adverse events (O) over the course of six months (T)?”
First, I used the ProQuest Nursing & Allied Health Database to identify two out of four peer-reviewed articles related to nurse understaffing. One article discussed the effect COVID-19 had on nurse staffing (Laster, 2021). The other article examines the relationship between undone care and nurse staffing (Senek, 2020). Next, I used PubMed to identify the other two out of four peer-reviewed articles. Boolean operators are used to narrow search results in a database to retrieve more relevant results (Walden University, n.d.). For example, using connecting articles such as and, or, and not will search for more exact results. On my original search with the ProQuest Nursing & Allied Health Database, I returned 109 results. After using Boolean operators, I obtained 40 results. On my initial investigation with the PubMed database, I returned 258 results. After using Boolean operators, I produced 88 results. One article I found on this database is about the correlation between nurse staffing and infection rates (Shang et al., 2019). The fourth article talks about the effects understaffing has on healthcare professionals’ cardiovascular health (Wiegl, 2019).
One strategy I could use to increase the rigor and effectiveness of a database search would be to use truncation. Truncation is used to search for any ending of a root word by adding an asterisk at the end of the root (Walden University, n.d.). Another strategy is to filter the results by choosing what type of research article I’m looking for and selecting the date range to ensure that my articles are current. Additionally, I could replace words that could either be too specific or too broad (University of Washington, 2020). If the terms are too specific, not many results may appear, and if the words are too broad, too many results may appear.
References
Andel, S. A., Tedone, A. M., Shen, W., & Arvan, M. L. (2022). Safety implications of different forms of understaffing among nurses during the COVID‐19 pandemic. Journal of Advanced Nursing (John Wiley & Sons, Inc.), 78(1), 121–130. https://doi.org/10.1111/jan.14952
Lasater, K. B., Aiken, L. H., Sloane, D. M., French, R., Martin, B., Reneau, K., McHugh, M. D. (2021). Chronic hospital nurse understaffing meets COVID-19: An observational study. BMJ Quality & Safety, 30(8), 639-647. doi:http://dx.doi.org/10.1136/bmjqs-2020-011512
Senek, M., Robertson, S., Ryan, T., King, R., Wood, E., & Tod, A. (2020). The association between care left undone and temporary nursing staff ratios in acute settings: A cross- sectional survey of registered nurses. BMC Health Services Research, 20, 1-8. doi:http://dx.doi.org/10.1186/s12913-020-05493-y
Shang, J., Needleman, J., Liu, J., Larson, E., & Stone, P. W. (2019). Nurse Staffing and Healthcare-Associated Infection, Unit-Level Analysis. The Journal of nursing administration, 49(5), 260–265. https://doi.org/10.1097/NNA.0000000000000748
Stillwell, S. B., Fineout-Overholt, E., Melnyk, B. M. & Williamson, K. M. (2010). Evidence-Based Practice, Step by Step: Asking the Clinical Question. AJN, American Journal of Nursing, 110 (3), 58-61. doi: 10.1097/01.NAJ.0000368959.11129.79.
University of Washington. (2020, March 17). How to improve database search results. Library Guides. Retrieved March 9, 2022, from https://guides.lib.uw.edu/hsl/improving
Walden University. (n.d.). Keyword searching: Finding articles on your topic: CONNECT KEYWORDS. Walden University Library. Retrieved March 9, 2022, from https://academicguides.waldenu.edu/library/keyword/boolean
Weigl, M., Schmuck, F., Heiden, B., Angerer, P., & Müller, A. (2019). Associations of understaffing and cardiovascular health of hospital care providers: A multi-source study. International journal of nursing studies, 99, 103390. https://doi.org/10.1016/j.ijnurstu.2019.103390
9 months ago
Albert Hatcher
RE: Discussion – Week 4
Marissa, the nursing field has been understaffing for many years. No matter how many new nurse grads we get every year, we still do not have enough nurses to give the proper care needed for caring for patients. Mistakes happen because we cut corners while caring for our patients. According to (Yanchus et al., 2017, “Insufficient staffing levels and imbalanced workload distributions are prominent challenges facing nurses in contemporary healthcare and can lead to higher patient mortality and a greater quantity of nurse-sensitive outcomes, such as patient urinary tract infection, sepsis, and pneumonia.” The nursing staff becomes burnt out because we attempt to compensate for understaffing by signing up for more workdays. Management takes too long to hire extra nurses, which causes their experience nursing to staff the resign. Then management hires new grads who transition to the floor too soon without proper orientation, which can be a factor for errors. Mistakes happen, and we learn from them so that we can grow, but most errors can be prevented with enough staff and proper training.
I wish you well on your evidence-based research on understaffing. When you understand how to look for supporting peer-reviewed articles, you should find the information needed to prove your PICOT question. (Melnyk & Fineout-Overholt, 2019) says that “questions asked in a PICOT format result in an effective search that yields the best, relevant information and saves an inordinate amount of time.” The process will help us focus on the best article for our evidence-based research and prevent frustration when so many articles are found.
References
Melnyk, B., & Fineout-Overholt, E. (2019). Evidence-based Practice in Nursing & Healthcare (4th ed.). Wolters Kluwer.
Yanchus, N., Ohler, L., Crowe, E., Teclaw, R., & Osatuke, K. (2017). You just can’t do it all’: a secondary analysis of nurses’ perceptions of teamwork, staffing and workload. Journal of Research in Nursing, 22(4), 313–325. Retrieved March 24, 2022, from https://doi.org/10.1177/1744987117710305
9 months ago
Mary Bemker-page WALDEN INSTRUCTOR MANAGER
RE: Discussion – Week 4
As you note, a PICOT question is a good way to organize one’s thoughts so the specific area of interest is actualized. Depending upon how the question is written, content will be narrowed to meet the topic under review. The more consistent that the desired findings are reflected in the PICOT question, the higher the probability that the literature search will yield the desired result.
Dr. B.
8 months ago
Motunrayo Aigbedion
RE: Discussion – Week 4
Thank you, Marissa, for your post.
As you rightly shared, the issue of understaffing has been a long-standing problem that affects healthcare workers. The desire to explore understaffing in nursing is excellent, but have you considered exploring it in the healthcare industry as a whole, in addition to nursing? I ask this because the nurse’s role dramatically affects the patient, but it is also influenced by adequate staffing of other healthcare work positions. I am curious to know if the root cause of nursing staffing issues is due to nurses having to take on non-nursing tasks because of staffing shortages in other professions like dietary, housekeeping, or nursing assistant roles. From first-hand experience as a bedside COVID-19 nurse, I remember nurses having to take on the roles of housekeeping, phlebotomy, dietary, respiratory therapy, and nursing assistants in addition to our workload as nurses because of staffing shortages hospital-wide during the height of the pandemic. Staffing shortages, nursing turnover, and understaffing affects nurse workload in patient numbers and tasks associated with patient care (Musy et al., 2021). Driscoll et al. (2018, as reported by Musy et al. 2021), state that “…high patient-to-nurse ratios are linked to a higher likelihood of hospital-related mortality” (p. 2).
Davies et al. (2011) share that real-world problems and issues drive evidence-based practice and great importance is placed on urgent issues. Your interest in nursing shortages in healthcare is indeed an urgent problem. Melnyk and Fineout-Overholt state the importance of “determining the ‘real’ clinical issue” (2018, p. 34) in creating a PICOT question for a literature search. A clear and well-defined PICOT question will serve as the basis for a comprehensive literature search (Melnyk and Fineout-Overholt, 2018). Moreover, proper identification of keywords and synonyms for the keywords will allow for a systematic search of the literature. Walden University Library (2021) teaches the importance of keywords and Boolean operators. Having also learned about truncating root words, I encourage the truncation of keywords in combination with the use of Boolean operators for thoroughness in the literature search.
References
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
Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Wolters Kluwer.
Musy, S. N., Endrich, O., Leichtle, A. B., Griffiths, P., Nakas, C. T., Simon, M. (2021). The association between nurse staffing and inpatient mortality: A shift-level retrospective longitudinal study. International Journal of Nursing Studies 120, 1-9. https://doi.org/10.1016/j.ijnurstu.2021.103950
Walden University Library. (2021). Keyword searching: Finding articles on your topic: Boolean terms. http://academicguides.waldenu.edu/library/keyword/boolean
8 months ago
Chaquita Nichols
RE: Discussion – Week 4
Marissa great post
I enjoyed reading your post. Our issues of interest are similar. I researched issues that affect recruitment and retention of nurses. The nursing shortage is a global issue, and the issues need to be addressed. I agree the shortage has gotten worse since Covid 19. Even though we have nursing students graduating at a higher rate, most do not stay in the nursing profession due to the harsh working environments. It seems like no matter where you go the issues are still the same, but the environment is the only thing that has changed. You still have the short staff, unsafe nurse-patient ratios, bullying, no support from staff, and poor management. I mentioned resilience being important in the nursing field. Lopez, Yobas, Chow, & Shorey, 2018 (2018) noted, “Resilience is defined as the ability to return to a state of normalcy from adversity and having a positive outlook of the future” (p.1). If nurses do not build up resilience, they could easily get burnout which decreases their intent to stay on the job adding to the nursing shortage.
You did an excellent job using the PICOT acronym to come up with your clinical question. You also showed how important it is to use Boolean operators. I saw a significant difference in your search after you included them. You can also put quotation marks around phrases so the database will know to keep is as a phrase and not use the words individually (Walden University Library, n.d.). I will include truncation to help with my next search. Your post was highly informative.
Lopez, V., Yobas, P., Chow, Y.L., Shorey, S. (2018). Does building resilience in undergraduate nursing students happen through clinical placements? A qualitative study, Nurse Education Today, 67, 1-5. https://doi.org/10.1016/j.nedt.2018.04.020
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/jnisearchhelp
8 months ago
Sharon Muchina
RE: Discussion – Week 4
8 months ago
Cory Legan
Response 2
Inadequate staffing leads to many adverse issues within the workplace. As a result, the safety of the patient and staff declines. This not only puts the patient in harm’s way, but also negatively affects job satisfaction and increases the chance of human error (Delgado, 2021). Bringing attention to this issue, demands change. Nurse to patient ratios are used to minimize the chance of human errors and to increase patient safety (Ashe, 2018). The nursing shortage is real, and it affects all parties withing the healthcare industry.
References:
Ashe, L. (2018). The importance of adequate staffing. Retrieved from
https://journals.lww.com/nursingmanagement/fulltext/2018/12000/the_importance_o
f_adequate_staffing.3.aspx
Delgado, S. (2021). Nurse Staffing: A Reason to Leave and a Reason to Stay. Retrieved from
https://www.aacn.org/blog/nurse-staffing-a-reason-to-leave-and-a-reason-to-stay
8 months ago
Rona Adams
RE: Discussion – Week 4
Marissa,
Thank you for discussing this subject of nursing understaffing. Nurses are very stressed and overworked due to many healthcare organizations being understaffed. According to ANA, n.d., if facilities are appropriately staffed, this should improve patient/staff engagement and outcomes and reduce the risk of medical errors. Many organizations have worked for numerous years to combat the nursing shortage. Safety is essential to maintain and achieve improved patient outcomes in the nursing profession. Nursing home nurses, I believe, are at greater risk for medical errors and burnout due to nursing staff shortages. Maintaining staff in these facilities is tough due to the advanced aging population. These facilities should provide adequate staffing and supplies to ensure the safety of their patients and staff. Inadequate staffing could increase elderly abuse and neglect due to the overworked nursing staff (Nursing Home Abuse Guide.org, n.d.).
References
ANA. (n.d.). Nurse staffing. https://www.nursingworld.org/practice-policy/nurse-staffing/
Nursing Home Abuse Guide.org. (n.d.-a). Nursing home understaffing – neglect and liability. https://www.nursinghomeabuseguide.org/neglect/understaffing
9 months ago
Tosin Addeh
RE: Discussion – Week 4
9 months ago
Matthew Cluderay
RE: Discussion – Week 4
9 months ago
Marissa Ludwig
RE: Discussion – Week 4
Hi Tosin,
I selected a clinical issue somewhat similar to yours. My issue deals with the impact nurse understaffing has on poor nurse and patient outcomes including burnout. Nurse understaffing is a chronic issue that has recently been exacerbated by COVID-19 (Andel et al., 2022). I am excited to hear your take on the well-being of nurses on COVID units versus nurses on non-COVID units. COVID-19 has put an immense amount of stress and increased workload on nurses by causing nurses to work increased hours with more acute patients and decreased resources (Sullivan et al., 2022). I believe that burnout is something that isn’t discussed as often as it should be, and nursing well-being needs to be prioritized.
References
Andel, S. A., Tedone, A. M., Shen, W., & Arvan, M. L. (2022). Safety implications of different forms of understaffing among nurses during the COVID‐19 pandemic. Journal of Advanced Nursing (John Wiley & Sons, Inc.), 78(1), 121–130. https://doi.org/10.1111/jan.14952
Sullivan, D., Sullivan, V., Weatherspoon, D., & Frazer, C. (2022). Comparison of Nurse Burnout, Before and During the COVID-19 Pandemic. Nursing Clinics of North America, 57(1), 79–99. https://doi.org/10.1016/j.cnur.2021.11.006
9 months ago
Mary Bemker-page WALDEN INSTRUCTOR MANAGER
RE: Discussion – Week 4
You provided aa solid rationale for this topic to be an area of interest for you. As you note, current “best practices” were applied at the start of the pandemic. These practices shifted as more was learned about this specific disease. That is the reason that you are taught the process as opposed to static information. Thank you for providing an excellent example of this need.
Dr. B.
9 months ago
Memory Rinomhota
RE: Discussion – Week 4
Hi Tosin
Thank you for choosing this topic. I was of the people affected by nursing burnout. I worked on a COVID-19 floor for six months when the pandemic started. We were not allowed to take time off because of the shortage. Guidelines were changing all the time, and no Personal protective equipment (PPE). We would sometime twelve-hour shift for seven days straight. It stressed seeing the patients’ health deteriorate and knowing there is not much you can do except provide support. The number of health workers who died during COVID-19 was alarming. There was stress, anxiety, working in isolated units, and living in hotels without family members (Wan et al., 2022). I think management must provide mental health support to health care so they can be able to take care of the patients
I agree with you that sometimes the articles which come up have nothing to do with what you are looking for. You can search articles that are peer-reviewed and are five years old. Using the Boolean/phrase will narrow the search.
Wan, Z., Lian, M., Ma, H., Cai, Z., & Xianyu, Y. (2022). Factors associated with burnout among Chinese nurses during COVID-19 epidemic: a cross-sectional study. BMC Nursing, 21(1), 1–8. https://doi.org/10.1186/s12912-022-00831-3
Kim, M.-N., Yoo, Y.-S., Cho, O.-H., & Hwang, K.-H. (2022). Emotional Labor and Burnout of Public Health Nurses during the COVID-19 Pandemic: Mediating Effects of Perceived Health Status and Perceived Organizational Support. International Journal of Environmental Research and Public Health, 19(1). https://doi.org/10.3390/ijerph19010549
9 months ago
Chaquita Nichols
RE: Discussion – Week 4
Before starting research into any kind of clinical issue, you must start with a good clinical question. The PICOT format is set up so you can form a clinical question that would help your searching process easier. The letters all have different meanings which helps make the wording and process easier. P is for patient population or population of interest, I is for issue or intervention of interest, C is for comparison of interest, O is for outcome expected, and T is time for the intervention to achieve the outcome (Melnyk & Fineout-Overholt, 2018, p.34). Another innovative idea to have when doing clinical research is having a good database. My clinical issue of interest was issues affecting the recruitment and retention of nurses. My PICOT question would be, In the nursing profession, how do employers deal with the recruitment and retention of new graduates’ vs experienced nurses within the first year of employment? In the nursing profession, what issues affect the recruitment and retention of nurses within the first year of employment? There are other things to consider when looking at a clinical trial such as sample size, statistical methods, limitations, and ethical issues (Lira & Rocha, 2019).
There are a lot of different databases out there, it just depends on your goal and the question you are trying to answer. I used CINAHL with full text and MEDLINE with full text. Some of the databases require subscriptions, but I was able to access the articles through my institution. The search terms I used were retention, recruitment, nursing, and profession. When I typed the search terms into CINAHL 38 articles showed up. When I typed in the search terms in MEDLINE 32 articles showed up. Boolean Operators are used to connect terms and phrases together to give the database a better understanding of what you are trying to find (Walden University Library, n.d.). I did not think to use Boolean Operators which are and, not, and or, but I will use them in the upcoming assignment. I will also use parentheses in the search engine when I want to keep wording together. Another helpful source would be to use a librarian if there is one available. Those are some things I would use to improve my database search.
References
Lira, R. P. C., & Rocha, E. M. (2019). PICOT: Imprescriptible items in a clinical research question. Arquivos Brasileiros de Oftalmologia, 82, 1-1.
Melnyk, B., & Fineout-Overholt, E. (2018). Evidence-Based Practice in Nursing Practice and Healthcare (4th ed.). Wolters Kluwer.
Walden University Library. (n.d.-g). Keyword searching: Finding articles on your topic: Introduction to keyword searching. Retrieved September from September 19, 2018, from https://academicguides.waldenu.edu/library/keyword/searching-basics
9 months ago
Chaquita Nichols
RE: Discussion – Week 4
8 months ago
Britny Ray
RE: Discussion – Week 4
8 months ago
Brittni Rodio
RE: Discussion – Week 4
9 months ago
Sarah Lockwood
RE: Discussion – Week 4
The healthcare industry is constantly evolving with technology advancements and expansion of nursing informatics. Due to electronic medical records, patient health information access tools, and the growing complexity of diseases, physicians and nurses must be competent in obtaining information when they need it. Health information is readily available when needed however, members of the care team must understand how to obtain and how to recognize the information. According to Melnyk & Fineout-Overholt (2019), digital resources are available to physicians and nurses and guarantee retrieval of information to give the best care possible. Finding the appropriate information starts with a good question, which is the first step in the evidence-based practice (EBP) process (Melnyk & Fineout-Overholt, 2019). The EBP process allows for good information-seeking practices and maximizes information retrieval while reducing time investment (Melnyk & Fineout-Overholt, 2019). According to Davies (2011), forming a searchable, answerable question is the driving force behind EBP and must be clearly defined and well-structured to successfully retrieve information. Formulating a solid question begins with the PICO process. PICO is an acronym for: Patient or problem, intervention, comparison, and outcome (Davies, 2011). Additionally, after creating a PICO question, using Boolean operators can increase relevancy and narrow search results. Boolean operators are the words AND, OR, and NOT that are used following expressions and aid in precision of search results (Library of Congress, n.d.). Formulating a question to begin an EBP process requires a PICO question with Boolean operators, which will give successful results.
My clinical area of interest is the use of pneumatic compression devices (PCD) in the hospitalized patient. I am familiar with this topic as I was an inpatient floor nurse for nine years and PCDs were ordered for majority of patients however, the PCDs were not always utilized for multiple reasons. I am interested in the research completed on this topic because currently, I am in an outpatient orthopedic surgery center and all the joint replacement patients are required to wear PCDs for about six weeks, post-operatively.
My original, broad search of PCDs resulted in 1,530 articles. After adding Boolean operators, such as AND hospitalized patients, my results narrowed to 34 articles. I believe 34 is an appropriate amount to sort through for a research project however, I narrowed my search even further by changing the date range to recent years and viewing peer-reviewed articles only, resulting in nine articles. To increase the rigor and effectiveness of searches, the researcher must utilize multiple Boolean operators and the method of nesting, where parentheses are used with complex Boolean operator phrases (Library of Congress, n.d.). Also, narrowing date ranges and types of articles will increase successful results.
References
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.
Library of Congress. (n.d.). Search/browse help- Boolean operators and nesting.
Retrieved March 17, 2022, from
https://catalog.loc.gov/vwebv/ui/en_US/htdocs/help/searchBoolean.html
Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing &
Healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.
9 months ago
Motunrayo Aigbedion
RE: Discussion – Week 4
RESPONSE TO OTHER LEARNER
Thank you for your post, Sarah.
Pneumatic compression devices (PCDs) are instrumental in preventing deep vein thrombosis in patients. Your interest in this clinical area offers an opportunity to explore the need for and use of PCDs for in-patient and out-patient settings. Greenall & Davis (2020) give an in-depth analysis of patient adherence to PCD use. They identify eight factors that affect patient adherence, including patient discomfort and equipment availability. I am not sure of the intervention you want to explore for your EBP project, but adherence to the use of PCDs may be of interest to you, given that patients in your orthopedic clinic are required to use PCDs for six weeks post-operatively. Davies (2011) expresses the challenge of identifying answerable questions when developing PICOT questions. With so much to consider about PCDs, whether it be adherence to use, availability of equipment, patient knowledge about the need for it, or healthcare professionals’ desire to use PCDs, developing a clear PICOT question that is specific enough will help streamline your literature search.
I agree with you that Boolean search terms increase the rigor and effectiveness of a literature search. However, have you considered using multiple keywords and alternate names for PCDs in your search? For example, PCDs are also referred to as “intermittent pneumatic compression.” I would also recommend keywords like “compression therapy OR compression device” to ensure that you have exhausted all possible names for PCDs. Also, truncating root words like “compress*” and “device*” may allow for a more comprehensive literature search. Walden University Library states that “using an asterisk at the end of root words tells the database to search for that word with any ending” (Walden University Library, 2021a, para 1). Deciding on a research topic and identifying a relevant database also helps find the correct articles (Walden University Library, 2021b). I strongly recommend using CINAHL plus with full text because their search bar auto-suggests alternate keywords.
References
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
Greenall, R., & Davis, R. E. (2020). Intermittent pneumatic compression for venous thromboembolism prevention: a systematic review on factors affecting adherence. British Medical Journal 10(9), 1-10. http://doi.org/10.1136/bmjopen-2020-037036
Walden University Library. (2021a). Keyword searching: Finding articles on your topic: Boolean terms. http://academicguides.waldenu.edu/library/keyword/boolean
Walden University Library. (2021b). Keyword searching: Finding articles on your topic: Introduction to keyword searching. http://academicguides.waldenu.edu/library/keyword/searching-basics
9 months ago
Motunrayo Aigbedion
RE: Discussion – Week 4
The formatting changed when I copied and pasted this discussion response.
I provide the references list again here.
References
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
Greenall, R., & Davis, R. E. (2020). Intermittent pneumatic compression for venous thromboembolism prevention: a systematic review on factors affecting adherence. British Medical Journal 10(9), 1-10. http://doi.org/10.1136/bmjopen-2020-037036
9 months ago
Tosin Addeh
RE: Discussion – Week 4
First Student Response:
Hello Sarah,
You wrote on a fascinating topic in your discussion. I admire how you first of all defined Evidence base-practice and the use of PICOT. I will be adding some more light to your discussion.
According to Lira & Rocha (2019), “a poorly devised research question can affect the choice of study design, potentially lead to futility, and thus impede the chance of determining anything of clinical significance.” (para. 2). So it is essential to construct the PICOT question that can lead you as a guide to finding those quality research databases to support your paper. I think you got that already because, based on your discussion, you did not have any problem finding resources to support your exciting topic.
I am trying to imagine what your PICOT question will be from the topic of interest you chose- use of a pneumatic compression device (PCD). I am assuming you could have your PICOT question in this simple format : In patient with post-operative orthopedic surgery, will use of PCD compared to no use of PCD prevent Venous thromboembolism (VTE). Venous thromboembolism (VTE) is a severe complication that can result in death after orthopedic surgery. A randomized controlled study done on a couple of patients with total joint arthroplasty showed that using a portable intermittent PCD reduced the incidence rate of VTE (Takahashi et al., 2020). You chose a very interesting topic.
References
Lira, R. P. C., & Rocha, E. M. (2019). Picot: Imprescriptible items in a clinical research question. Arquivos Brasileiros de Oftalmologia. Retrieved March 24, 2022, from https://www.scielo.br/j/abo/a/V3NtFJWpRqzTcdfgkYy8HJz/?lang=en
Takahashi, Y., Takashira, N., & Shibuya, M. (2020, March). A portable pneumatic compression device to prevent venous thromboembolism in orthopedic patients with the highest risks of both venous thrombosis and bleeding: A case series study. Journal of orthopedic Surgery. Retrieved March 24, 2022, from https://journals.sagepub.com/doi/abs/10.1177/2309499020905711
8 months ago
Shirley Harleston
RE: Discussion – Week 4
Hello Sarah,
Most patients admitted to the hospital have to use pneumatic compression devices (PCD) because they are often in bed for the majority of the time. However, when they start to move around they no longer use them because these devices are attached to the bed. At this point, they can only have them on when they are sleeping. I could also see why surgical patients have to use them for up to six weeks. They are at very high risk for pulmonary embolism (PE). The risk of PE is greatest 1-6 weeks post-surgery (Caron, et al., 2019).
Knowing how to find articles and making the most use of the library is very crucial to Evidenced-Based Practice. It reduces the time spent on researching articles and getting to relevant articles in a short space of time. Searching the school library will give you full articles, as the library has subscriptions to over 100 databases with access to full-text articles, books, and journals (Walden, n.d.-g)
References:
Caron A, Depas N, Chazard E, et al.(2019) Risk of Pulmonary Embolism More Than 6 Weeks After Surgery Among Cancer-Free Middle-aged Patients. JAMA Surg.154(12):1126–1132. doi:10.1001/jamasurg.2019.3742
Walden library. (n.d.-g) Keyword searching: Finding articles on your topics: Introduction to Keyword searching. Retrieved September 19, 2018, from htps://academicguides.waldenu.edu/library/keyword/search-basics
9 months ago
Motunrayo Aigbedion
RE: Discussion – Week 4
Main Discussion Post
Studies have shown that people who experience trauma early in life are more likely to have mental illnesses in adulthood, given the biological and psychological effects of trauma (Beckett et al., 2017; Cilia Vincenti et al., 2021; Isobel & Delgado, 2018; Rahman et al., 2018; Stokes et al., 2017). The prevalence of traumatic events in a person’s life, or those felt through second-hand experiences, causes one to consider the effects of traumatic events on mental health and wellness. Trauma-informed care (TIC) is “cognizant of the prevalence and adverse effects of trauma” (Cilia Vincenti et al., 2021). Though TIC should be considered for all areas of healthcare, my clinical area of interest is the use of TIC in mental health practice and services. Rahman et al. (2018) report that the extent to which someone is traumatized or has adverse childhood experiences affects their response to psychiatric care and should dictate the level and type of psychiatric care and mental health services they receive. I believe that psychiatric and mental health services should be trauma-informed instead of led by diagnoses because diagnoses alone do not account for trauma and the occurrence of retraumatization in mental health care and services received (Rahman et al., 2018; Isobel & Delgado, 2018). To explore this clinical area of interest, I did a literature search in nursing and allied health databases to determine current evidence on the use of TIC in healthcare. My PICOT question is “in psychiatric patients (P), how does trauma-informed mental healthcare (I) compared to non-trauma informed mental healthcare (C) affect the quality and outcome of mental healthcare services received (O) in the past five years (T).”
There are 15 nursing and allied health databases provided by Walden University Library. Of the 15, I chose CINAHL, MedLine, ProQuest, and PubMed databases because these databases are noted to be the most comprehensive. To make my search precise, Boolean search phrases were made using keywords in combination with Boolean operators “AND,” “OR,” and “NOT” to streamline the results. Boolean operators connect keywords to create search phrases that achieve more relevant results (Walden University Library, 2021b). Root words were truncated using an asterisk to ensure a more in-depth search of articles. I explored each database one at a time and limited the search results to primary resources. Primary resources are described as original research projects where the authors designed the study and collected and analyzed raw data to arrive at a sound conclusion (Melnyk & Fineout-Overholt, 2018, Walden University Library, 2021a). My initial Boolean search phrase looked at “trauma informed care.” My final Boolean search phrase looked for literature on trauma-informed care and mental health services in hospitals from the perspective of the healthcare worker.
The CINAHL plus database was the most useful in creating comprehensive Boolean search phrases because the database search engine is designed to suggest synonyms for the keywords identified. In CINAHL plus, my initial Boolean search phrase was “trauma informed care OR trauma informed practice OR trauma OR trauma informed approach.” This search phrase yielded 5754 hits, a number far too large to find the best article. I added “AND mental health OR mental illness OR mental disorder OR psychiatric illness” to this Boolean search phrase and brought the number down to 1866 hits. With “AND healthcare OR health care OR hospital OR health services OR health facilities OR medical care,” the results came down to 721 hits. Finally, adding “AND healthcare workers OR nurses OR medical workers OR healthcare professionals” brought the number down to 98 hits. I repeated this process in MedLine, Proquest, PubMed. The initial number of hits in MedLine was 7,006 research articles. The final Boolean search yielded 333 hits. In ProQuest, the number of articles started at 23,504 hits and dwindled to 324 hits. When I tried this method in the PubMed database, the hits came down from 2488 to 49 articles, but the articles found were not relevant despite several attempts and variations in searching. This is when I found the TRIP database.
In the TRIP Database, you can physically enter your PICO question by population, intervention, comparison, and outcome and then limit the articles to peer-reviewed scholarly journal articles between 2017 and 2022. Using keyword searching, Boolean operators, truncating root words for the PICO format, and limiting results to primary resources published between 2017 and 2022, the number of research articles dropped from 602 hits when the intervention was “trauma* inform*” to 275 relevant results when the intervention was “trauma* inform* care” (Walden University Library, 2021b; Walden University Library, 2021c). These strategies increased the rigor and effectiveness of my database search on my PICO(T) question.
References
Beckett, P., Holmes, D., Phipps, M., Patton, D., & Molloy, L. (2017). Trauma-Informed Care and Practice: Practice Improvement Strategies in an Inpatient Mental Health Ward. Journal of Psychological Nursing 55(10), 34-38.
Cilia Vincenti, S., Grech, P., & Scerri, J. (2021). Psychiatric hospital nurses’ attitudes towards trauma-informed care. Journal of Psychiatric Mental Health Nursing 2022(29), 75-85. https://doi.org/10.1111/jpm.12747
Isobel, S., & Delgado, C. (2018). Safe and Collaborative Communication Skills: A Step towards Mental Health Nurses Implementing Trauma Informed Care. Archives of Psychiatric Nursing 32(2018), 291-296. https://doi.org/10.1016/j.apnu.2017.11.017
Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Wolters Kluwer.
Rahman, A., Perri, A., Deegan, A., Kuntz, J., & Cawthorpe, D. (2018). On becoming Trauma-informed: Role of the Adverse Childhood Experiences survey on tertiary child and adolescent mental health services and the association with standard measures of impairment and severity. The Permanente Journal 22(17), 1-9. https://doi.org/10.7812/TPP/17-054
Stokes, Y., Jacob, J.D., Gifford, W., Squires, J., Vandyk, A. (2017). Exploring nurses’ knowledge and experiences related to Trauma-Informed Care. Global Qualitative Nursing Research 4, 1-10. https://doi.org/10.1177/2333393617734510
9 months ago
Mary Bemker-page WALDEN INSTRUCTOR MANAGER
RE: Discussion – Week 4
Providing a solid foundation and clear communication is a key factor in being successful in research a topic and communicating findings. It denotes professionalism and increases your position of authority within the advanced practice nurse’s role. In addition, you are modeling the correct format for written communication, and as educators – we all are educators if we are nurses – we can offer insights into how this process needs to be done.
Kudos for such efforts!
Dr. B.
8 months ago
Inderpreet Sandhar
RE: Discussion – Week 4
Great post Motunrayo,
Your clinical inquiry is such an interesting and current topic. PICOT question is a strategy; formed to provide the terms necessary to search for the best evidence to answer a clinical inquiry (Gallagher Ford, L. & Melnyk, B. M., 2019). The PICOT question you have formed has all the keywords you need to start your search for articles to answer your clinical inquiry. The words you used also have a lot of synonyms that you can swap with to broaden your search results. (Bermudez, 2021).
When there are many articles coming up for a certain topic, I may suggest that I find it helpful; look at related citations. Most databases offer the option to find relevant articles related to the articles already found; the databases CINHAL and Ovid have it as “Find Similar Results,” and PubMed has it as “Similar Articles” (Melnyk & Fineout-Overholt, 2019). I also look at the list of references at the end of the research studies I already chose, and I usually find articles there that are relevant to my topic. Melnyk & Fineout-Overholt called this ancestry method. When you find yourself looking for more articles, try it and I hope it benefits your search.
References:
Bermudez, N. (2021). Formulating well-written clinical practice questions and research questions. Nursing and Health Sciences Research Journal, 4(1), 70-82.
Gallagher Ford, L. & Melnyk, B. M. (2019). The unappreciated and misunderstood PICOT question: A critical step in the EBP process. Worldviews on Evidence-Based Nursing, 16(6), 422-423.
Melnyk, B. M. % Fineout-Overholt, E. (2019). Evidence-Based practice in nursing &healthcare: A guide to best practice (4th Ed.) Wolters Kluwer.
8 months ago
Motunrayo Aigbedion
RE: Discussion – Week 4
Hi Inderpreet,
Thank you so much for the suggestion to look at citations within articles. I also like your suggestion to look at similar articles. These suggestions will help me continue in my search. Thank you once again.
Motun
8 months ago
Tosin Addeh
RE: Discussion – Week 4
Second Student Response:
Hello Motunrayo,
I enjoy reading your post because it taught me some new term which I have not heard since my practice as a registered nurse. You mentioned Trauma Informed Care (TIC) as it relates to caring for psychiatric patient because of its benefit in patient care system delivery.
So, I did some more research on it and found out that you can use Trauma Informed Care at any healthcare setting. TIC means that you as the health care provider must have the awareness that a patient might have had trauma in their childhood or prior early years in life that could be resulting in their recent health issues. Using TIC means you will be providing a compassionate approach to your patient and for this to be effective all members of the health care team must practice it as well and this start from the greeter at the door entrance, the receptionist, nurses, physicians and everyone (Purkey et al., 2018).
Another part of your discussion that interest me the most was your formulated PICOT question. I like that you would love to research the effectiveness of using TIC in psychiatric patient, this to me is evidence base practice; the act of asking answerable questions and finding useful resources to provide evidence (Melnyk & Fineout-Overholt, 2018). Results from such research works can be used in the future in other setting and applied into practice.
References
Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Wolters
Kluwer.
Purkey, E., Patel, R., & Phillips, S. P. (2018, March). Trauma-informed care: Better Care For Everyone. Canadian family physician Medecin de famille canadien. Retrieved March 26, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5851387/
