Discussion: Searching Databases 2025

Searching Databases (APA 7 format and at least 3-4 references) 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. Mike RE: Discussion – Week 4/Initial (at least 2-3 references and APA 7 format) Given the diverse nature of the health care industry, the ubiquitous array of multi faceted axillary services, the sector we service the most sometimes becomes the focus of our interest given the opportunity and longevity in such an institution. For the purpose of this discussion post I will be posing a question on post operative pain management since this sector happens to be a critical pivotal point in patient recovery following either inpatient or outpatient surgical interventions. Using the PICOT question format; Does the management of pain using pharmacological and non pharmacological interventions on a post operative surgical adult patient improve pain control in four days post surgery? Following from the PICOT abbreviation, the P represents the population which refers to our surgical patients, I represents the intervention; pain management, C represents comparison; the comparison of pharmacological and alternate pain management strategies, O represents the outcome which is pain management while T speaks to our time frame for achieving this goal which is four days post surgery. According to Melnyk, (2018, p34) “the desire to gather the right information in the right way at the right time is not sufficient. Mastering practical, lifelong learning skills (e.g., asking focused questions, learning to systematically search) is required to negotiate the information rich environment that clinicians encounter.” For the purpose of this post, the search engines I utilized were ProQuest and CINAHL Plus database. My key word search was pain management, which returned 20,494 results and 21,460 respectively. After the utilization of limiters for full text, peer review, date range of 2016 to 2020 the streamlined search result was 13,601 and 15,787 respectfully. The inclusion of Boolean search parameter for surgical patients further helped narrow down the search as follows; 3,070 and 5,179 respectfully, my inclusion of a final modifier for the most recent year of publication “2020” further help streamline my search results as follows ProQuest 232, while CINAHL Plus with full text returned 203 searches. “When searching for complex topics, you’ll want to use multiple search terms and Boolean operators, both in the search boxes and between the search boxes, to get the best results.” (Retrieved September 6th, 2019) With the desire to increase the rigor and effectiveness on my data base search results, some of the strategies I will employ will be the refining of my search limiters which will help streamline my research to the most current year, using year of publication limiters, I will also include key words from my PICOT question like surgical, post surgical, pharmacological and or non pharmacological to help narrow in on the much desired research article that mirrors my PICOT question. “Keyword searching is the process of choosing search terms and entering them into the database search boxes to locate information on your topic.” (Retrieved September 19th, 2018) References Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer. Walden University Library. (n.d.-c). Evidence-based practice research: CINAHL search help. Retrieved September 6, 2019, from https://academicguides.waldenu.edu/library/healthevidence/cinahlsearchhelp Walden University Library. (n.d.-g). Keyword searching: Finding articles on your topic: Introduction to keyword searching. Retrieved September 19, 2018, from http://academicguides.waldenu.edu/library/keyword/searching-basics Lau RE: Discussion – Week 4 I work on an IMCU, and it is hectic. Patient care is often interrupted for transferring improved patients to lower levels of care units to make room for admissions. About 1/3 of the unit will be newly admitted on my shift. The admission process includes asking patients about suicide and depression. I don’t feel awkward asking patients directly about the subject, but I see that patients are surprised that I ask even when I tell them in advance that I will be doing so. I have queried the significance of asking about suicidal ideation when patients are being admitted for a physical illness unrelated to psychiatric disorders. P- patients admitted for physical illness unrelated to psychiatric disorders I- hospital staff asking about suicidal ideation on admission to acute care settings C- not asking about suicidal ideation on admission to acute care settings O- value; decrease in the number of suicide attempts, an increase in patients seeking assistance in mental health care T- one year PICO question: Is there value in asking patients admitted to an acute care setting for physical illness unrelated to psychiatric disorder, about suicidal ideation, compared to not asking over one year. Search phrases could include ask suicide, medical admission, suicide screening, and asq suicide. I used Sage journals and queried “ask suicide” and received 39,212 results (Sage Journals, 2020). Using the same search terms on Taylor & Francis Online there were 75,136 results (Taylor & Francis Online, 2020). Using Boolean operators changed the results returned. Using “and” narrowed my search and “or” broadened my results. Adding more search terms linked together further narrowed the results by approximately 75% by using “and.” Both databases have the ability for the user to narrow searches by searching for terms in specific article type, journal type as well as the publication date. Strategies to increase the rigor and effectiveness of a database search might include using more than one database (UTHealth, 2019). One study on search strategies found a higher number of systematic reviews were obtained using a 2 PICO element search rather than a 4 element search. Additionally, it was found that it was essential to combine at least three databases together to achieve a 90% retrieval of relevant literature (Ho, Liew, Ng, Shunmugam, & Glasziou, 2016). This could provide me with the opportunity to find more significant studies to review. Another strategy would be to combine search terms and phrases with Boolean operators to refine my search. UTHealth libguides also points out that all databases are not created the same (UTHealth, 2019). They each have different rules and quirks. I must familiarize myself with the tool I choose to use, or it will not be effective. References Ho, G. J., Liew, S. M., Ng, C. J., Shunmugam, R. H., & Glasziou, P. (2016, 12). Development of a Search Strategy for an Evidence Based Retrieval Service. PLoS One, 11 (2), e0167170. doi:10.1371/journal.pone.0167170 Sage Journals. (2020). Search Results . Retrieved 12 22, 2020, from Sage Journals: https://journals-sagepub-com.ezp.waldenulibrary.org/action/doSearch?AllField=Ask+Suicide Taylor & Francis Online. (2020). Your search for All: ask suicide . Retrieved 12 22, 2020, from Taylor & Francis Online: https://www-tandfonline-com.ezp.waldenulibrary.org/action/doSearch?AllField=ask+suicide UTHealth. (2019). Best Practices for Developing Search Strategies: Home . Retrieved 12 22, 2020, from UTHealth: https://libguides.sph.uth.tmc.edu/c.php?g=543359

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Week 2/Discussion 2/ my post While interviewing and examining a 17-year-old male, you discover a white patch on his buccal mucosa and slanting palpebral fissures in his eyes. He also states during the interview that he plays baseball and is hoping to earn an athletic scholarship to college. When the 17-year-old boy says he plays baseball and would like to get an athletic scholarship for college, we can suspect that he spends a lot of time in the field, exposed his self to sun and has been exposed to smokeless tobacco which is prevalent in the baseball sport. An increased use of smokeless tobacco use in sports, mainly in baseball is been reported in 2016 (Jarvis, 2016). ), “Leukoplakia is chalky white, thick raised patch with well-defined borders.” This is attached firmly to the buccal mucosa, even if you scraping hard it will not come off. You can also see it in individual who are heavily tobacco user as well as alcohol (Jarvis, 2016). White patches in the mouth also called excessive Candida you may see it in patient with weak immune system, steroid inhaler user, and HIV infection, use of broad-spectrum antibiotics, leukemia, and malnutrition.Slight upward or downward slanting of palpebral fissures normally occurs on a familial basis or in groups such as people of Asian descent. So in this case the slating palpable fissures in his eyes found during the assessment can be suspect that this patient is Asian or is an Asian descent. In non-Asians, the palpebral fissures are horizontal (Jarvis, 2008). Usually when narrowed, upward slanted palpebral fissures are present it could be indication of Down syndrome. In this case this 17-year-old boy should have been ruled out earlier than the age of 17. I would conduct a cranial nerve examination using Snellen chart test for visual acuity to see if there are any deficits in the optic nerve. Patients near vision could also be assessing (Jarvis, 2016). An ophthalmoscope consult should be place to “examine the ocular fundus to determine the color, size, and shape of the optic disc” (Jarvis, 2016, p. 644). I will also get order for a CT scan to rule out ICP if during retina exam patient’s margins of the optic disc become blurred and indistinct. I would first want to initially suspect that the patient has papilledema, also known as a choked disc which is an increase in cranial pressure (ICP) (Jarvis, 2016). As a Health care professionals we are educated and trained on strategies to teach patients and family members about this condition. First and foremost, would be for the patient to have genetic testing done to confirm a Down syndrome diagnosed. If the test results are positive, then the health care professional can provide the family and patient with the appropriate resources and specialty professionals to aid them in coping with their new diagnosis. The one most important thing that a health care professional can do is to empower the patient and family. This can be accomplished by carrying out interventions in a manner in which family members acquire a sense of control over their own efforts to meet their needs. Health care professionals can also enable families by creating opportunities for family members to become more competent and self-sustaining with respect to their abilities to mobilize their social networks to get their needs met and attain desired goals (Cohen, 2013). It is important to also let the patient know that his career of playing baseball may be limited in college may grossing diminish if other manifestations of condition sets in later in life. Some special considerations that can help to educate the patient and family on health promotion and disease intervention would include continuous monitoring measures, including yearly audiologic assessment and yearly ophthalmologic assessment, ongoing management of manifestation of the disorder and related conditions, as well as discussion of issues identified with the move into adulthood. If it were discovered that the patient has developed the habit of using smokeless tobacco, I would educate him on the harmful effects of smokeless tobacco such as the increase risk for cancer, and encourage him to seek out measures to quit. I would also remind him that at the age of 17 it is illegal to obtain to tobacco products and that he could jeopardize his chances of playing baseball on the collegiate level via an athletic scholarship if caught breaking the law. Furthermore, I would encourage this patient to seek alternative measure to quit smoking, and pick up healthier habits like chewing sugar free gum in place of using smokeless tobacco. References Cohen, W. I. (2003). Health Care Guidelines for Individuals with Down Syndrome-1999 Revision. Down Syndrome , 237-245. doi:10.1002/0471227579.ch17 Jarvis, C. (2016). Physical examination & health assessment. (7th ed.). St. Louis: Elsevier. Jarvis, C. (2008). Pocket companion for physical examination and health assessment. (5thed.). St. Louis: Elsevier. PROFESSOR QUESTION/NEEDS TO ANSWER TO PROFESSOR BASE ON MY POST. For our 1st pt- The diagnosis of whiplash is a key differential diagnosis for our first patient. When we consider the patients complaints; HA, decreased ROM in the neck, vertigo, loss of hearing to one ear, sweating and uncontrollable eye movements, along with the recent possible mechanism of injury; the MVA whiplash does fit a possible diagnosis for this patient. When we think of the causes of whiplash, we think of a force strong enough to whip the patients neck backward and forward, placing a great deal of stress on the neck muscles and ligaments. What additional differential diagnosis is appropriate for our first patient, based on the S/S?

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