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 PIC

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This is a graded discussion: 100 points possible due Mar 22 at 10:59pm

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When you decide to purchase a new car, you first decide what is important to you. If mileage and dependability are the important factors, you will search for data focused more on these factors and less on color options and sound systems.

The same holds true when searching for research evidence to guide your clinical inquiry and professional decisions. Developing a formula for an answerable, researchable question that addresses your need will make the search process much more effective. One such formula is the PICO(T) format.

In this Discussion, you will transform a clinical inquiry into a searchable question in PICO(T) format, so you can search the electronic databases more effectively and efficiently. You will share this PICO(T) question and examine strategies you might use to increase the rigor and effectiveness of a database search on your PICO(T) question.

SEARCHING DATABASES

RESOURCES

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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.

*Library tip:

Walden Library recommends starting your search broadly with one concept or search word and adding more elements one at a time. Depending on your topic, the evidence will not necessarily address all the aspects of your PICO(T) question in one article. Select the most important concepts to search and find the best evidence available, even if that means assembling evidence from multiple articles.

Nursing Research Page (https://academicguides.waldenu.edu/library/subject/nursing) – databases and resources specifically for Nursing Evidence-Based Practice guide: Evidence Types (https://academicguides.waldenu.edu/library/healthevidence/types) Nursing and Health research videos (https://academicguides.waldenu.edu/library/webinararchives/nursing) , including a 15- minute introduction Get Help (https://academicguides.waldenu.edu/library/help) page, including Ask a Librarian (https://academicguides.waldenu.edu/library/ask) service

Quick Answers:

Be sure to review the Learning Resources before completing this activity. Click the weekly resources link to access the resources.

WEEKLY RESOURCES (https://waldenu.instructure.com/courses/53151/modules/items/1043729)

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Search entries or author

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How do I find an article that reports on research that uses a specific methodology? (https://academicanswers.waldenu.edu/faq/72633) How do I find original or primary research that analyzes empirical data? (https://academicanswers.waldenu.edu/faq/72640) What is the Find at Walden button? (https://academicanswers.waldenu.edu/faq/73252)

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.

Respond to at least two of your colleagues on two different days and provide further suggestions on how their database search might be improved.

BY DAY 3 OF WEEK 4

BY DAY 6 OF WEEK 4

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3/21/23, 4:07 PM Topic: Module 3: Discussion

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(https:// Emily F Keyes (She/Her) (https://waldenu.instructure.com/courses/53151/users/2872)

Yesterday

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Hi, All,

This week is *the* week for you to select your final topic of interest for your remaining work in the course. It must be a researchable topic, of course! You may or may not have your complete PICO(T) in place, but you must at least describe your topic and aims with it in detail! You must have your PICO(T) in place for next assignment! Of note: the T means timeframe over which you would collect data on all subjects in your study. It is not necessary to include a timeframe unless you wish!

Hope this helps! 🙂

Dr. Keyes

(https:// Samantha Hrabik (https://waldenu.instructure.com/courses/53151/users/76342)

Yesterday 

For my clinical issue of interest, I chose birth control and sexual education for adolescents. I chose this topic because it is something I feel strongly about, teens and adolescents deserve quality and competent sexual education along with knowledge and education about birth control and contraception. “A quality sexual health education curriculum includes medically accurate, developmentally appropriate, and culturally relevant content and skills that target key behavioral outcomes and promote healthy sexual development” (Center for Disease Control and Prevention, 2020). There are many benefits to quality sexual education and different types of birth control access such as fewer experiences of unprotected sex, increase in protection, fewer partners, and even a delay in initiation of sexual intercourse (Centers for Disease Control and Prevention, 2020).

The PICOT format of research helps with research questions by effectively identifying the P- population, I- intervention of interest, C- comparison of interest, O- outcome, and T- time for the intervention to achieve the outcome (Melnyk & Fineout,

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2018). Using the PICOT format for research helps dial in what you are looking for and provides better results. When I used the basic search of “adolescents and birth control” I had 9,341 results through the “Nursing Research Page”. I then narrowed my search by limiting years from 2018-2023 and that gave me 2,442 results. I was able to find a couple of articles with that search, but I then added a sub search of “sexual education” this gave me 181 results.

I always like to start by using the Walden Library Nursing Database, I have found the best results starting here. Starting off with a solid topic also helps, with this topic I started with just birth control and added more specifications as I went. Knowing more about the PICOT format of research would have helped prior to this assignment. When I researched only birth control my results were very broad with many different populations, ages groups, and reasons for birth control use. When I decided to do a more specific population search of adolescents it brought my focus in a lot better and I was able to research more efficiently. Adding in key words, specific years, and full text limiters also helped bring down the results to specifically what I was looking for.

Centers for Disease Control and Prevention. (2020, February 3). What Works: Sexual Health Education. CDC. https://www.cdc.gov/healthyyouth/whatworks/what-works-sexual-health-education.htm (https://www.cdc.gov/healthyyouth/whatworks/what-works-sexual-health-education.htm)

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.-a). Databases A-Z: Nursing (https://academicguides.waldenu.edu/az.php?s=19981) Links to an external site. (https://academicguides.waldenu.edu/az.php?s=19981) . Retrieved September 6, 2019, from https://academicguides.waldenu.edu/az.php?s=19981

(http Wemimo Ojetunde (https://waldenu.instructure.com/courses/53151/users/74061)

Yesterday 

Samantha, I appreciate your insight into your clinical interest in teenage sexual education and contraception. The PICOT style is a great approach to organize questions for research and narrow down the results when looking for scholarly publications, as you said. You were able to locate more specifically tailored content thanks to this style. Database searches

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may be optimized in a number of different ways, by deciding on a subject in advance and then narrowing it down using keywords and other filters. (Melnyk, et., al 2009).

The database search might be enhanced by including more databases, such as PubMed, CINAHL, and Cochrane database. These databases have a plethora of nursing and healthcare publications and may therefore provide a more comprehensive selection of resources. The database is also additional source of evidence since these sorts of research give an in-depth study of several studies and provide a greater degree of evidence. Library of Congress. (n.d.).

To further refine the database search, it may be useful to include additional search terms related to social and cultural factors, such as "stigma," "gender norms," or "culture." Additionally, limiting the search to specific study designs, such as randomized controlled trials or systematic reviews, can help to identify high-quality evidence. (Lopez et al., 2016).

References

Library of Congress. (n.d.). Search/browse help – Boolean operators and nesting. Retrieved March 20, 2023, from https://catalog.loc.gov/vwebv/ui/en_US/htdocs/help/searchBoolean.html

Lopez, L. M., Grey, T. W., Chen, M., Tolley, E. E., Stockton, L. L., & Chen, M. (2016). Theory-based interventions for contraception. The Cochrane database of systematic reviews, (11), CD007249. https://doi.org/10.1002/14651858.CD007249.pub4 (https://doi.org/10.1002/14651858.CD007249.pub4)

Melnyk, B. M., Fineout-Overholt, E., Stillwell, S. B., & Williamson, K. M. (2009). Evidence-based practice: Step by step: Igniting a spirit of inquiry Links to an external site. Links to an external site. American Journal of Nursing, 109(11), 49–52. doi:10.1097/01.NAJ.0000363354.53883.58

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(http Emily F Keyes (She/Her) (https://waldenu.instructure.com/courses/53151/users/2872)

11:36am 

Samantha,

I love your topic of interest! I am with you that our teens must know about birth control options early on! I hear you about knowing more concerning PICOT before your search, yet it should not have hindered your ability to search very much! The options are to choose a topic, to see what is there in the published literature, and then, formulate your PICO(T) as you go! I can pass along your opinion to our course designers for consideration; they may be able to introduce it somewhere earlier. I do not design our courses (no faculty member does!), and we are not allowed to alter the structure of any course, at all!

Thanks for your good review of literature, and for all material otherwise! 🙂

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Dr. Keyes

(http Samantha Hrabik (https://waldenu.instructure.com/courses/53151/users/76342)

2:27pm

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Thank you, Dr. Keyes! I do agree with you that it did not ultimately hinder my search or ability to do the assignment. I think some of the resources that were provided this week could have been helpful for last week, but I did feel like I was adequately prepared and able to complete last week's assignment without anything from this week.

Samantha

(http Joshua Albert Rangel (https://waldenu.instructure.com/courses/53151/users/78224)

2:33pm 

Reply #1

Hello Samantha Hrabik,

This week’s discussion topics are endless; some are highly important, and others are hot topics of government debates. I love that your topic of choice is birth control and sexual education. It is such a controversial topic with so many crucial elements and options. I read an article recently about the topic was to not addressing sexual education or gender until a certain age. Pushing this critical education off simply because we want to protect our children is very naïve. Kids are becoming more and more sexually active among younger generations. Evidence-based practice shapes healthcare practice (Melnyk & Fineout-Overholt, 2018). With the recent changes to abortions and decreased sexual education, I fear for our futures. As a foster parent, I fear how many more children will be added to the numerous children already in foster care. Great topic of discussion; I am sure choosing a topic for the assignment will be complex.

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Melnyk, B. M., & Finest-Overholt, E. (2019). Evidence-Based Practice in Nursing & Healthcare (4th ed.). Wolters Kluwer.

Walden University Library. (n.d.-c). Evidence-based practice research: CINAHL search, Retrieved from https://academicguides.waldenu.edu/library/healthevidence/cinahlsearchhelp

(https:// Joshua Albert Rangel (https://waldenu.instructure.com/courses/53151/users/78224)

Yesterday 

Initial Post:

Hello Colleagues,

My clinical issue of choice is diabetes; I choose diabetes because, as a nurse, we often care for patients with diabetes. These patients we care for often have unmanaged diabetes and lack education on adequately managing it. To improve patient outcomes, new knowledge must be transformed into clinically useful forms and measured in terms of how it impacts the patient's health (Stevens, 2013). To research a question, you first have to identify the health issue and then identify a problem. My research question is, "does diabetes education reduce the future risk of complications compared to none?" In the last several years of education, I have seen many patients who lack the knowledge to manage diabetes properly. I have had patients who need to learn their HbA1C levels or daily blood glucose. To begin my research, I went to Walden's Library nursing database. I utilized the CINAHL search by using the words diabetic, education, and complications, to name a few.

I refined the outcomes by limiting the years and selecting peer articles only. A hand full of articles were left for the choosing. Most, if not all, related to my interests and research topic. In the textbook, I utilized the PICOT question template (Melnyk & Finest-Overholt, 2019). The PICOT question template identifies the population, intervention of interest, comparison of interest, outcome, and time for the intervention to achieve the outcome (Melnyk & Fineout, 2019). Using the PICOT format for research helps dial in what you seek and provides better results. The Walden Library also has links to PubMed and Science Digest; I utilized these searches to find additional search articles.

Reference

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Melnyk, B. M., & Finest-Overholt, E. (2019). Evidence-Based Practice in Nursing & Healthcare (4th ed.). Wolters Kluwer.

Stevens, K. R. (2013). The Impact of Evidence-Based Practice in Nursing and the Next Big Ideas.

The Online Journal of Issues in Nursing, 18 (2).

Walden University Library. (n.d.-c). Evidence-based practice research: CINAHL search, Retrieved from https://academicguides.waldenu.edu/library/healthevidence/cinahlsearchhelp

(http Emily F Keyes (She/Her) (https://waldenu.instructure.com/courses/53151/users/2872)

11:40am

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Joshua,

This is a wonderful presentation of your search process, as well as of your topic of interest! T2 DM is widespread, and when our patients lack education about how to manage or even prevent it, we must take action to help them!

Great job! Thanks! 🙂

Dr. Keyes

(https:// Wemimo Ojetunde (https://waldenu.instructure.com/courses/53151/users/74061)

Yesterday 

Current healthcare system and patient care are being shaped by evidence-based practice (Melnyk & Fineout-Overholt, 2018). Health-related concerns inspired the creation of the PICO framework and its variants. PICO(T) stands for patient, intervention, comparison, outcome, and timeframe (Davies, 2011). My clinical issue of interest is diabetes and my PICO(T) question is:

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In patients with Type 2 diabetes, does intermittent fasting compared to no intervention or usual care lead to a significant improvement in glycemic control (HbA1c level) after 12 weeks?

P: Patients with Type 2 diabetes.

I: Intermittent fasting

C: No intervention or usual care

O: Improvement in glycemic control (HbA1c level)

T: 12 weeks

The two databases used to search these questions were PubMed and CINAHL Plus in the Walden University Library (Walden University Library, n.d.). The initial search using the keywords "Type 2 diabetes", "intermittent fasting", "glycemic control", and "HbA1c level" yielded a total of 126 articles on original research in the PubMed database. As additional search terms were added using Boolean operators, the number of articles returned decreased. When "12 weeks" was added as a search term, the number of articles decreased to 52. When the term "usual care" was added as a search term, the number of articles decreased to 36.

Many techniques may be used to improve the thoroughness and accuracy of a database search for this PICO(T) question using Pub Med:

Firstly, guaranteeing complete search coverage by using both free-form keywords and restricted vocabulary phrases (MeSH terms). Diabetic coma, fasting, and glycosylated hemoglobin A are all examples of restricted vocabulary phrases that may be used in conjunction with the keywords. Secondly, to accommodate for any terminology differences, truncate strings and generic symbols can be used. Just appending the truncation symbol "*" to the word "diabetes" will return results including the phrases "diabetic," "diabetes mellitus," and "diabetes insipidus," among others. Thirdly, making use of many databases to assure completeness. Cinahl Plus, the Ebsco database, are some of the other useful databases that may be searched in addition to PubMed. Fourthly, establish criteria for what to include and what to leave out of your search. Because of this, only relevant articles will be included in the study. Articles may be disregarded for a variety of reasons, including not being written in English, not including human subjects; and not reporting on relevant outcomes (in this case, glycemic control). Library of Congress. (n.d.) If these methods are used, the search will provide more complete, accurate, and relevant results for the PICO(T) inquiry.

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After conducting a search on CINAHL Plus using the initial search terms "Type 2 diabetes" and "intermittent fasting," a total of 5 articles were returned. When using Boolean operators to refine the search, the search terms "Type 2 diabetes AND intermittent fasting" yielded 5 articles, "Type 2 diabetes AND intermittent fasting AND glycemic control" yielded 2 articles, and "Type 2 diabetes AND intermittent fasting AND HbA1c" yielded 1 article.

To increase the rigor and effectiveness of a database search on this PICO(T) question with CINAHL, one strategy is to use a combination of controlled vocabulary and keywords. Controlled vocabulary includes standardized terms used in a specific database to describe concepts, which can help ensure that all relevant articles are retrieved. For example, in CINAHL Plus, the controlled vocabulary term for Type 2 diabetes is "diabetes mellitus, type 2." Using this term in addition to the keyword "Type 2 diabetes" could potentially retrieve more relevant articles. Another strategy is to use the search filters provided by the database to narrow down the results by publication type, study design, an

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