NURS-6052 Discussion: Searching Databases

 NURS-6052 Discussion: Searching Databases

“Evidence-based practice questions center on real-world problems and issues.” The more pressing the question, the more important it is to place it in an EBP context.” Davies (2011) This week, I used the question “How do I prevent deep vein thrombosis in inpatientsover the age of forty?” to inform my PICO(T). I chose this topic because I work in a medical-surgical setting, but I previously worked on an acute rehabilitative floor where anticoagulation was a clinical priority for all of my patients. I still work with adults, the majority of whom are elderly, and many of them are not anticoagulated for a variety of reasons. I recently requested a rapid response for one of my patients,    who turned out to have bilateral pulmonary emboli, so this topic has piqued my interest more than ever. “P-patient or Problem: Who is the Patient?” Davies breaks down the elements of the PICO(T) inquiry for us. What are the patient’s most important characteristics?

What is the primary issue, disease, or co-occurring condition? I – Intervention: What is the primary intervention under consideration? C – Comparison: What is the main intervention in comparison? “What are the anticipated measures, improvements, or effects?” “When a nurse possesses a spirit of inquiry within a supportive EBP culture, she or he can routinely ask questions about clinical practice while care is being delivered,” Melnyk et al remind us. In the spirit of inquiry, I formulated the following from my initial question: (P) in patients over 40 at risk for deep vein thrombosis, (I) is an anticoagulant the most effective prevention (C) compared to physical therapy (O) in preventing deep vein thrombosis (T) while in the hospital.

“Boolean operators and nesting allow you to look for combinations of words or phrases that have been processed in a specific order” (Boolean Operators and Nesting, 2018). I searched “deep vein thrombosis prevention” in Walden’s library’s CINAHL database, which yielded 123 results. When I entered “in elderly patients” as my Boolean operator in the advanced search box, I received only three results, which are much easier to sort through than 123. When I am conducting research in online databases, I use several strategies to narrow down the results. One such strategy is to check the ‘peer-reviewed’ box, as I only want to use reliable research. I also select ‘only inpatients’ on occasion because I work in an inpatient setting.

Nesting and Boolean Operators (2018). The Library of Congress https://catalog.loc.gov/vwebv/ui/enUS/htdocs/help/searchBoolean.html

K. S. Davies (2011). A Review of the Frameworks for Formulating the Evidence-Based Practice Question 75-80 in Evidence-Based Library and Information Practice. https://doi.org/10.18438/B8WS5N

B. Melnyk, E. Fineout-Overholt, S. Stillwell, and K. Williamson (2009).

Evidence-Based Practice: Step by Step: Creating an Inquiry Spirit