NURS 6052 Discussion Searching Databases

NURS 6052 Discussion Searching Databases

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RE: Discussion – Week 4

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PICO(T): (P) Registered nurses in the emergency room (I) Nurse burnout and turnover rate (C) other areas of nursing (O) Patient safety and satisfaction.

The topic I chose as my clinical interest is, The burnout in emergency room nurses. Nursing burnout is defined as “Nurse burnout is a physical, mental, and emotional state caused by chronic overwork and sustained lack of job fulfillment and support” (Nursing.org, 2019). Burnout has become a chronic issue in healthcare. Due to the increased demand in workload and patient satisfaction nurses are facing burnout at a faster rate. The focus has started to shift towards the environment that the nurses are working in, nurses that have stressful encounters on a daily basis have a difficult time coping with stress. Nursing burnout is experienced in all fields of nursing. The studies I have found focus more on oncology and emergency room nurses with the highest rates of burnout.

The databases I used to search were EBSCO, Walden library, Cochrane, Pubmed, and CINAHL. I narrowed the search to peer view articles with dates ranging from 2014 to 2020, this gave me the most up to date information with evidence-based practice articles. I added my filters and search term to the boxes for example I did “burnout” “Emergency room” and “Nurses” in the Walden library, my results came up 163. Walden library(2019) recommends adding Boolean term to get more of a precise search. When I added Boolean terms to my search 2,357 articles came up. One strategy to increase rigor and effectiveness of a database is to use alternative terms such as “burnout syndrome”, “fatigue”, “Nursing professional”, ”Emergency department” to improve my results. Another strategy is a feature called clinical inquires on Pubmed. Clinical inquires improves search results by “linking the type of question to a stored search strategy that retrieves the appropriate research methodology” (Schardt, 2009). All of these techniques will help me in developing my research in finding the most relevant peer- reviewed articles. NURS 6052 Discussion Searching Databases

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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.

Nursing.Org. (2019). Avoiding Burnout as a Nurse. Retrieved from https://www.nursing.org/resources/nurse-burnout/

Schardt, C., Adams, M., Owens, T., Keitz, S., & Fontelo, P., (2007). Utilization of the pico framework to improve searching pubmed for clinical questions. Retrieved from https://bmcmedinformdecismak.biomedcentral.com/articles/10.1186/1472-6947-7-16

Walden University Library. (2019). Keyword searching: Finding articles on your topic: Boolean terms.Retrieved from http://academicguides.waldenu.edu/library/keyword/boolean

Brian Thank you for your hard work in the ER! That my friend is not easy! Nurse burnout is a significant problem affecting the nursing workforce and is associated with significant personal suffering and high rates of nurse turnover. According to Thomas, Bantz, & McIntosh, job burnout is particularly high among nurses, with 74% of departing nurses citing acute and chronic stress responsibility, as well as nurse faculty vacancies increasing to 7.9%, putting more pressure and work on the already overloaded nurses (2019, p. 112). Nurses are continually confronted with very demanding workloads due to patient-to-nurse ratios, high acuity patients, lack of time which either cuts charting short or cuts breaks short, and heavy patient assignments. These issues arise because of nursing shortages due to nursing burnout, and nursing burnout continually rises because of nursing shortages. I don’t work in the emergency room but I have so many friends that have transferred from the ER to The OR. This is why I chose this as my topic it is very interesting. So when I began my search I started on Google Scholar with the terms of compassion fatigue in healthcare workers. The inclusion dates of articles were from 2014 to 2019. My search terms were compassion fatigue, vicarious traumatization, compassion fatigue interventions, community service workers’ problems, healthcare workers’ problems, healthcare providers’ problems, mental health providers problems, child protective services caseworkers’ mental health, burnout and first responders, nurses’ environmental problems, secondary traumatic stress response, Professional Quality of Life Screening, compassion satisfaction, self-care, wellness retreats for nurses, physicians and mental health workers organizational environment, stress-reducing practices for healthcare workers in ICU and emergency room, and physician burnout. . I also searched the keywords patient to nurse ratios and patient outcomes, and this study revealed 326 articles. However, right away, I noticed that evidence-based research articles appeared within the first 20 results. Another tidbit of information that will help narrow down the type of research articles needed is as follows: For treatment, questions search for systematic reviews of randomized controlled trials. For meaning questions, search first for meta-syntheses of qualitative studies. For prognosis or prediction, questions search first for the synthesis of cohort case-control studies. For diagnosis, questions search first for the synthesis of randomized controlled trials or cohort studies. For etiology questions, search first for the synthesis of cohort or case-control studies. These are just some ideas that have been passed down to me. (Melnyk & Ellen, 2018, p. 53). NURS 6052 Discussion Searching Databases

References

Melnyk, B., & Ellen, F. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice(4th ed.). Wolters Kluwer.

Thomas, C. M., Bantz, D. L., & McIntosh, C. E. (2019). Nurse Faculty Burnout and Strategies to Avoid it. Teaching and Learning in Nursing, 14(2), 111–116. https://doi-org.ezp.waldenulibrary.org/10.1016/j.teln.2018.12.00

NURS 6052 Discussion Searching Databases

When you decide to purchase a new car, you must first determine your priorities.
If mileage and dependability are critical, you’ll look for data that focuses on these factors rather than 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. NURS 6052 Discussion Searching Databases

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. 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.

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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.

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 4 Discussion Rubric

Post by Day 3 and Respond by Day 6 of Week 4

To participate in this Discussion:

Week 4 Discussion

onse	Points Range: 17 (17%) – 18 (18%) Response exhibits synthesis, critical thinking, and application to practice settings. Responds fully to questions posed by faculty. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of learning objectives. Communication is professional and respectful to colleagues. Responses to faculty questions are fully answered, if posed. Response is effectively written in standard, edited English.	Points Range: 15 (15%) – 16 (16%) Response exhibits critical thinking and application to practice settings. Communication is professional and respectful to colleagues. Responses to faculty questions are answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English.	Points Range: 13 (13%) – 14 (14%) Response is on topic and may have some depth. Responses posted in the discussion may lack effective professional communication. Responses to faculty questions are somewhat answered, if posed. Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.	Points Range: 0 (0%) – 12 (12%) Response may not be on topic and lacks depth. Responses posted in the discussion lack effective professional communication. Responses to faculty questions are missing. No credible sources are cited.
Second Response	Points Range: 16 (16%) – 17 (17%) Response exhibits synthesis, critical thinking, and application to practice settings. Responds fully to questions posed by faculty. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of learning objectives. Communication is professional and respectful to colleagues. Responses to faculty questions are fully answered, if posed. Response is effectively written in standard, edited English.	Points Range: 14 (14%) – 15 (15%) Response exhibits critical thinking and application to practice settings. Communication is professional and respectful to colleagues. Responses to faculty questions are answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English.	Points Range: 12 (12%) – 13 (13%) Response is on topic and may have some depth. Responses posted in the discussion may lack effective professional communication. Responses to faculty questions are somewhat answered, if posed. Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.	Points Range: 0 (0%) – 11 (11%) Response may not be on topic and lacks depth. Responses posted in the discussion lack effective professional communication. Responses to faculty questions are missing. No credible sources are cited.
Participation	Points Range: 5 (5%) – 5 (5%) Meets requirements for participation by posting on three different days.	Points Range: 0 (0%) – 0 (0%)	Points Range: 0 (0%) – 0 (0%)	Points Range: 0 (0%) – 0 (0%) Does not meet requirements for participation by posting on 3 different days.

Total Points: 100

Name: NURS_6052_Module03_Week04_Discussion_Rubric

Kelsie Clark Initial Discussion Post Week 4 Attachment

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Stress in Healthcare

Healthcare workers, nurses, in particular, have high occupational stress levels, which can result in poor health, absenteeism, and burnout symptoms (Hersch et al., 2016). Sources of work-related stress in nursing are a heavy workload, long or unusual work hours, death of patients, different management styles, and poorly designed work environments. Healthcare professionals use various coping mechanisms to manage stress and stress-related complications (W.j et al., 2021). Nurses attempt to utilize stress-relieving measures while outside of work, but are workplace interventions effective in reducing healthcare workers’ stress and burnout symptoms? NURS 6052 Discussion Searching Databases

Search Results with Boolean Operators

Boolean operators are an essential feature to use when searching for peer-reviewed research literature. Searching the Walden Library using the boolean phrases of healthcare professionals or healthcare workers or healthcare providers or physician or nurse or doctor and work-related stress or job-related stress or occupational stress stipulating Full Text and Peer-Reviewed Scholarly Journals Only from 2016 to 2021 in the CINAHL Plus with Full-Text database resulted in 1,623 results. Searching with the same keywords and years in the MEDLINE with Full-Text database resulted in 1,017 results. Narrowing these same searches by adding and program or services or interventions allowed a more detailed review.

Strategies

Strategies to find appropriate clinical studies included skipping any literature reviews and allowed a more tapered search of the topic. Finding studies with control groups made it easier to contemplate a PICOT question. A more formulated PICOT question allows an even more precise search. While I have not determined my exact PICOT question, I am searching for information on a question I have been working on formulating. Will healthcare workers who are provided a stress relief program by employers have decreased psychological distress compared to those in the control group (or not in the program)? I have not yet determined the time frame. Suggestions for changes are welcome since I have never before made a PICOT question.

Conclusion

Although I use the fundamentals of evidence-based practice in my workplace, as a nurse who graduated in 2001 with a bachelor’s degree, I did not learn how to make a PICOT question or use today’s search engines. As a person who did not own a computer until attending Walden University, this class’s learning curve has been immense. I now more clearly understand that evidence-based practice in healthcare means using clear rationale with the latest and best-quality research to promote the best care (Rowles & McNaughton, 2017), and I have a new appreciation for the process.

References

Ameli, R., Sinaii, N., West, C. P., Luna, M., Panahi, S., Zoosman, M., Rusch, H. L., & Berger, A. (2020). Effect of a brief mindfulness-based program on stress in health care professionals at a us biomedical research hospital. JAMA Network Open, 3(8), e2013424. https://doi.org/10.1001/jamanetworkopen.2020.13424

Hersch, R. K., Cook, R. F., Deitz, D. K., Kaplan, S., Hughes, D., Friesen, M., & Vezina, M. (2016). Reducing nurses’ stress: A randomized controlled trial of a web-based stress management program for nurses. Applied Nursing Research, 32, 18–25. https://doi.org/10.1016/j.apnr.2016.04.003

Lin, L., He, G., Yan, J., Gu, C., & Xie, J. (2018). The effects of a modified mindfulness-based stress reduction program for nurses: A randomized controlled trial. Workplace Health & Safety, 67(3), 111–122. https://doi.org/10.1177/2165079918801633

Rowles, E., & McNaughton, A. (2017). An overview of the evidence-based practice process for novice researchers. Nursing Standard, 31(43), 50–60. https://doi.org/10.7748/ns.2017.e10643

W.j, N., Sekar, L., Manikandan, A., K, M., T, G., Shriraam, V., Silambanan, S., & R, P. (2021). Mahamantra chanting as an effective intervention for stress reduction among nursing professionals—a randomized controlled study. Advances in Integrative Medicine, 8(1), 27–32. https://doi.org/10.1016/j.aimed.2020.05.007

COLLAPSE

Discussion Post

I started the process by looking more into what this whole ‘PICO-T’ thing is. It is an acronym to methodically breakdown what kind of information a good research question should ask, and it is important to ask questions using this method due to the way it refelects a systemic breakdown of the components of a research issue (Stillwell et al., 2010). My topic of interest is medication errors and prevention. I did not know to what capacity I wanted to learn more about medication errors. I thought it would be nice to look at reconciliation but could not narrow down the results to a specific intervention. I first searched just ‘medication errors’ and was led to a ton of references ranging from pediatrics to pharmacist involvement. I knew I did not want any information on pediatrics. And it seems too convoluted to ask what degree pharmacist involvement had on medication errors. Plus, when I did check that box, the results were minimal. Then it dawned on me, why not broaden the question to all interventions? I checked the Walden library, PubMed.gov, and the Cochrane Library. All of which grave me plenty of results when searching for medication error prevention policies. I guess that is my interest, after all. Before starting an entirely new experiment of study, I guess it is best to see where your colleges have already traveled, right? So I came up with the following as my PICO-T question: What inpatient medication prevention policies have proven to reduce medication errors in adult patients admitted to the hospital for at least 24 hours? Then I questioned if this were too general or vague after reading the resources for this discussion/assignment. NURS 6052 Discussion Searching Databases. There is a good breakdown of background versus foreground questions on ohsu.edu which gives examples of questions that are too generalized or specific enough to meet the PICO-T criteria (ohsu.edu, 2021). So I decided to search further and try to focus on a specific intervention being effective. Are electronic medical records, compared to hand-written records, effective at reducing medication errors for adult patients in a hospital setting? Where is my timeframe? Is ‘hospital setting’ implied? These are the questions I am asking myself. Then I start to think I am too hung up on this timeframe thing. But I think that’s a pretty good PICO, I am just not sure if I need to keep the “hand-written” comparison. When I add it to my search criteria, my results suffer tremendously. So if I can keep the comparison out, I will.

References

(2021, September 13). ohsu.edu. Retrieved September 20, 2021, from https://libguides.ohsu.edu/nursing/PICO

Stillwell, S. B., Fineout-Overholt, E., Melnyk, B. M., & Williamson, K. M. (2010). Evidence-based practice, step by step: Asking the clinical question: A key step in evidence-based practice. American Journal of Nursing, 110(3), 58–61.

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NURS 6052 Discussion Searching Databases

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