NURS 5052 Walden University Week 4 Emergency Care Discussion

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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As a practicing Emergency Department (ED) nurse, I see patients with sepsis every shift. However, managing sepsis is a complicated task for healthcare facilities in the United States (US), where clinical evaluation, recognition, and sepsis management are essential for patient survival (Onawola, 2021). I chose sepsis management as my clinical issue of interest. I chose this topic because I am on the sepsis committee of my current organization and want to improve current organization sepsis protocols and policies based on up-to-date, evidence-based research to ensure septic patients are receiving high-quality care.

Throughout my time at Walden, I have found my favorite search engine to be CINAHL & MEDLINE combined search that the library provides (Walden University Library, n.d.). When I type sepsis into the search bar, 86,127 results display. That number seems overwhelming to try to sift through. Adding Boolean operators such as AND, OR, and NOT, helps to research phrases processed in a specified order (Library of Congress, n.d.). For example, when I search sepsis in the first line and use AND emergency department as a Boolean operator, the results are now down to 5,258. This makes the search more specific to what I am want to study. By going even further searching sepsis AND emergency department AND fluid management changing the years from 2017-2021, the results now display 21 articles. These articles are very specific to my topic of interest. This specific search will increase the rigor and effectiveness of the database search by ensuring my search displays up-to-date research and will save me time by not sifting through 86 thousand articles.

References

Library of Congress. (n.d.). Search/browse help – Boolean operators and nesting. Retrieved March 21, 2021, from https://catalog.loc.gov/vwebv/ui/en_US/htdocs/help…

Onawola, A. (2021). Early recognition and management of sepsis in the elderly: A case study. Critical Care Nursing Quarterly, (44)2, 175-181. http://doi/org/10.1097/CNQ.0000000000000351

Walden University Library. (n.d.). Databases A-Z: Nursing. Retrieved March 21, 2021, from https://academicguides.waldenu.edu/az.php?s=19981

Write response to this post: My nursing specialty is to become a psychiatric mental health nurse practitioner and my topic of interest is the emerging use of telemedicine in thisfield. The use of telemedicine and telepsychiatry has increase dramatically since the onset of the pandemic. Improved patient access is the common metric used in favor of this technology and we are seeing it in a variety of traditional and nontraditional healthcare settings (Kemp et al, 2020). Therefore, there is a greater need to understand best practices surrounding telemedicine to ensure quality patient care is being delivered.

The database I have been using at Walden and have experienced the best variety of articles come up is the combined search CINAHL & MEDLINE. CINAHL stands for Cumulative Index to Nursing & Allied Health Literature and includes peer-reviewed articles, systemic reviews etc. (Walden Library, n.d.). MEDLINE consist of biomedical and life sciences journals. I always can find more than enough literature on my subject matter. Upon doing my basic search I will enter key words in the data base, (e.g., telemedicine, telehealth, telepsychiatry, mental health, best practices, etc.). In addition, I enter full text and scholarly peer reviewed articles to narrow my search. There is an abundance of literature available on this topic and more than enough articles pop up.

When I want to narrow my search further I may use Boolean Operators to help search a combination of words or phrases processed in a specified order (Walden Library, n.d.). For example, I may enter “telemedicine and best practices”, or “telepsychiatry and patient satisfaction”. When I enter these in the search bar I can narrow my search and receive more specific results on my topic.

Other strategies I may use to increase the rigor of the database search regarding my PICO(T) question is to pose my question with use of key words. I would identify my patient population, “people with mental health disorders”, and intervention, “telepsychiatry or in-person treatment”, and outcome, “effect patient satisfaction”, or “observed best practices”. This will allow me to focus my search for relevant articles that answer my question of interest.

P-people with mental health disorders I- prefer telepsychiatry or C- in-person treatment O- improve patient satisfaction.

Beth

Kemp, J., Zhang, T., Inglis, F., Wiljer, D., Sockalingam, S. Crawford, A., Lo, B., Charow, R., Munnery, M., Singh, T. & Strudwick, G. (2020). Delivery of compassionate mental health care in a digital technology-driven age: scoping review. Journal of Medical Internet Research. https://web-a-ebscohost-com.ezp.waldenulibrary.org/ehost/detail/detail?vid=8&sid=ecf33970-7eee-44bf-a5c3-ce4f9eb9a49b%40sdc-v-sessmgr01&bdata=JnNpdGU9ZWhvc3QtbGl2ZSZzY29wZT1zaXRl#AN=32141833&db=mnh

Library of Congress. (n.d.). Search/Browse help-Boolean operators and nesting. https://catalog.loc.gov/vwebv/ui/en_US/htdocs/help/searchBoolean.html

Walden University Library. (n.d.). Databases A-Z: Nursing. https://academicguides.waldenu.edu/az.php?s=19981