Searching Databases in Clinical Inquiry
The clinical issue of interest for this clinical inquiry is pressure ulcers in bed-bound patients. This is a significant problem that affects those patients who have been bed-ridden for long periods of time and who lack appropriate or timely nursing care. Pressure ulcers are therefore a quality improvement (QI) concern and are an indicator that the quality of care in the setting in which the patient is admitted is wanting. Nurses can assess the risk of developing pressure ulcers in bed-ridden patients by using the Braden Scale. The other two scales or tools that can be used are the Norton Scale and the Waterflow Scale (Gaspar et al., 2019; Kottner et al., 2019). Some of the causes of pressure ulcers include neglect, being bed-ridden or immobile, poor nutritional status, and frailty. To discover the available evidence-based interventions to prevent pressure ulcers, a search of research databases is carried out using a PICOT statement that provides key words for the search (Melnyk & Fineout-Overholt, 2019; Melnyk et al., 2009). Searching Databases in Clinical Inquiry Essay
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When carrying out the search for evidence for this topic in research databases, the original search yielded a total of 8,032 articles. On close scrutiny, it was clear that most of these were not quite specific to what the PICOT question is asking. What were therefore needed were filtering and the use of Boolean operators to narrow down the search. When the search terms “pressure ulcers,” “prevention,” and “bed-ridden” were combined using the Boolean operator “AND”, the search now yielded more specific articles numbering 76. Out of this, the strategies that might be used to increase the rigor and effectiveness of the database search on the PICOT question include filtering using the dates of publication (for instance, within the last ten years or five years), and filtering using the type of study (e.g. randomized controlled trial or RCT, systematic review and meta-analysis, and so on).
Gaspar, S., Peralta, M., Marques, A., Budri, A., & Gaspar de Matos, M. (2019). Effectiveness on hospital-acquired pressure ulcers prevention: A systematic review. International Wound Journal, 16(5), 1087-1102. http://dx.doi.org/10.1111/iwj.13147
Hekmatpou, D., Mehrabi, F., Rahzani, K., & Aminiyan, A. (2018). The effect of Aloe Vera gel on prevention of pressure ulcers in patients hospitalized in the orthopedic wards: A randomized triple-blind clinical trial. BMC Complementary and Alternative Medicine, 18(1), 1-11. https://doi.org/10.1186/s12906-018-2326-2
Kottner, J., Cuddigan, J., Carville, K., Balzer, K., Berlowitz, D., Law, S., … & Sigaudo-Roussel, D. (2019). Prevention and treatment of pressure ulcers/injuries: The protocol for the second update of the international Clinical Practice Guideline 2019. Journal of Tissue Viability, 28(2), 51-58. https://doi.org/10.1016/j.jtv.2019.01.001 Searching Databases in Clinical Inquiry Essay
Melnyk, B.M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing & healthcare: A guide to best practice, 4th ed. Wolters Kluwer.
Melnyk, B.M., Fineout-Overholt, E., Stillwell, S.B., & Williamson, K.M. (2009). Evidence-based practice: Step by step: Igniting a spirit of inquiry. American Journal of Nursing, 109(11), 49–52. http://dx.doi.org/10.1097/01.NAJ.0000363354.53883.58
Nixon, J., Smith, I. L., Brown, S., McGinnis, E., Vargas-Palacios, A., Nelson, E. A., … & Henderson, V. (2019). Pressure relieving support surfaces for pressure ulcer prevention (PRESSURE 2): Clinical and health economic results of a randomized controlled trial. EClinicalMedicine, 14, 42-52. http://dx.doi.org/10.1016/j.eclinm.2019.07.018 Searching Databases in Clinical Inquiry Essay