SEARCHING DATABASES NURS 6052

When nerve signals between the bladder and the brain do not work effectively, it results in Overactive bladder (OAB). About 30% of men and 40% of women in the U.S. live with OAB (Urology Care Foundation,2020). A well-constructed PICOT question helps find the best evidence available to influence practice. The question should be formulated before starting a literature search (Melnyk, et al. 2009).

PICO(T) Question: Does the InterStim neuromodulator implant for the treatment of Overactive bladder really work by decreasing or even stopping urinary urgency and frequency?

To formulate questions in Evidence Based Practice, the PICO(T) format is used. PICO(T) is a mnemonic derived from:

Population/Patient problem: Patients diagnosed with Overactive Bladder.
Intervention: Insertion of a neuro modulator implant.
Comparison: Alternative treatments such as Diet modification, Bladder training, use of Anticholinergic drugs, Kegel exercises, Hydrodistension of the bladder, Bladder Botox
Outcome: Reduction of day and nighttime frequency as well as episodes of uncontrollable urgency.
Time: (Time element is not always included): Trial implant for a week, if symptoms improve within a week, a permanent neuromodulator is implanted under the skin of the upper buttock and connected to the sacral nerve by way of a wire tunneled under the skin.

CINAHL Plus with Full Text and Medline with full text were the two databases used for the research.

SEARCHING DATABASES NURS 6052

MEDLINE with full text search:

Original Term: Overactive bladder. This resulted in 10,322 articles. I limited my search to articles within 11 years, only peer reviewed, full text articles When I added search terms using Boolean operators, it resulted in 3 articles.

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CINAHL Plus with Full Text search:

Original Term: Overactive bladder resulted in 7,822 articles. When I added search terms using Boolean operators, it resulted in 12 articles.

One strategy to increase the effectiveness of a database search for a PICO(T) question is to be specific in using the keywords for your search. I had a difficult time initially finding information for treatments for Overactive bladder, using the InterStim treatment. I also learned that the search cannot be a long, broad search, however it should be disease specific and search using minimal words. Also know the correct abbreviation of the keywords you want to use in your search, I attempted to use O.B. for Overactive bladder instead of O.A.B, and it yielded no results.

Reference

Library of Congress(n.d.). Boolean Operators and Nesting. Retrieved December 21, 2020 from https://catalog.loc.gov/vwebv/ui/en_US/htdocs/help/searchBoolean.html

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.

Urology Care Foundation. (2020). What is Overactive bladder? Retrieved on December 21, 2020 from https://www.urologyhealth.org/urology-a-z/o/overactive-bladder-(oab)

Walden University Library. (n.d.-a). Databases A-Z: Nursing. Retrieved December 21,2020 from https://academicguides.waldenu.edu/az.php?s=19981

Searching Databases

              Evidence-based practice, also known as EBP, can be discovered in many different places, including journals, textbooks, databases, and so on. When conducting research, one must make certain that the information that they are looking for and evaluating comes from a reputable source. If credible resources are utilized, the evidence and study will have a greater potential to be held to a higher level. It is possible to acquire resources on your own or through places of employment or educational institutions. Unfortunately, policymakers continuously signal that dependable resources are required to ensure that patients are receiving the greatest patient care that is available from their healthcare providers; however, resources are not always available without constraints as required (Melnyk & Fineout-Overholt, 2018).

What is PICO(T)?

              The population of interest (P), intervention or issue of interest (I), comparison of interest (C), the outcome expected (O), and time for an intervention to achieve the outcome (T) is PICOT (Melnyk & Fineout-Overholt, 2018). PICOT questioning is a method of research that is utilized to identify the clinical evidence that is of the highest quality for use in practice. This is accomplished by conducting investigations in a manner that is both objective and productive (Ford & Melnyk, 2019). The researcher has the ability to employ a form of research known as PICOT questioning in order to reduce the outcomes of the evidential investigation to a more manageable level. The use of opioids in patients who are suffering from severe shortness of breath is an area of clinical interest that is both exciting and interesting.

—In patients that are suffering from severe dyspnea during end-of-life (P), can the use of opioids (I) be a beneficial intervention, compared to those not near end-of-life (C), to reduce the feeling of breathlessness (O), within a period of 2 weeks or less (T)?

Research With and Without The Boolean process is a method that is utilized that inserts a variety of phrases (such as OR, AND, etc.) between the primary terms that helps to limit down the search results by processing them in a given order. This method is called the Boolean method (Library of Congress, n.d.). Within the Walden Nursing Library, a search for publications using the key phrases “opioids for dyspnea” resulted in the retrieval of 486 different articles. When searching for “opioids for dyspnea AND end-of-life AND morphine,” only nine articles were retrieved. This was the result of employing the Boolean approach. When the primary search terms were altered to read “opiates for dyspnea AND morphine sulfate,” only one result was discovered. 313 articles were found when searching for “dyspnea OR breathlessness AND opioid use.” There were twenty publications discovered when the search terms “dyspnea OR breathlessness, AND opioid use, AND efficacy” were used. Last but not least, using the search terms “dyspnea OR breathlessness, AND opioid usage, AND end-of-life care,” 62 articles that are linked to this topic were found.ut the Boolean Process

             Strategies for an Effective Database Search

When looking at the differences in the numbers that resulted from the searches that were carried out, it is obvious to see that the utilization of various words and the combination of these phrases can provide a variety of different results. When looking for particular publications, it is essential to be certain that the researcher is use the appropriate terminology in their search. When looking for particular articles that are associated with the administration of opioids during end-of-life care, there are quite a number distinct word combinations that can be searched for. Some of these combinations include: The researcher ought to make use of combos that will bring about the most specific materials, for as employing “dyspnea OR breathlessness, AND opioid use,” in conjunction with “AND effectiveness” or “AND end-of-life care.” These two searches appeared to turn up a number of articles that would be useful in compiling information on the topic at hand. The researcher’s inability to obtain sufficient information, in addition to the aggravation that comes from having to read a large number of articles in order to amass a relatively small quantity of new information, can undermine the thoroughness of the investigation. The level of rigor can be maintained so long as the researcher makes it a point to keep in mind the vast number of papers that have been written on each and every subject. The researcher merely needs to keep up the pace and keep seeking until all of the relevant material is located and validated. 

References

Gallagher Ford, L., & Melnyk, B. M. (2019). The Underappreciated and Misunderstood PICOT Question: A Critical Step in the EBP Process. Worldviews on Evidence-Based Nursing, 16(6), 422–423. https://doi.org/10.1111/wvn.12408

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

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.

Grading Rubric

Performance Category	100% or highest level of performance 100% 16 points	Very good or high level of performance 88% 14 points	Acceptable level of performance 81% 13 points	Inadequate demonstration of expectations 68% 11 points	Deficient level of performance 56% 9 points	Failing level of performance 55% or less 0 points
Total Points Possible= 50	16 Points	14 Points	13 Points	11 Points	9 Points	0 Points
Scholarliness Demonstrates achievement of scholarly inquiry for professional and academic topics.	Presentation of information was exceptional and included all of the following elements: Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.	Presentation of information was good, but was superficial in places and included all of the following elements: Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.	Presentation of information was minimally demonstrated in all of the following elements: Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.	Presentation of information is unsatisfactory in one of the following elements: Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.	Presentation of information is unsatisfactory in two of the following elements: Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.	Presentation of information is unsatisfactory in three or more of the following elements Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information
	16 Points	14 Points	13 Points	11 Points	9 Points	0 Points
Application of Course Knowledge Demonstrate the ability to analyze and apply principles, knowledge and information learned in the outside readings and relate them to real-life professional situations	Presentation of information was exceptional and included all of the following elements: Applies principles, knowledge and information from scholarly resources to the required topic. Applies facts, principles or concepts learned from scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.	Presentation of information was good, but was superficial in places and included all of the following elements: Applies principles, knowledge and information from scholarly resources to the required topic. Applies facts, principles or concepts learned from scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.	Presentation of information was minimally demonstrated in the all of the following elements: Applies principles, knowledge and information from scholarly resources to the required topic. Applies facts, principles or concepts learned from scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.	Presentation of information is unsatisfactory in one of the following elements: Applies principles, knowledge and information from scholarly resources to the required topic. Applies facts, principles or concepts learned from and scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.	Presentation of information is unsatisfactory in two of the following elements: Applies principles, knowledge and information from scholarly resources to the required topic. Applies facts, principles or concepts learned from scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.	Presentation of information is unsatisfactory in three of the following elements Applies principles, knowledge and information and scholarly resources to the required topic. Applies facts, principles or concepts learned scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.
	10 Points	9 Points			6 Points	0 Points
Interactive Dialogue Initial post should be a minimum of 300 words (references do not count toward word count) The peer and instructor responses must be a minimum of 150 words each (references do not count toward word count) Responses are substantive and relate to the topic.	Demonstrated all of the following: Initial post must be a minimum of 300 words. The peer and instructor responses must be a minimum of 150 words each. Responses are substantive Responses are related to the topic of discussion.	Demonstrated 3 of the following: Initial post must be a minimum of 300 words. The peer and instructor responses must be a minimum of 150 words each. Responses are substantive Responses are related to the topic of discussion.			Demonstrated 2 of the following: Initial post must be a minimum of 300 words. The peer and instructor responses must be a minimum of 150 words each. Responses are substantive Responses are related to the topic of discussion.	Demonstrated 1 or less of the following: Initial post must be a minimum of 300 words. The peer and instructor responses must be a minimum of 150 words each. Responses are substantive Responses are related to the topic of discussion.
	8 Points	7 Points	6 Points	5 Points	4 Points	0 Points
Grammar, Syntax, APA Points deducted for improper grammar, syntax and APA style of writing. The source of information is the APA Manual 6th Edition Error is defined to be a unique APA error. Same type of error is only counted as one error.	The following was present: 0-3 errors in APA format AND Responses have 0-3 grammatical, spelling or punctuation errors AND Writing style is generally clear, focused on topic,and facilitates communication.	The following was present: 4-6 errors in APA format. AND/OR Responses have 4-5 grammatical, spelling or punctuation errors AND/OR Writing style is somewhat focused on topic.	The following was present: 7-9 errors in APA format. AND/OR Responses have 6-7 grammatical, spelling or punctuation errors AND/OR Writing style is slightly focused on topic making discussion difficult to understand.	The following was present: 10- 12 errors in APA format AND/OR Responses have 8-9 grammatical, spelling and punctuation errors AND/OR Writing style is not focused on topic, making discussion difficult to understand.	The following was present: 13 – 15 errors in APA format AND/OR Responses have 8-10 grammatical, spelling or punctuation errors AND/OR Writing style is not focused on topic, making discussion difficult to understand. AND/OR The student continues to make repeated mistakes in any of the above areas after written correction by the instructor.	The following was present: 16 to greater errors in APA format. AND/OR Responses have more than 10 grammatical, spelling or punctuation errors. AND/OR Writing style does not facilitate communication
	0 Points Deducted					5 Points Lost
Participation Requirements	Demonstrated the following: Initial, peer, and faculty postings were made on 3 separate days					Failed to demonstrate the following: Initial, peer, and faculty postings were made on 3 separate days
	0 Points Lost					5 Points Lost
Due Date Requirements	Demonstrated all of the following: The initial posting to the graded threaded discussion topic is posted within the course no later than Wednesday, 11:59 pm MT. A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT.					Demonstrates one or less of the following. The initial posting to the graded threaded discussion topic is posted within the course no later than Wednesday, 11:59 pm MT. A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT.