Prepare To Review Resources And Identify A Clinical I 256409

To Prepare Review The Resources And Identify A Clinical Issue Of Int

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, search at least two different databases in the Walden Library to identify at least four relevant peer-reviewed articles related to your clinical issue. Select original research articles and avoid systematic reviews. Develop a PICO(T) question of interest for further study, preferably intervention-type, which are most effective for this course. Describe your clinical issue of interest—specifically, fall prevention—and explain how your search results evolved as you refined your search terms with Boolean operators. Discuss strategies to increase the rigor and effectiveness of your database searches for your PICO(T) question, providing specific examples.

Paper For Above instruction

Fall prevention is a critical concern in healthcare settings, especially given the significant morbidity, mortality, and healthcare costs associated with falls among older adults. Falls can lead to fractures, head injuries, and a decline in independence, emphasizing the importance of effective prevention strategies. Therefore, the clinical issue of fall prevention serves as a vital focus for evidence-based practice initiatives aimed at reducing fall incidences and improving patient outcomes. This paper details the process of developing a research inquiry into fall prevention, including literature search strategies, refinement of search terms, and development of a PICO(T) question to guide a focused investigation.

Initially, a broad search on “fall prevention” was conducted across two databases: CINAHL and MEDLINE via PubMed. Using keywords such as “falls,” “aging,” “elderly,” and “preventive strategies,” the initial search in CINAHL yielded approximately 150 articles, many of which were systematic reviews, meta-analyses, or narrative reviews. In contrast, the search in MEDLINE returned around 130 articles under similar keywords. Recognizing the need to focus solely on original research, filters were applied to exclude systematic reviews and limit results to peer-reviewed journal articles, which reduced the yield to approximately 50 articles in each database.

To refine the search, Boolean operators were employed. For example, combining “falls” AND “elderly” AND “intervention” narrowed the results further, resulting in about 20 articles per database. Adding specific terms like “exercise,” “physical therapy,” or “home safety” further refined the results, facilitating the identification of relevant original research articles. As more specific keywords were included, the number of articles decreased, but the relevance increased. For instance, searching “falls AND elderly AND intervention AND exercise” yielded only 10-12 articles, all of which focused on empirical data regarding interventions for fall prevention among seniors.

To increase the rigor and effectiveness of the database search, several strategies were implemented. First, applying filters such as publication date (last five years) ensured retrieval of current evidence. Second, using subject headings and MeSH terms enhanced the precision of searches, especially in MEDLINE. Third, combining search terms with Boolean operators strategically (e.g., AND, OR, NOT) refined results and reduced irrelevant articles. Additionally, saving search strategies and employing alerts for new articles helped maintain search currency.

Developing a focused PICO(T) question was the next step. Based on the clinical issue of fall prevention, the intervention of interest was “exercise programs,” the comparison was “usual care,” the outcome was “reduction in fall incidence,” and the population was “community-dwelling older adults.” The resultant PICO(T) question was: “In community-dwelling adults aged 65 and older, does participation in structured exercise programs compared to usual care reduce the incidence of falls?” This question guides further inquiry into the effectiveness of exercise interventions in fall prevention among seniors.

In conclusion, a systematic and strategic approach to database searching—using precise keywords, Boolean operators, filters, and controlled vocabulary—significantly improves the retrieval of relevant evidence. Refining search terms iteratively and documenting strategies ensures a comprehensive yet efficient evidence-gathering process. This method fosters the development of focused clinical questions, laying a solid foundation for evidence-based practice interventions aimed at fall prevention and other important healthcare issues.

References

  • Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Wolters Kluwer.
  • Davies, K. S. (2011). Formulating the evidence based practice question: A review of the frameworks for LIS professionals. Evidence Based Library and Information Practice, 6(2), 75–80.
  • Library of Congress. (n.d.). Search/browse help - Boolean operators and nesting. Retrieved September 19, 2018, from https://www.loc.gov
  • 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.
  • 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(1), 49–52. doi:10.1097/01.NAJ.0000352975.27996.4e
  • Stillwell, S. B., Fineout-Overholt, E., Melnyk, B. M., & Williamson, K. M. (2010). Evidence-based practice step-by-step: Searching for evidence. American Journal of Nursing, 110(5), 41–47.
  • Walden University Library. (n.d.-a). Databases A-Z: Nursing. Retrieved September 6, 2019, from https://library.waldenu.edu
  • Walden University Library. (n.d.-c). Evidence-based practice research: CINAHL search help. Retrieved September 6, 2019, from https://library.waldenu.edu
  • Walden University Library. (n.d.-d). Evidence-based practice research: Joanna Briggs Institute search help. Retrieved September 6, 2019, from https://library.waldenu.edu
  • Walden University Library. (n.d.-e). Evidence-based practice research: MEDLINE search help. Retrieved September 6, 2019, from https://library.waldenu.edu

Related Assignments