Essentials Of Evidence-Based Practice

PICO (T), which is a process that is commonly used in evidence-based practice to structure, ask, and answer a question as regards the health-related question, is often used in evidence-based nursing practice. It is also used in another evidence-based research. The P stands for a population which can be age, sex, and ethnicity; I stand for intervention that is done, the C is the comparison O is the outcome while T is the time frame for the study (Melnyk & Fineout- Overholt, 2015). It can be used for the etiology of a disease process, interpretation of research, diagnosis regimen, and epidemiology of diseases. My PICO question is “In the emergency center, how does handwashing with soap and water reduce the risk of nosocomial infections compared to the use of hand sanitizer among healthcare workers within eight months?” The listing for the population, intervention, comparison, and outcome are listed below :

P- Health care workers in emergency centers

I- Hand washing with soap and water

C- Use of hand sanitizers

O- Reduce the risk of nosocomial infections

T- Six months

One of the problems of the health care system across the nation is a hospital-acquired infection. This affects healthcare workers, relatives, and patients. Nosocomial infections otherwise called hospital-acquired infections can only be acquired in healthcare facilities. The commonest of these infections are pneumonia and urinary tract infections. These infections affect the respiratory and genitourinary system as well as other systems if poorly treated or Complicated. Various organisms (micro and macro) are responsible for these infections. The commonest of the bacterial organism is the Pseudomonas aeruginosa because this organism can survive and adapt in a different type of habitat, which includes soil, water, sewage, and hospitals, hence made this opportunistic pathogen the commonest cause of nosocomial infection (Zaher Ali & Nusrat munitaz, 2015).

The databases searched were PubMed, CINAHL, CINAHL & MEDLINE Combined Search in Walden Library. My search was narrowed down to search for peer review where I used a date range of 2015 to 2020 (5 years) to show the most recent articles in evidence-based practice. For PubMed, an advance search was utilized where the article was filtered to narrow down the search. The only articles that were filtered were the studies done on the human that was published between 2015-2020. Moreover, another strategy that I utilized is a feature of PubMed that is referred to as Clinical Inquiries. Clinical Inquiries provide the ideal answers to clinical questions: using a structured search, critical appraisal, authoritative recommendations, clinical perspective, and rigorous peer review. Clinical Inquiries deliver the best evidence for point of care use. Clinical Inquiries are designed to improve search results by linking the type of question (therapy, diagnosis, etiology, and prognosis) to a stored search strategy that retrieves the appropriate research methodology (Schardt, 2007). With the use of these techniques, there will be an improvement in the search results which will be used to find the important peer-reviewed articles. Immediately I added a filter and search with a term When I add my filters and search the terms “Hospital Acquired Infection” in the Walden Library, I got over 212 results. The University recommends that students should use Boolean terms to create a more precise search with more relevant results (Walden Library, 2020. Immediately I added the Boolean terms to my next search and got over 84,623 results. Furthermore, a study concluded that it is important to search with a minimum of three different databases to achieve approximately 90% of all important literature on the subject. In addition to this, a strategy to increase the rigor and effectiveness of a database search is to use alternative terms (Ho et al., 2016). However, to improve my search results, alternative terms such as “Nosocomial infection”, “Proper hand-hygiene” or Hand sanitizers” can be used to improve the chance of useful evidence-based research.

References

Ho, G. J., Liew, S. M., Ng, C. J., Hisham Shunmugam, R., & Glasziou, P. (2016). Development of a Search Strategy for an Evidence Based Retrieval Service. PloS one, 11(12), e0167170. doi:10.1371/journal.pone.0167170

Melnyk, B. M., & Fineout-Overholt, E. (2015). Evidence-based practice in nursing & healthcare: A guide to best practice (3^rd ed.). Wolters Kluwer, Philadelphia. ISBN- 13: 978-1- 4511-9094-6.

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. (2020). Keyword searching: Finding articles on your topic: Boolean terms. Retrieved from http://academicguides.waldenu.edu/library/keyword/boolean

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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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