NURS 6052 Walden University Automated Machine Learning Responses – Description
Respond to these two people:
Ilsa Waterman
Clinical issue of interest
Ambulatory care nurses are responsible for transitional care management (TCM) for patients after inpatient hospitalization to ensure continuity of care, provide education, and decrease readmissions (American Academy of Family Physicians, n.d.). When I transferred from acute care to the ambulatory setting, TCM was stressed as a critical nursing duty without explaining its purpose. My clinical issue of interest is transitional care management – understanding the goals and importance, crucial information to review, and it impact on the patient. To best facilitate a systematic search for supporting articles, a PICOT question should be used (Melnyk & Fineout-Overholt, 2023). The tentative PICOT question posed is: In patients recently discharged from the inpatient setting, how does a nurse transitional care management outreach, compared to no outreach, affect patients’ readmission rates within 30 days of discharge? I may also like to include health variables such as primary care follow-up appointments and medication compliance.
Search results, Boolean operators, and filters
I began my search with the subject heading “transitional care management” in the nursing research section, which yielded 819 results. I limited the search to peer-reviewed scholarly journals and full text only within the last five years, decreasing the search results to 321 articles. I then added the search concept of “impact or effect or influence or outcome or result or consequence,” producing 150 results. By adding the concept of “readmission or rehospitalization or readmittance”, 59 articles resulted. I did not choose the population group, patients discharging from the inpatient settings, as TCMs only occur with that group.
I reviewed the subject line for several articles and noticed that the “transitional care management” search produced several results for case management, which were not applicable and needed exclusion. I added quotation marks around “transitional care,” which allowed the search to look for those two words together for a targeted subject, producing 53 results. I then generated the fourth concept of nurse or nurses or nursing or RN, which yielded 14 results. I looked through the article titles and subjects to see which looked applicable and added them to my folder to review. I could have further filtered the results by adding the concept of readmissions, but I wanted to look more closely at the study design to ensure it was an original research article.
Strategies to improve the effectiveness of a database search
The Walden Library had several beneficial video presentations to guide effective searches. The presenters advised beginning in the nursing research box with one primary phrase, adding concepts one at a time instead of the entire question. The recommended brainstorming synonyms for words to increase results, such as children or youth, or adolescents; the search box will also automatically suggest synonyms for the researcher to choose. One should also look for alternate spellings to a word, such as behavior or behaviour. A researcher should be aware that some databases retrieve all terms relevant to the search terms; however, some databases require choosing the option to “explode” to increase the search terms.
By using the nursing research section, all databases are searched instead of individual ones. The use of the Boolean operators “and” or “or” is essential; “not” is infrequently used but may be helpful at times. Filters should be applied to select peer-reviewed journals, full text, and articles published within the last five years (WaldenULibrary, 2020, 2021). A filter for publication type under advanced search can also be used to search certain types of articles like systematic reviews or randomized clinical trials (Melnyk & Fineout-Overholt, 2023) .
The WaldenULibrary (2018) video discussed several unique ways to refine a search in the library. The presenter discussed the use of an asterisk when seeking truncations of a word in the search; for example, one could use “form*”, which allows the search to find all the options with that root word, like formation, forming, formulary, or other expansions on the root word. Once an appropriate number of articles are generated, if the researcher needs help determining key concepts, one could review the subject headings section under each publication name to gather ideas for topics or alternate search words. The researcher should look for the “Find@Walden” links to ensure a full-text article is available in the library. Lastly, James (n.d.) also discusses the best databases to use if seeking filtered versus unfiltered resources such as systematic reviews or randomized control trials. She also encouraged contacting a librarian via email with the publication citation to request a journal if unavailable at the Walden Library.
References
American Academy of Family Physicians. (n.d.). Transitional Care Management. Www.aafp.org. https://www.aafp.org/family-physician/practice-and…
James, J. (n.d.). Academic Guides: Evidence-Based Practice Research: Levels of Evidence Pyramid. Academicguides.waldenu.edu. https://academicguides.waldenu.edu/library/healthe…
Melnyk, B. M., & Fineout-Overholt, E. (2023). Evidence-based practice in nursing & healthcare: A guide to best practice (5th ed.). Wolters Kluwer.
WaldenULibrary. (2018). Webinar: Mysteries of the Library: Revealed! Databases. In YouTube.
WaldenULibrary. (2020). CINAHL Quick Guide at Walden Library. In YouTube.
WaldenULibrary. (2021). Nursing and Health Library Research: Introduction. In YouTube.
Patience Nnochin Ebi
Initial Post
Clinical Issue of Interest
Nosocomial infections, otherwise known as hospital-acquired infections, are one of the issues that the national healthcare system is facing in this country. These are those infections acquired in hospitals or healthcare service units that first appear 48 hours or more after hospital admission or within 30 days after discharge following patient care. The most prevalent of these infections are pneumonia and urinary tract infections. If these infections are poorly treated, or if they become complicated, they can have negative effects (spread) on the genitourinary and respiratory systems. These infections are caused by a variety of organisms, both microscopic and macroscopic. Pseudomonas aeruginosa is the most prevalent cause bacterial organism because it can survive and adapt in a variety of environments, such as soil, water, sewage, and hospitals. As a result, This opportunistic pathogen is the most common cause of nosocomial infection (Zaher Ali & Nusrat Munitaz, 2015).
Search Result from Walden Library Database
The databases that I searched for in Walden Library include PubMed, CINAHL, CINAHL, and a combination of CINAHL and MEDLINE. I narrowed down my search to peer-reviewed, and I set a date range from 2015 to 2020 (five years) so that it would show the most recent papers in evidence-based practice. An advanced search was used for PubMed, and the article was filtered to focus the search. Therefore, only articles that dealt with human studies were published in 2015 and 2020 and were filtered.
Strategies I used to enhance my database search
I used a feature of PubMed known as Clinical Inquiries as a further tactic. The best answers to clinical questions are given by clinical inquiries, which employ a structured search, critical evaluation, reliable recommendations, a clinical perspective, as well as rigorous peer review (Ho et al., 2016). According to Schardt (2020), Clinical Inquiry links the type of questions (therapy, diagnosis, etiology, and prognosis) to a saved search strategy that retrieved the appropriate research methodology to enhance search results. I added my filters and searched “Hospital Acquired Infection” in the Walden Library, I then received over 212 results. The school advises students to use Boolean terms to narrow their search and produce more pertinent results (Walden Library, 2020). When I added the Boolean terms, I got over 84,623 results. The search results that will be used to locate significant peer-reviewed articles will be improved with the use of these techniques. The result of a study indicated that is essential to conduct a search using a minimum of three separate databases to obtain around 90% of all significant literature about the topic (Ho et al., 2016).
The PICO (T) (mnemonic) method is a technique that is commonly used in evidence-based practice to frame, ask, and answer a question about health-related inquiry and is frequently utilized. (Melnyk & Fineout-Overholt, 2015). The letter P represents a population, which can be classed according to age, gender, or ethnicity; the letter I indicates the intervention that was carried out; and the letter C indicates the comparison; the letter O is the outcome which is contrasted with the period denoted by T (Melnyk & Fineout-Overholt, 2015). The etiology of a disease process, the interpretation of research, the diagnosis, and the epidemiology of diseases can all make use of it (Schardt, 2020). Below are my PICO (T) questions.
P – Medical personnel in emergency rooms
I – Washing hands using water and soap
C- Utilizing hand sanitizers
O – Decrease the likelihood of patients contracting nosocomial infections
T – Symbols of six months
References
Fineout?Overholt, E. (2015). Getting Best Outcomes: Paradigm and Process Matter. Worldviews on Evidence?Based Nursing, 12(4), 183-186.
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
Library at Walden University (2020). Using keywords, you can find articles on a particular subject. Extracted from Academic Guides, Walden University, Keyword: Boolean
Melnyk, B. M., & Fineout-Overholt, E. (2015). Evidence-based practice in nursing & healthcare: A guide to best practice (5th ed.). Wolters Kluwer.
Schardt, C., Adams, M., Owen, T., Keitz, S., & Frontelo, P. (2020). Utilization of the PICOT framework to facilitate an improved search of the PubMed databases for clinical questions. Retrieved June 19, 2023, from https://bmcmedinformdecismak.biomedcentral.com/articles/10.1186/1472-6947-7-16Links to an external site.
Walden University Library. (2020). Keyword searching: Finding articles on your topic: Boolean terms., Retrieved from http://academicguides.waldenu.edu/library/keyword/booleanLinks to an external site.
Walden Library. (2020). CINAHL Quick Guide at Walden Library. In YouTube.
Zaher, A., & Nusrat, M. (2015). Essentials of Evidence-Based Practice. Nosocomial infections.
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