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.
Adding AND to narrow the search: I added the term "nursing interventions" using the AND operator (e.g., "hospital-acquired infections" AND "nursing interventions"). This reduced the number of results to a more manageable range (e.g., around 1,500). The articles became more relevant, focusing on the role of nurses in HAI prevention.
Adding AND with a specific population: Further refining my search, I added the term "ICU" (e.g., "hospital-acquired infections" AND "nursing interventions" AND "ICU"). This narrowed the results even more, often to a few hundred, as it targeted the specific patient population of interest.
Using OR for synonyms: To avoid missing relevant articles, I used the OR operator for related terms (e.g., "hospital-acquired infections" OR "healthcare-associated infections"). This slightly increased the number of results by including studies that used different terminology.
Strategies to Increase Rigor and Effectiveness
To increase the rigor and effectiveness of my database search, I would employ several strategies:
Use Subject Headings and Controlled Vocabulary: Databases like CINAHL and PubMed use a controlled vocabulary (CINAHL Subject Headings and MeSH terms, respectively). Instead of just using my keyword "hospital-acquired infections," I would search for the specific subject heading like "Infection Control" or "Cross Infection." This ensures I find all articles tagged with that subject, even if the authors didn't use my exact keywords.
Sample Answer
My clinical issue of interest is the prevention of hospital-acquired infections (HAIs), specifically in the intensive care unit (ICU) setting. This issue is a major concern in patient safety, leading to increased morbidity, mortality, and healthcare costs. The focus is on the role of nursing interventions in preventing these infections.
Search Results with Boolean Operators
My initial search using the broad terms "hospital-acquired infections" returned an overwhelming number of articles (over 10,000 in a database like CINAHL). This initial search included a mix of original research, reviews, case studies, and non-academic sources.
As I began to refine my search with Boolean operators, the number of results changed significantly.