to Prepare:

Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry.
Develop a PICO(T) question to address the clinical issue of interest for the Assignment.
Use the key words from the PICO(T) question you developed and search at least four different databases in the Walden Library. Identify at least four relevant systematic reviews or other filtered high-level evidence, which includes meta-analyses, critically-appraised topics (evidence syntheses), critically-appraised individual articles (article synopses). The evidence will not necessarily address all the elements of your PICO(T) question, so select the most important concepts to search and find the best evidence available.
Reflect on the process of creating a PICO(T) question and searching for peer-reviewed research.

Advanced Levels of Clinical Inquiry and Systematic Reviews

Create a 6- to 7-slide PowerPoint presentation in which you do the following:

Identify and briefly describe your chosen clinical issue of interest.
Describe how you developed a PICO(T) question focused on your chosen clinical issue of interest.
Identify the four research databases that you used to conduct your search for the peer-reviewed articles you selected.
Provide APA citations of the four relevant peer-reviewed articles at the systematic-reviews level related to your research question. If there are no systematic review level articles or meta-analysis on your topic, then use the highest level of evidence peer reviewed article.
Describe the levels of evidence in each of the four peer-reviewed articles you selected, including an explanation of the strengths of using systematic reviews for clinical research. Be specific and provide examples.

Clinical Inquiry and Systematic Reviews

Clinical Inquiry and Systematic Reviews

Introduction

Clinical inquiries involve asking nursing-related questions about the practice and profession to provide the best care among patients. In addition, clinical queries help addresses potential clinical issues with the purpose of quality improvement and even formulating evidence-based research and practice. The clinical problem of interest and that forms the basis for the PICO (T) question is on healthcare-acquired infections (HCAI). HCAI has become common in hospitals as well as highly compromising and affecting the inpatients treated in the hospitals. The purpose of these hospitals is to provide the best and high-quality care that requires basic hygiene practices to prevent the HCAI (Marin H. Kollef, 2008). Nurses must ensure that they and other staff in the hospitals practice good hygiene and comply with laws regarding Infection control. Therefore, with the interest of understanding why these healthcare-acquired infections are prevalent, it led to the development of the PICO (T) question on how better to prevent and address the clinical issue.

Discussion

Therefore, when developing the question, the keywords in mind were nurse hygiene, hygiene practices among nurses, and healthcare-acquired infections. These keywords helped identify possible solutions to the issue being hand washing hygiene or better systems such as systematic improvement methods. Hence, with the guidance from the PICO (T) tool, the development of the question in the area of interest was easily facilitated. Below is a discussion on the PICO (T) question developed, the databases used to acquire peer-reviewed resources that will be used to answer the question, and a reflection of the entire process that highlights the challenges and exciting issues.

PICO (T) Question 

The developed question recharging healthcare-acquired infections was “For improved hospital hygiene and sanitation, does the use of handwashing detergents reduce and control future risks of hospital-acquired infections compared with the systematic improvement methods?” The question follows the Patient/Problem, Intervention, Comparison, and Outcome (NLM, 2020). More importantly, it is a prevention EBP based question, and as analyzed below, the table shows the compliance with the PICO (T) tool (Cochrane, 2020).

As seen above, the main problem focuses on HCAIs in the nursing practice, and the intervention solution of the problem would be using handwashing detergents or integrating systematic improvement methods. The two interventions are compared to seek which solution is the most effective to address the issue. Finally, the main goal is to ensure the problem is reduced, and patient care is improved depending on which intervention strategy is the most effective and efficient. The question is a preventive question, which seeks to highlight and enhance effectiveness among nurses and staff in the hospitals while attending to patients and handling procedures. Moreover, the outcomes and intended results will prevent or reduce morbidity rates in hospitals. Therefore, when researching from the resources, it is imperative to find evidence-based articles, peer viewed resources, and highly filtered sources to acquire comprehensive and conclusive information and data. The preventive measures have both benefits and limitations, which should be researched and addressed concurrently.

Databases Analysis

The searching for the content in the resources, the keywords used included nurse hygiene, hygiene practices among nurses, healthcare-acquired infections, infection control in hospitals, clinical queries, and “handwashing detergents or systematic improvement methods in the sanitation and hygiene of nurses. From the searches, five databases are identified, namely, NLM, Cochrane, CINAHL, MEDLINE, and MeSH of the NLM nursing journal databases. In addition to the question’s keywords, more search terms used included systematic reviews and clinical queries. In the Cochrane database, the term used was a systematic review, which acts as a filtered resource. In the NLM nursing journal database, the resources are unfiltered, with the clinical query being the search term used. The CINAHL resources are limits as well as in MEDLINE.

From the articles and resources seen throughout the search process, the most outstanding and relevant sources include a peer-reviewed article from the Indian Journal of Medical Research on hand hygiene and an article synopsis on combating HCAIs from the Nurse Management article. In addition to a peer-reviewed article on the exploration of the impact on HCAIs in the hospital’s working practices most notably, care deliveries, and finally, a critical appraisal on HAI as emerging threats in the healthcare sector. Each of these resources and articles has comprehensive research and information that would help answer the developed question with precision and the presence of evidence. These sources are scholarly articles providing authentic information acquired from qualitative and quantitative research and data. As stated above, it is crucial to ensure the sources and results received while answering the question are evidence-based to improve the quality of healthcare, develop essential and useful research and development, and provide exemplary healthcare among the inpatients.

These resources are filtered, advanced, and limited, especially in the Cochrane, CINAHL, and MEDLINE databases. They are diverse, comprehensive in that they are peer-reviewed and critically appraised articles, hence issues that minimize argument credibility such as personal biases, and information asymmetries are avoided and addressed. More importantly, the above-identified databases and sources exclusively provide information on nursing issues and clinical queries, as is the case with the issue of interest and the question developed. The extensive subject coverage on the question will help provide credible information while trying to find essential and useful solutions. The writers and authors are experts in the nursing field, providing recent information and findings from research projects.

Reflection 

The process of developing the PICO (T) question and searching for peer-reviewed research sources is exciting and, at the same time, challenging. The exciting part of the process is that it is exciting to learn new concepts and more natural ways of developing questions. Finding specific questions that one would like to research adequately and comprehensively is quite challenging and challenging. However, with the PICO (T) tool at hand, the development of the question with respect to the clinical area of interest becomes easy. At first, when reading the instructions on “develop a PICO (T) question,” it was challenging and did not know where to start or even consider. However, when searching, learning, and understanding the PICO (T) model from the internet, there were many templates and examples on how to develop the question. This helped settle on the preventive EPB question type after deliberating on other kinds of questions such as intervention, etiology diagnosis, prognosis, and meaning question types. Each question had a PICO template and guiding notes, which made it easier to think of a question in the area of interest.

On the other hand, searching for peer-reviewed sources was not as challenging as developing the PICO question. This is because of the profound information and knowledge of using scholarly articles and reading authentic articles to acquire credible and evidence-based information. What made it easier was the presence of comprehensive subject coverage of nursing issues. Searching for nursing journals was easy as it needed typing scholarly nursing journals, and all the possible nursing journals and databases emerged. The only challenge was on researching the resources that offer the most effective and compressive articles and that address the question exhaustively. The results were many and ambiguous and not addressing the main components of the questions. This required the narrowing of search terms and using the keywords such as included nurse hygiene, hygiene practices among nurses, healthcare-acquired infections, and infection control in hospitals, clinical queries since “handwashing detergents or systematic improvement methods in the sanitation and hygiene of nurses” this was not yielding the most desired results. For instance, in MEDLINE, the search results were 57 when using the clinical query term; however, while narrowing the research and using keywords, the results reduced to less than 20. New strategies had to be incorporated to save time and decide on the best articles, including combining the key search words with systematic review filters in MeSH and other databases for valid results (Gah Juan Ho, 2016).

Conclusion

Concisely, the entire process was both exciting and challenging, taking much time to decide on the best decision to settle with. The question developed followed the PICO (T) criteria addressing an important and prevalent clinical issue involving HCAIs. The searching process including the databases and articles selected are all-essential as they play an imperative role in addressing the question and provide diverse, comprehensive and authentic information.

References

Cochrane. (2020). Cochrane Database of Systematic Reviews. Retrieved from https://www.cochranelibrary.com/search

Gah Juan Ho, 1. S. (2016). Development of a Search Strategy for an Evidence Based Retrieval Service. PLoS One, Vol 11(12).

Johnson, S. (2018). Combating hospital-acquired C. diff. Nurse Management, Vol 49(3):16-22.

Marin H. Kollef, L. M.-G. (2008). Health Care—Associated Infection (HAI): A Critical Appraisal of the Emerging Threat—Proceedings of the HAI Summit. IDSA, Vol 47(2), pp: 55-99.

Mathur, P. (2011). Hand hygiene: Back to the basics of infection control. Indian Journal of Medical Research, Vol 134(5): 611–620.

NLM. (2020). What is a PICOT Question? Retrieved from https://meshb.nlm.nih.gov/search