INSTRUCTION : Respond to of your colleagues o and provide further suggestions on how their database search might be improved.

MAIN POST BY MY CLASSMATE :

I had trouble deciding on which route I wanted to take my PICOT (Patient, intervention, comparison, outcome, time) question. I wanted to review the effect of taking nonopioid pain medication instead of using opioid medication in hopes of decreasing the rising opioid abuse epidemic. I wasn’t sure if I wanted to research this topic in patients with chronic pain or pain in patients after outpatient surgeries. Since I work in the preoperative care unit, I decided to go with outpatient surgery. Per Walden University (n.d.,-a), prevention is an achievable guide for developing a PICOT question, and I decided to form my question with this in mind. My PICOT question is, for people undergoing outpatient surgeries, does the use of nonopioid medication versus using opioid medication achieve less perceived pain by the patient?

In the Walden Library, there are several databases to use for a search. Walden University (n.d.,-b) provided Medline and CINAHL as databases that were the easiest for me to use. I searched them separately and then together under the nursing research option. I did not want a systematic review and according to Walden University, less systematic reviews are in the CINAHL with full-text databases (n.d.,-c). I searched with the words, “nonopioid and opioid and pain and after and surgery” in the first search box. Only 13 options populated with the combination of the two databases. When I cut back to “opioid and nonopioid and surgery,” Medline produced 105 results, and CINAHL produced 36 results.

I expected more articles to result than 105 and 36. I contacted the Walden librarians via email to increase the effectiveness of my search. I was making a mistake by putting all of my search terms in the first search box only. A. Lemieux (personal communication, March 16, 2020) gave me a better suggestion to put the word, “surgery” in the first search box, “medication” in the second search box, and “pain management” in the third search box. The word “and” was between all words. I searched Medline and CINAHL using her example, and 347 articles populated.

Resources

Walden University Library. (n.d.-a). Academic guides: Evidence-based practice research: clinical question anatomy. Retrieved from https://academicguides.waldenu.edu/library/healthevidence/clinicalquestion

Walden University Library. (n.d.-b). Databases A-Z: Nursing. Retrieved from https://academicguides.waldenu.edu/az.php?s=19981

Walden University Library. (n.d.-c). Quick Answers: How do I find a systematic review article related, to health, medicine, or nursing? Retrieved from https://academicanswers.waldenu.edu/faq/72670

Discussion Response

It is indeed difficult and challenging to settle on the ‘perfect’ PICOT question, and as seen from your journey in search of the question, you have similar dilemmas as I did. However, the healthcare issue you settled on is interesting to research and maybe easier since you have a direct connection with the problem being a preoperative care unit  (Cochrane, 2020).. The effective development and construction of comprehensive research on this issue require adequate scholarly resources from the needed database and through the database search on can either acquire academic and useful resources or be limited to inadequate and lesser valuable resources. While conducting database searches, I would suggest key strategies that I have learned over time to acquire sufficient, useful, and satisfying results  (Gah Juan Ho, 2016). Primarily, when searching use specific words or subject headings such as non-opioid and opioid medication among outpatients. As seen, the results could be many, but by incorporating the ‘and’ conjunction one is more specific; hence, particular findings on the subject matter may appear.

Secondly, one could limit the search process to resources such as peer-reviewed articles written in a particular language, which is English, and current years. This will help bring the results in relevance order as well. Moreover, using the ‘related article’ can smoothen one’s database search once you key in search terms that are correctly spelled and have specific terms as in the PICO (T) question (NLM, 2020). A third strategy that I have found so effective in database searching is learning about the database one is using and use its unique subject search, for instance, when using the Medline database an advanced and handy subject search would be the MESH. It is advanced and will make searching easier.

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).

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