Constructing A Search Strategy For Evidence

Constructing A Search Strategy For Evidence

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Constructing A Search Strategy For Evidence

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Constructing A Search Strategy For Evidence

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Evidence based practice can be defined as the use of scientific evidences for determining the best practice. Evidence based practice in nursing differs from the conventional nursing protocol by the fact that it enables safe care delivery to the patient on the basis of scientific evidences (Schmidt & Brown, 2014). EBP involves critical analysis and evaluation of the research findings and ten determining how the EBP can be applied to the clinical practice.
Purpose of the assignment
EBP enables critical thinking in health care professionals regarding a particular clinical condition and helps to apply the best interventions. One such way is the development of the PICO question. The capability to develop a well-built clinical question is one of the fundamental skills in EBP. Such questions should be directly relevant to the problems of the patient and should be phrased in way that guides one’s search.
A properly built clinical question has got four components. The PICO tool is useful in formulating the PICO question.
Brief outline of the steps
P = Patient, Problem, Population 
I = Intervention, Prognostic Factor, Exposure 
C = Comparison (Can be None or placebo) 
O= Outcome 
The completion of the above mentioned steps are done by a literature search using data bases using relevant search terms.
Problem and answerable question
PICO question- Does appointment of patient sitters reduce fall rates among the hospital inpatients?
P = Hospital inpatients  
I = Appointment of patient sitters or assistants
C = compared to those patients without any sitters.  
O=Reduction of the fall rates in the hospital inpatients
Rationale for choosing this PICO question 
Slips and falls has been reported as one of the major harm that occurs in the inpatients and is largely responsible for mortality in the inpatients. Especially the elderly ones. A fall may cause fractures, internal bleedings, lacerations, leading to increased utilization of the care (Dunne et al., 2014). In Singapore, one of the leading cause of the injury among the older adults are fall. As per the reports of the National Registry of Diseases Office (NRDO) of Singapore, in 2012 the prevalence of the unintended fall has been 277.7 per 100,000 for older adults (Health promotion Board , 2015). The prevalence rate of the falls has been found to be increasing with age. As per the research one third of the falls can be prevented. Specific interventions such as appointment of patient attendants or sitters can reduce the risks of falls (Melnyk et al., 2015). Among the various interventions to avoid falls among the hospital inpatients, use of patient sitters for reducing falls has been identified as an important interventions. Using patient sitters for observing the patients who are at high risks of falls has been suggested by several literatures as a part of the evidence based fall prevention guidelines (Lang, 2014). In fact few studies have also suggested the use of virtual sitters in order for fall reduction in the hospital inpatients.
Locating the evidence
In order to find the evidences a number of databases have been brainstormed such as PUBMED, CINAHL and Cochrane library. It is required to have a strong focus on the key on the topic hence specific keywords has to be used such as ” patient sitters”, ” falls” , ” limb injury” are some of the key words that has been used. Boolean search terms such as Falls AND sitters, Fall AND elderly, Falls AND Singapore were used to search relevant literatures regarding fall rates in Singapore and the possible interventions followed by the inpatients. Wild cards and truncations has been used such as * fal OR *elder. This resulted in a huge number of papers which was further refined by using inclusion criteria. The inclusion and the exclusion criteria has to be reasonable enough (Aromataris & Riitano, 2014). The inclusion criteria for the researches were primary researches, systematic reviews. The inclusion criteria included English peer reviewed journals within 2012 to 2018. Without the limiters, the search at first obtained 145688 results. The application of the inclusion criteria returned a good amount of articles. Websites of Singapore department of health was also brainstormed through for obtaining the relevant statistical data related to elderly fall.
Aromataris, E., & Riitano, D. (2014). Systematic reviews: constructing a search strategy and searching for evidence. AJN The American Journal of Nursing, 114(5), 49-56.
Dunne, T. J., Gaboury, I., & Ashe, M. C. (2014). Falls in hospital increase length of stay regardless of degree of harm. Journal of evaluation in clinical practice, 20(4), 396-400.
Health promotion Board ( 2015). Falls prevention among older adults living in the community. Access date: 21.6.2016. Retrieved from:
Lang, C. E. (2014). Do sitters prevent falls?: A review of the literature. Journal of gerontological nursing, 40(5), 24-33.
Melnyk, B. M., Gallagher?Ford, L., Long, L. E., & Fineout?Overholt, E. (2014). The establishment of evidence?based practice competencies for practicing registered nurses and advanced practice nurses in real?world clinical settings: proficiencies to improve healthcare quality, reliability, patient outcomes, and costs. Worldviews on Evidence?Based Nursing, 11(1), 5-15.
Schmidt, N. A., & Brown, J. M. (2014). Evidence-based practice for nurses. Jones & Bartlett Publishers.

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