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.
PICOT
Student’s Name
Institutional Affiliations
PICOT
Part 1: Clinical Issue of Interest
Central line-associated bloodstream infections (CLABSIs) are among the healthcare-associated infections that are commonly diagnosed among patients in hospital settings. While the medical condition can affect people of different age groups, vulnerable persons such as children and the elderly might take time to recover from their illnesses thereby increasing healthcare costs (Zhao et al., 2020). The clinical issue of interest is high rates of CLABSIs among the elderly. The organization has been recording increasing rates of CLABIs among older adults. In the past month alone, CLABSI rate among older adults was 7%. High rates of CLABI are associated with increasing lengths of hospital stay and high hospital expenditure in the facility. According to Toor et al. (2022), high rates of CLABSI are linked with approximately 12-15% of deaths, prolonged length of hospital stay, and increased healthcare costs in the United States. The facility should implement evidence-based interventions to reduce rates of CLABSIs among older adults. The proposed intervention is the use of chlorhexidine wipes instead of daily showers.
PICOT
“In elderly patients aged 65 years and above (P), does the use of chlorhexidine wipes (I) compared with daily shower (C) reduce CLABSI rates (O) during hospitalization (T).”
Part 2: Article Search
Articles that contain evidence supporting the effectiveness of chlorhexidine wipes in reducing CLABSI rates were located by conducting a detailed database search. The databases that were searched were Google Scholar, Medline, and CINAHL. The search terms and phrases used include; reducing rates of CLABSIs; preventing CLABSI in the elderly; and chlorhexidine wipes and CLABI rates reduction. The original search that was conducted on Google Scholar using “chlorhexidine wipes and CLABI rates reduction” as the search phrase returned 1,400 articles. When Boolean Operators, specifically “chlorhexidine wipes and CLABI rates reduction and the elderly)” returned 923 results. As Bramer et al. (2018) explain, some of the key strategies to increase the vigor and effectiveness of a database search include eliminating spelling errors in the search terms, using precise search terms, and narrowing to the year of publication. For example, the use of these strategies during the search facilitated the location of current articles to use for the literature review.
References
Bramer, W. M., de Jonge, G. B., Rethlefsen, M. L., Mast, F., & Kleijnen, J. (2018). A systematic approach to searching: an efficient and complete method to develop literature searches. Journal of the Medical Library Association: JMLA, 106(4), 531–541. https://doi.org/10.5195/jmla.2018.283
Toor, H., Farr, S., Savla, P., Kashyap, S., Wang, S., & Miulli, D. E. (2022). Prevalence of Central Line-Associated Bloodstream Infections (CLABSI) in Intensive Care and Medical-Surgical Units. Cureus, 14(3), e22809. https://doi.org/10.7759/cureus.22809
Zhao, X., Wang, L., Wei, N., Zhang, J., Ma, W., Zhao, H., & Han, X. (2020). Epidemiological and clinical characteristics of healthcare-associated infection in elderly patients in a large Chinese tertiary hospital: a 3-year surveillance study. BMC Infectious Diseases, 20(1), 121. https://doi.org/10.1186/s12879-020-4840-3