Advanced Levels of Clinical Inquiry and Systematic Reviews-Evidence based

P - Patient/Problem: Who is the patient? What are the most vital characteristics? What is the problem, disease, or co-existing condition?

I – Intervention: What is the primary intervention being considered?

C – Comparison: What is the main comparison intervention?

O - Outcome: What are the anticipated measures, improvements, or affects?

The majority of hospice patients are bedbound or chairbound. Because of the pressure on bony prominences, pressure ulcers occur frequently. There are many views as to how to treat pressure ulcers at stage 1 or 2. One of the ideas is to simply leave the area open to air and another view is to place preventative dressings.

In developing my PICO(T) question I looked at the following. The population (P) focus is the bedbound patient. The intervention (I) would be preventative/prophylactic dressings. I would compare (C) the intervention to leaving the area open to air. And finally, the outcome (O) would be if it prevented further breakdown and promote healing. The question I developed is: In the bedbound patient, what is the effect of preventative/prophylactic dressings on the decrease/prevention of pressure ulcers compared with leaving areas open to air?

Using the Walden Library, I utilized CINAHL, Medline, and PubMed databases. My initial search was ‘pressure ulcers’ which yielded 10,668. I then filtered results by publication date in the last 5 years and peer review/scholarly. This decreased the results to 2594. I then utilized the AND with prophylactic dressings. This decreased my search to 38. When adding and additional search of bedbound, my results were 0.

After learning how to use the Boolean search, I discovered that by being more specific either by filters or more search words with the and/or option, my results are more specific to my research question. If you are too specific, such as above example, it will filter everything out and have no results. The different databases will yield different results so it is beneficial to utilitze more than one database.

References