This document discusses how healthcare professionals use PICOT questions to efficiently find relevant information to answer clinical questions. It provides an example of a PICOT question asking if hand hygiene using soap and water or hand sanitizers is more effective in reducing hospital-acquired infections in geriatric patients over three months. The author describes searching two databases, limiting results to five years, and using search terms related to the question. Boolean operators were added to change the search significantly by decreasing and increasing relevant article amounts. Strategies to increase search rigor and effectiveness include using Boolean operators, limiting year ranges, searching multiple databases, and getting librarian assistance.

1. WEEK4 RESPONSE 6052
Juliet Anyanwu RE: Discussion – Week 4COLLAPSEHealthcare professionals use PICOT
questions to clear clinical issues in a way that assists to efficiently and quickly find the right
information to answer the clinical question (Melnyk & Fineout-Overholt, 2018). The
purpose of the PICOT question is to direct the systematic search of healthcare databases to
find the best available evidence to answer the question (Melnyk & Fine-out-Overholt, 2018).
Understanding how to appropriately formulate a clinical question in PICOT format and
using it systematically in your search is vital to efficiently begin the EBP process (Melnyk &
Fine-out-Overholt, 2018). Systematically formulating a clinical question makes it possible to
find an answer faster and proficiently, leading to enhanced methods and patient outcomes
(Stillwell et al., 2010). Question– In geriatric inpatients, does hand hygiene using soap and
water compared to the use of hand sanitizers help in lessening the occurrences of Hospital
Acquired Infection within three months?PICOT QuestionIn geriatric inpatients (P), does
hand hygiene using soap and water (I) compared to the use of hand sanitizers(C), help in
lessening of Hospital Acquired Infection (HAIs) incidences (O) within three months
(T)?Search Terms usedThe search terms used were: Hand Hygiene, hand washing, Hospital-
acquired infections, inpatient geriatrics, and hand sanitizers.Database usedThe two
databases used were CINAHL Plus with Full Text and MEDLINE with Full Text. Search
ResultsCINAHL Plus with Full Text produced 120 results, while MEDLINE with Full Text,
which had 80 (Walden University Library, n.d. – a). These presented both original research
articles and systematic reviews. The search was restricted to articles within five years. Also,
to conduct the search, the article towards the research question was used. It was all related
to hand hygiene, hand washing, hand sanitizers, and hospital-acquired infections
management. Two articles were from original research.Addition of Boolean OperatorAdding
the search terms using the Boolean operators changed my search significantly. The amounts
of records returned were remarkably decreased and increased on the articles available
based on their significance to my study. It expedited the accomplishment of more detailed
results and helped save time as the results became more suitable for my desires. It also gets
rid of unsuitable articles. Boolean operators and nesting help one search for combinations
of words or phrases processed in a particular order (Library of Congress, n.d.).Strategies to
increase the rigor and effectiveness of a database search and exampleThe strategies I will
make to increase the rigor and effectiveness of a database search for my PICOT question
include: Using Boolean operators. The use of Boolean operators helps facilitates, confines
the search to the most relevant results, and is more focused. I will also limit the search to a

2. particular year range. Limiting the year range, this helps in returning current searches and
also uses more than one database for my search, because everyone may have more articles.
I will seek the help of a Librarian to assist me in the preliminary inquiry. Another strategy is
using parentheses. The use of Parentheses will help me get the search I
want.ReferencesLibrary of Congress. (n.d.). Search/browse help-Boolean Operator and
nesting. Retrieved September 22, 2020, from
https://catalog.loc.gov/vwebv/ui/en_US/htdocs/help/searchBoolean.htmlMelnyk, B. M., &
Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare (4th ed.).
Philadelphia, PA: Lippincott Williams & Wilkins.Stillwell, S. B., Fineout-Overholt, E., Melnyk,
B. M., & Williamson, K. M. (2010). Evidence-based practice, step by step: asking the clinical
question: a key step in evidence-based practice. AJN The American Journal of
Nursing, 110(3), 58-61.Walden University Library (n.d.-a). Databases A-Z. Retrieved
September 22, 2020, from https://academicguides.waldenu.edu/az.php?s=19981Angel
Brockington-Hall RE: Discussion – Week 4: Main PostCOLLAPSEAfter reviewing the five
types of foreground questions, it was determined that a meaning question would be the
most suitable approach for posing a question using PICOT. According to Melnyk and
Fineout-Overholt (2018), meaning questions explore the relationship between an
experience and an outcome, the extent or range of a rare occurrence, or “the influence of
culture on healthcare” (p. 39).PICOT ComponentDescriptionPatient populationSexual
assault survivorsIntervention/issue of interestOngoing treatment and support/cultivating
community support cultureComparison intervention/issue of interestChallenging
traditional beliefs and attitudes with awareness and educationOutcomeIncreased rates of
reporting and support networksTimePost-assault through three monthsPICOT
QuestionWhat is the quality of life (O) for sexual assault survivors (P) who report the
incident and receive treatment and ongoing community support (I) within the first three
months (T), compared to their counterparts who choose not to report (C) their lived
experience?Search Terms Used and Databases Used for PICOT QuestionThe search terms
used included sexual assault victims or sexual assault survivors, rape and quality of life,
community support, and treatment, contributing factors, reporting sexual assault, sexual
assault, coping behavior, and trauma. Boolean operators and nesting were applied to
“search for combinations of words or phrases processed in a specified order” (Library of
Congress, n.d.), and expanders such as “apply related words” and “search with the full text
of the articles” were applied to refine results. CINAHL Plus with Full Text, MEDLINE with
Full Text, APA PsycINFO, and APA PsycArticles were databases used to research the PICOT
question. The American Psychological Association (APA) publishes articles available in the
APA PsycArticles and APA PsycINFO databases. According to Walden University Library
(n.d.), both databases are “a definitive source of full text, peer-reviewed scholarly and
scientific articles in psychology” (para. 1). CINHAL Plus, with full text, offers “a robust
collection of full-text nursing and allied health journals” (Walden University Library, n.d.,
para. 1). It provides and permits access to nearly 800 journals indexed in the original
CINAHL database. According to Walden University Library (n.d.), “CINAHL Plus with Full
Text is the core research tool for all areas of nursing and allied health literature” (para.
1). Similarly, Medline with Full text presents “the authoritative medical information” on

3. various health professions, including nursing. Nearly 1,500 journals are indexed in
MEDLINE, which offers full text (Walden University Library, n.d., para. 1).Search Results and
Changes Noted with Boolean Operators Walden University’s Library “Database search
skills: Set up your search” option encourages the use of one term when searching databases
to return the best and broadest results. Entering a single word can be used to determine
whether the precise term aligns with “scholarly works” (Walden University Library,
Database search skills: Set up your search, n.d.-b.). Applying this recommendation produced
over 20,000 articles. Limiters such as peer-reviewed scholarly journals and a publication
date no older than 2015 were used, resulting in the following results:MEDLINE with Full
Text (151)CINAHL Plus with Full Text (120)APA PsycArticles (35)APA PsycInfo
(6) Without the Boolean search operators and, or, and not, a search for sexual assault
survivors returned a total of 1,039 results. The number of original research articles
returned within the APA PsycINFO database was five out of six, proving a high probability of
finding trustworthy, scholarly, current, and original research applied to the PICOT
question. When the Boolean search operator AND was used to include reporting sexual
assault, collectively, all four databases were reduced to five total search results. Search
results increased exponentially, when an additional field of the Boolean operator OR was
employed. In the second field of the database search, the terms beliefs or perceptions or
views or attitudes were added. Including the Boolean connector OR, produced greater than
400,125 results. However, the articles resulting from adding OR produced fewer articles
germane to the PICOT question. Strategies to Increase Rigor and Effectiveness of Database
Search for PICOTSome strategies could be applied to databases that make searching a
PICOT question more efficient and rigorous. These strategies include: Ensuring databases
are reliable and produce trustworthy content rooted in scholarly work.Apply best practices
in the methodological review of data.Utilize a combination of sources to establish
evidenceOrganize citations and search strategies (Hartzell & Fineout-Overholt, 2018, p.
57).Solicit help from the librarian when needed.Select articles most germane to the PICOT
question (Hartzell & Fineout-Overholt, 2018, p. 57).According to Hartzell and Fineout-
Overholt (2018), the above represent “basic and advanced behaviors that clinicians would
use to competently search bibliographic databases such as the Cumulative Index to Nursing
and Allied Health Literature (CINAHL) and MEDLINE” (p. 56). Searching databases that
have relevancy to a PICOT question facilitates the evidence searching and gleaning
process. Boolean operators serve as “connectors” which can be used to expand (using OR)
or narrow (using AND) searches. Overall, there are standard competencies expected of
advanced practice clinicians, and there are various resources available to facilitate and
promote honing these critical skills.ReferencesHartzell, T. A. & Fineout-Overholt, E.
(2018). Chapter 3: Finding relevant evidence to answer clinical questions. In B. M. Melnyk,
B. M., & E. Fineout-Overholt (Eds.), Evidence-based practice in nursing & healthcare: A guide
to best practice (pp. 607-653). Philadelphia, PA: Wolters Kluwer.Library of Congress. (n.d.).
Search/browse help – Boolean operators and nesting.
https://catalog.loc.gov/vwebv/ui/en_US/htdocs/help/searchBoolean.htmlMelnyk, B. M., &
Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide
to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.Walden University Library.

4. (n.d.-a). Databases A-Z: Nursing.
https://academicguides.waldenu.edu/az.php?s=19981Walden University Library. (n.d.-b).
Database search skills: Set up your search.
https://academicguides.waldenu.edu/library/databasesearchskills/setupyoursearch3SOU
RCES FOR EACH DISCUSSION