Advanced Levels Of Clinical Inquiry And Systematic Reviews

Discussion: Searching Databases


“Analysis of Workplace Related Stress among the Nurses”

Ariel Cordova Lopez

Walden University


“Analysis of Workplace Related Stress among the Nurses”

Description of the Issue

Stress in the workplace is an area that is attracting healthcare professionals to address it collectively. This requires the nurse administrators to be considerate of various factors that might impact the nursing professionals in the workplace including the workload. The nurses can be impacted by being overburdened, which might lead to failure to manage emotional distress, especially when dealing with critically ill patients. Therefore, an environment that enables the nurse to dispense their work effectively free of stressors needs to be provided. Such an environment is critical to promoting safety culture that promotes better dispensation of duties and achieving better patient outcomes. Thus, workplace stress not only affects the workers, but also affects the organization and customers at large.

Pico (t) Question and how to increase rigor in database search in picot question

PICO (T): Patients under critical care units, does nursing care under stressful environment lead to poor patient outcomes?

To increase rigor in the database searches so that I can get literature that will address the question. Strategies that can increase effectiveness of the search in database include:

Conceptualizing the search such that key words are used to conduct the search, including workplace stress, nursing stress, and patient outcomes. This requires using the appropriate vocabulary related to the search. Boolean operators can combine terms and concepts when conducting the search. The strategy need to be revised in order to streamline search results to specifically address the question. More than one database will be used in conducting the search so that adequate literature to address the question is found (Toronto, Quinn, & Remington, 2018). It is also important to adhere to all the database rules and peculiarities or ask the librarian platform to assist in case of a problem.

Search Description

The databases that were included in the search were Walden Library, CINAHL and the PubMed. The search was then narrowed to peer reviewed articles and adjusted the date to 2017-2021 so that I could get the most recent articles in evidence based practice. Adding filters to search the term nursing related stress in the Walden databases, 160 results were found. However, adding Boolean term so that the search could be more relevant in the next search, I got 55000 results (Walden University Library, 2021). I found that searching on the three databases was more effective in getting the right literature to address the clinical issues. Rigor in the search can be increased by using alternative terms like nursing stress in the workplace. I can also words like how workplace stress among the nurses affects patient outcomes.

Explain strategies you might make to increase the rigor and effectiveness of a

Database search on your PICO (T) question

To increase the rigor of the search I consider using alternative terms related to the clinical issues such as workplace stress, nursing stress, patient outcomes based on workplace stress so that the findings of the search can improve. In addition, advanced filters when searching for the sources in the PubMed database need to be used in order to narrow down the results of the search. Besides, it is important to restrict the search article published within the past five years. A clinical inquiry approach needs to be utilized in the search so that the question under consideration is linked with the stored searches in order to retrieve the appropriate research results (Aveyard & Bradbury‐Jones 2021). These research strategies will be instrumental in improving the results by getting the most relevant peer reviewed evidence based articles on the topic.


Aveyard, H., & Bradbury‐Jones, C. (2021). Writing for Publication: Reporting your Literature Review. Writing for Publication in Nursing and Healthcare: Getting it Right, 111-121.

Toronto, C. E., Quinn, B. L., & Remington, R. (2018). Characteristics of Reviews Published in Nursing Literature. Advances in Nursing Science41(1), 30-40.

Walden University Library. (2021). Keyword searching: Finding articles on your topic: Boolean terms. Retrieved from

Assignment: Evidence-Based Project, Part 2: Advanced Levels of Clinical Inquiry and Systematic Reviews


In this Assignment, you will delve deeper into clinical inquiry (See attachment “Assignment part 1) by closely examining your PICO(T) question. (See attachment “Discussion PICOT Question) You also begin to analyze the evidence you have collected.


To Prepare:

· Use the key words from the PICO(T) question you developed and search at least four different databases in the Walden Library. Identify at least four relevant systematic reviews or other filtered high-level evidence, which includes meta-analyses, critically-appraised topics (evidence syntheses), critically-appraised individual articles (article synopses). The evidence will not necessarily address all the elements of your PICO(T) question, so select the most important concepts to search and find the best evidence available.

· Reflect on the process of creating a PICO(T) question and searching for peer-reviewed research.


The Assignment (Evidence-Based Project)

Part 2: Advanced Levels of Clinical Inquiry and Systematic Reviews

Create a 6- to 7-slide PowerPoint presentation in which you do the following:


1. Identify and briefly describe your chosen clinical issue of interest. (See attachment “Assignment part 1)

2. Describe how you developed a PICO(T) question focused on your chosen clinical issue of interest. (See attachment “Discussion PICOT Question )

3. Identify the four research databases that you used to conduct your search for the peer-reviewed articles you selected.

4. Provide APA citations of the four relevant peer-reviewed articles at the systematic-reviews level related to your research question. If there are no systematic review level articles or meta-analysis on your topic, then use the highest level of evidence peer reviewed article.

5. Describe the levels of evidence in each of the four peer-reviewed articles you selected, including an explanation of the strengths of using systematic reviews for clinical research. Be specific and provide examples.


Instructions from Teacher about reference list:

Be sure to use 2 outside resources related to the peer reviewed (systematic review) articles when synthesizing information. Feel free to use Johns Hopkins as one of the outside resources (attached).

In the end, be sure you have the following sources within your presentation:

· Use 2 outside resources to related to the peer reviewed (systematic review) articles you selected as you synthesize them.

· Additional, include 2-3 course specific resources that support the presentation.

· ALL TOTAL — Your reference list will contain the 4 systematic reviews, and 2 outside resources (at least), and 2-3 course resources.


Course Resources (Attached articles)


Stillwell, S. B. , Fineout-Overholt, E. , Melnyk, B. M. & Williamson, K. M. (2010). Evidence-Based Practice, Step by Step: Searching for the Evidence. AJN, American Journal of Nursing, 110(5), 41-47. doi: 10.1097/01.NAJ.0000372071.24134.7e.


Melnyk, B. M. , Fineout-Overholt, E. , Stillwell, S. B. & Williamson, K. M. (2009). Evidence-Based Practice: Step by Step: Igniting a Spirit of Inquiry. AJN, American Journal of Nursing, 109(11), 49-52. doi: 10.1097/01.NAJ.0000363354.53883.58.


Stillwell, S. B. , Fineout-Overholt, E. , Melnyk, B. M. & Williamson, K. M. (2010). Evidence-Based Practice, Step by Step: Asking the Clinical Question. AJN, American Journal of Nursing, 110(3), 58-61. doi: 10.1097/01.NAJ.0000368959.11129.79.



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