Developing a PICOT question takes time and thought. A major component in this process includes understanding how to create the PICOT question. The question should consist of population, intervention or issue of interest, comparison, and the timeframe to accomplish the outcome (Melnyk & Fineout-Overholt, 2019, p.34)
My topic of interest is Transcranial Magnetic Stimulation and depression. Transcranial Magnetic Stimulation Therapy (TMS) is a non-invasive treatment that uses a magnetic coil placed on the left dorsal lateral prefrontal cortex to stimulate nerve cells in the brain to improve symptoms of depression. TMS is an alternative treatment that is used when antidepressants have not been effective (Mayo Clinic, 2018). My PICOT question is ‘What is the effect of Transcranial Magnetic Stimulation Therapy for Adults with Depression as Reflected in Depression Rating Scales?’
I used CINAHL Plus, Thoreau, and APA PsycInfo to conduct my search. The words I used initially to search were TMS and depression. Then, I broadened my search by adding rating scales, depression rating scales, depression assessment tools, and adults. I also used the search guides of peer-reviewed and stipulated the years in the sidebar to range from 2016 to 2022. At the top of the EBSCOhost page, directly above the search bar where one can type in the qualifiers, there is an option to choose databases (Walden University Library, 2022). One has the option to search several different databases at the same time. I was able to find randomized clinical trials, a pilot investigation, a cohort study, and two double-blind, randomized, parallel-group, sham-controlled clinical trials.
Understanding how to conduct research is imperative to all nurses. It is essential to understand how to conduct research and vital to have the capacity to interpret the research. Whenever a nurse presents an issue to be addressed to their supervisor or any key stakeholder, it should always be accompanied by evidence-based research.
Mayo Clinic. (2018). Transcranial Magnetic Stimulation – Mayo Clinic. Mayoclinic.org. https://www.mayoclinic.org/tests-procedures/transcranial-magnetic-stimulation/about/pac-20384625
Melnyk, B., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Wolters Kluwer
Walden University Library.(n.d-a).Databases A-Z: Nursing. Retrieved March 21,2022, from https://academicguides.waldenu.edu/az?s=19981
The clinical issue I have selected is safety in inpatient psychiatric facilities. When providing care to individuals with mental health disorders, aggression and violence can be a common occurrence in psychiatric facilities, especially when patients are admitted involuntarily. This patient population may act in an aggressive or violent manner related to altered reality, behavioral disorders, manic phases, attention seeking behavior, etc. (APA, 2021). To counter these behaviors and increase safety for the patient, peers, and staff members, de-escalation techniques should be emphasized, utilized, and improved in an attempt to avoid physical intervention to increase safety.
I used multiple databases to conduct my search for research articles relevant to my clinical issue. I used CINAHL Plus, PubMed, and BioMed Central (Walden, 2021). I began my search by using the term “de-escalation” and narrowed the results down by adding terms like “inpatient, aggression, mental illness, and restraints.” As I added and removed these terms the databases would refine the search and allow me to review various articles related to my clinical issue. The ability to constrict the search terms down to the year 2017-2022 makes finding up-to-date information very convenient. Using the key terms to only find articles relevant to my topic saved me a lot of time.
Understanding what strategies help to build a PICOT question is very helpful to efficiently forming an appropriate question. Strategies like brainstorming terms, using synonyms and similarities, and developing a list of different combinations of key terms to modify the search (Ho et al, 2017). My list of terms included seclusion, de-escalation, violence, aggression, mental illness, inpatient, involuntary, injuries, safety, etc.
American Psychological Association (APA) (2021). Mental Illness and Violence. Retrieved on March 20, 2022, from https://www.apa.org/monitor/2021/04/ce-mental-illness
Ho, G. J., Liew, S. M., Ng, C. J., Hisham Shunmugam, R., & Glasziou, P. (2017). Development of a search strategy for an evidence based retrieval service. PloS one, 11(12), e0167170.
Walden University. (2021). Databases A-Z. Welcome – Walden University Departments & Centers – Academic Guides at Walden University. https://academicguides.waldenu.edu/az.php