Lower Levels of Care Units

Nursing homework help: I work on an IMCU, and it is hectic. Patient care is often interrupted for transferring improved patients to lower levels of care units to make room for admissions. About 1/3 of the unit will be newly admitted on my shift. The admission process includes asking patients about suicide and depression. I don’t feel awkward asking patients directly about the subject, but I see that patients are surprised that I ask even when I tell them in advance that I will be doing so. I have queried the significance of asking about suicidal ideation when patients are being admitted for a physical illness unrelated to psychiatric disorders.

P- patients admitted for physical illness unrelated to psychiatric disorders

I- hospital staff asking about suicidal ideation on admission to acute care settings

C- not asking about suicidal ideation on admission to acute care settings

O- value; decrease in the number of suicide attempts, an increase in patients seeking assistance in mental health care

T- one year

PICO question: Is there value in asking patients admitted to an acute care setting for physical illness unrelated to psychiatric disorder, about suicidal ideation, compared to not asking over one year.

Search phrases could include ask suicide, medical admission, suicide screening, and asq suicide. I used Sage journals and queried “ask suicide” and received 39,212 results (Sage Journals, 2020). Using the same search terms on Taylor & Francis Online there were 75,136 results (Taylor & Francis Online, 2020). Using Boolean operators changed the results returned. Using “and” narrowed my search and “or” broadened my results. Adding more search terms linked together further narrowed the results by approximately 75% by using “and.” Both databases have the ability for the user to narrow searches by searching for terms in specific article type, journal type as well as the publication date.

Strategies to increase the rigor and effectiveness of a database search might include using more than one database (UTHealth, 2019). One study on search strategies found a higher number of systematic reviews were obtained using a 2 PICO element search rather than a 4 element search. Additionally, it was found that it was essential to combine at least three databases together to achieve a 90% retrieval of relevant literature (Ho, Liew, Ng, Shunmugam, & Glasziou, 2016). This could provide me with the opportunity to find more significant studies to review. Another strategy would be to combine search terms and phrases with Boolean operators to refine my search. UTHealth libguides also points out that all databases are not created the same (UTHealth, 2019). They each have different rules and quirks. I must familiarize myself with the tool I choose to use, or it will not be effective.

Ho, G. J., Liew, S. M., Ng, C. J., Shunmugam, R. H., & Glasziou, P. (2016, 12). Development of a Search Strategy for an Evidence Based Retrieval Service. PLoS One, 11(2), e0167170. doi:10.1371/journal.pone.0167170

Sage Journals. (2020). Search Results. Retrieved 12 22, 2020, from Sage Journals: https://journals-sagepub-com.ezp.waldenulibrary.org/action/doSearch?AllField=Ask+Suicide

Taylor & Francis Online. (2020). Your search for All: ask suicide. Retrieved 12 22, 2020, from Taylor & Francis Online: https://www-tandfonline-com.ezp.waldenulibrary.org/action/doSearch?AllField=ask+suicide

UTHealth. (2019). Best Practices for Developing Search Strategies: Home. Retrieved 12 22, 2020, from UTHealth: https://libguides.sph.uth.tmc.edu/c.php?g=543359


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