I work on an acute inpatient psychiatric unit where all of the patients have been detained on involuntary holds

All you have to do is read this post and respond to it in 1-2 paragraphs and use at least 2 sources. 3 is preferred but if you can only find 2 that is no problem.  The goal of the reply is to “provide further suggestions on how their database search might be improved.”

POST:

I work on an acute inpatient psychiatric unit where all of the patients have been detained on involuntary holds. A high number of these patients are readmitted over and over again. There are several agencies in my county that serve the same population, the patients hop from one facility to the next depending on who has an open bed. Having witnessed this firsthand, I can appreciate the need for strong outpatient support services and timely follow up appointments. My clinical area of interest deals with how prompt follow up care is associated with a reduction in rapid (within 30 days of discharge) readmission rates.

My PICOT question is:

In psychiatric patients, how does having outpatient supports and follow up appointments in the first 30 days of discharge compared with having delayed follow up care or no follow-up care affect readmission rates to an inpatient psychiatric facility within 30 days of discharge?

For the search, I used CINAHL Plus with full text, MEDLINE with full text, PubMed, PsychInfo, and Academic Search Complete all accessed through the Walden library (Walden University, 2019). The terms used during this search included “psychiatric readmission”, “psychiatric readmission rates”, “behavioral health,” or “mental health” in the first search box. Additionally, the terms “psychiatric units,” “adults,” “inpatient psychiatry,” “rehospitalization,” “prevention,” “psych hospitals,” and “readmission rates” were used. Using Boolean operators “AND” and “OR” I was able to focus my search further to better answer the PICOT question (Walden University Library). In general, I prefer to narrow my searches by choosing full text, peer-reviewed journals and limiting the date range within the last five years.

In the CINAHL database, I used the search terms “psychiatric readmission rates” AND “factors or causes or influences,” this search yielded 52 articles, they were trimmed down by checking the full-text box (33 articles) and limiting the date range to 2015-present. The use of these additional modifiers reduced the results to 17 articles. There are one or two that may be useful to my PICOT question, but there not enough quality results. I then searched “readmission” AND “psychiatric units” AND “adults,” which resulted in 147 articles. These were further focused by selecting ‘full text”, peer-reviewed”, and “academic journals” with a date range between 2015-present. This resulted in 25 articles, many of which look to be useful for this project.

The formation of a PICOT question is the first step of evidence-based practice (Melnyk & Fineout-Overholt, 2019). According to Melnyk and Fineout-Overholt (2019), it is essential to formulate a focused, well-designed PICOT question in order to generate relevant information. The PICOT question should include the patient population, intervention or issue of interest, comparison intervention, outcome, and a time frame in order to be specific enough to result in relevant results in a timely fashion (Melnyk & Fineout-Overholt, 2019). Before formulating a PICOT question, one must decide on a clinical area that interests them and generate a background question, one that is broad in nature (Stillwell, Fineout-Overholt, Melnyk & Williamson, 2010). Once the broad question has been formed, the next step is to narrow the area of interest into a foreground question which is more specific and relevant to the topic (Stillwell, Fineout-Overholt, Melnyk & Williamson, 2010). Utilizing the terms that comprise the PICOT, one can search databases to find pertinent research for their inquiry (Melnyk & Fineout-Overholt, 2019). More results can be obtained by using synonyms in the search and by separating terms with “OR” within the search boxes themselves (Walden University, 2019).

 

References

Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing & healthcare a guide to best practice (4th ed.). Philadelphia: Wolters Kluwer.

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.

Walden University Library. (n.d.). Evidence-Based Practice Research: CINAHL Search Help. Retrieved December 17, 2019, from https://academicguides.waldenu.edu/library/healthevidence/cinahlsearchhelp.

Walden University. (2019). Databases A-Z. Retrieved December 17, 2019, from https://academicguides.waldenu.edu/az.php?s=19981.

 

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