This report seeks to go over the best practice on the way of measuring of a lying down and standing blood pressure. In addition to this; formulate a search strategy to provide the best evidence established practice. Doctor David Sackett defines evidence based practice as; "The conscientious, explicit and judicious use of current best data to make decisions about the good care of individual patients" (Sackett et al. 2000). This in Laymen's conditions means; to work with all available sources of information to form an thoughts and opinions or judgement how to provide the best possible health care to the individual. Some people suffer from an ailment called Presyncope, this can lead them to feel lightheaded or unsteady on the feet when rising from a lying or sitting down position; this problem is often associated with the older generation and can lead them to land. They feel this way because the brain or cerebral cortex does not receive enough air, due to a lack of blood circulation when they stand up. This can then lead them to fall over or pass out. This condition is also known as Hypotension or Orthostatic Blood Pressure. The ultimate way to diagnose or determine if the patient is experiencing this problem, is too perform an operation called a lying down and standing blood pressure. This usually requires the Health Care Professional to use the patient's blood circulation pressure while they may be lying down, then to track record the blood pressure immediately on standing and then again when they have been standing for just two minutes; to ascertain if the individual has a substantial drop in their blood pressure in a standing position.
Formulating a search strategy for the three resources
The three resources because of this report that will be searched and mentioned are books, journals and the internet. The key words used in this statement will be; Lying and Standing Blood Pressure, Orthostatic Blood Pressure, Hypotension and dimension. The main phrase used will be dimension of orthostatic blood circulation pressure. Before you begin the search it could be beneficial to design a mind map, spider graph or brainstorm, to help make any new key phrases you can use in the search. (Cottrell, 2003). The main focus for this report will be on Measurement of Orthostatic blood circulation pressure.
A good search source of information is the internet since it is fast and instant. Start the computer and hook up to www. google. com; then in the search pub, type in what lying and located blood circulation pressure. This yielded nine hundred and forty two thousand serp's in fifty four mere seconds. The word way of measuring was used to try and narrow the search results down. Enter the words dimension of orthostatic blood pressure, this narrowed the search results down to 2 hundred and twenty four thousand. Applying Boolean reasoning to the search club, can help slim the results further; simply add the words "AND" or "OR". George Boole was a mathematician who came up with the idea to include either of the words to the keywords to narrow down a search, (Freeman and Thompson, 2009). The term AND added to the keywords lying down and standing blood pressure, will produce results which include both keywords lying and located. Adding the term OR will also produce results that are the keywords resting and ranking, this severely raise the search results. The word NOT can be added to the key words, which will thin the results significantly as this looks for only 1 of the main element words and rules out the other. (Freeman and Thompson, 2009). Using Boolean logic did not help in this specific search. Scrolling through the Google search results, unveiled that the majority of the websites were generated in another country. This can be reduced down by clicking on the search tool button, then clicking on country UK only, this reduced the results down by 50 %. To reduce the results further, type yahoo scholar in the Yahoo search club, this will access google scholar (www. scholar. yahoo. co. uk. ) Type in way of measuring of orthostatic blood pressure in the search bar, this produced a search consequence of forty-five thousand signifying it was substantially less. By clicking on advanced search and inputting the schedules to only five years, reduces the results down to twenty in seven secs. The downside to advance search on google scholar, is that there is no discrimination against foreign websites.
When looking the internet, it is important to remember the three 'W's. ' Who; What so when. Who produced the web site and can they be respected; for instance; could it be compiled by a drug company who want to sell their products. Where the website is from; is it United kingdom or from overseas? Ideally healthcare experts should be using information using their company own country in their tasks. And lastly, when was the website last updated? A lot of websites are seldom updated, so that it is important to look at when the web site was made and updated. (Freeman and Thompson, 2009).
Another great learning resource that healthcare experts can research are journals or e-journals. Journals are current and up to date. Written by qualified professionals and peer examined, in addition they contain many quantities. The downside to using journals is they can be too costly, difficult to store and hard to find (O'Dochartaigh, 2002). The college or university has a collection that may be reached day or evening, or you can use their library website or the school website. Sign in to the catalogue account and type in dimension of orthostatic blood pressure. This produced a hundred and seventy six results, this includes journals and literature. You can refine the serp's further by going to the advanced search section, and simply clicking the relevant containers that may be needed to do this, for example, in this case all those things was needed was to refine the search was the night out which yielded only fifty two results. Also underneath the refine results section is a list of the creators, the name of the publications and the databases they were seen in. This information is effective if the name of certain journals is not known; the same with directories. By clicking on the more options part of the lists, you can eliminate or include whichever journals or databases required; for example, in this case all articles from overseas were eliminated, minimizing the serp's down to forty nine. When the name of the journal is known, then the catalogue website has an e-journals section; click on the box that says "find e journals. " This will bring up another field with the alphabet, go through the relevant notice or type in the name of the journal in the search bar. For example the medical times was searched. This then starts up a fresh link box, click on the nursing times name; this will start a separate pack where the 12 months, volume, concern and page quantities can be inserted to access this e-journal required. For the intended purpose of this survey, it is well known that this nursing times journal was paper in the entire year two thousand and seven (2007), the quantity number is a hundred and three (103), the issue number is twenty (20), and the site starts on quantity 24 (24). These figures when inputted in to the boxes, will take you directly to the e-journal required. The hospital library also offers its journal and e-journals directories. Most of the e-journals are seen via an Athens data source account, this can be an Gain access to Management System produced by Eduserv; a safe service agency that allows access to all electronic resources the hospital or school are subscribed to. Usage of Athens can be carried out through the university or a healthcare facility, you can enroll a merchant account with them free to an individual, so long as you are a healthcare professional or student. Directories are a systematic assortment of data that may be reached for information, either through the internet, work or university library. Once again, it does help if you know the name of any databases. On the university or college webpage there's a package that says "databases". Simply clicking this link will start a separate pack to which you can enter the name of the data source required. For the purpose of this report; Cumulative Index to Nursing and Allied Health Books (Cinahl) will be used. Type Cinahl in to the search club, this produces one search result; double click on the title and this will need you directly to the database. Inside the search bar enter dimension of orthostatic blood pressure, this will then open up another hyperlink with new keywords; tick the containers of the keywords to be utilized. For example, in cases like this the keywords are measurement of orthostatic blood pressure. Click on the search databases button and this yielded ten results. To find other articles, enter lying and standing blood circulation pressure in the very best search pub; in the search bar underneath, type the term "AND" next to it and enter the word way of measuring this yielded no results. When looking journals, it is vital to ensure the writers are United kingdom; what their certification are; and are they licensed healthcare professionals. Checking out the time frame of the journal may be essential, as anything older than five years can be considered out of date. Precisely the same should be studied under consideration when searching databases.
Books are another great search tool for professional medical professionals; they can be easier than journals and the internet to search for, plus more reliable than the internet. Catalogs give the reader a listing of what's written in the booklet, by reading the blurb on the back. Books also include a details and index webpage; this allows the reader to go to a specific site or chapter instead of having to browse the whole publication; unlike journals. However books are costly and take up a great deal of space for storage. There are four options available when looking for books: The general public library, a healthcare facility library, the college or university library and google books (www. books. yahoo. co. uk). For the purpose of this survey the university library will be utilized. The school provide tuition about how to search and use the collection website within per month of starting the course. The university collection informs the researcher what literature are available, just how many catalogs there are, where they can be found in the collection and which campus, how long the reserve can be lent for and whether the book is available online as an e-book. Looking for way of measuring of orthostatic blood circulation pressure; or laying and standing blood pressure yielded no results for books; the search was then improved to hypotension which yielded one end result. To yield a few more results, the name was altered to orthostatic blood circulation pressure, this only yielded publications. Blood pressure was then typed into the search bar, this produced over 3 hundred and nineteen thousand results; they included publications, books and full text online. To lessen this down; there may be the choice to enhance the search; by simply clicking the "available in the catalogue" option reduced the results down to fifteen catalogs, ruling out all the journals etc. Choose an appropriate book and appearance at your options available underneath the title and information of the book. The positioning option lets you know which campus the e book is located on and therefore where it can be found in the library. This may also notify the researcher if the e book is open to borrow on your day, or when it becomes open to borrow; additionally, it may allow the user to hold the book; indicating the previous borrower cannot renew the booklet. Clicking on the facts option provides user the writer(s), the topic, identifier and a short explanation of the book; this can permit the customer to choose or get rid of the book efficiently. Simply clicking the virtual surf button, allows the user to see other catalogs that are across the same cabinets as the publication an individual is looking at. To the left of the library webpage as stated earlier; is the choice to enhance search. Above the words available in the collection is "full word online"; simply clicking this option gives the user access to the e-books online, allowing them to download the reserve for a maximum period of two days or to read the publication online. Once the individual has chosen the catalogs they require, it is just a simple subject of going to the collection and borrowing the catalogs. It's important when looking at catalogs for an individual to take into consideration the time frame, who published the book and whether it contains the relevant information required.
Formulating a search strategy requires planning, company, time and practice. Journals, internet and books are essential tools had a need to enhance the quality of information built from the study. Therefore it is necessary to check the credentials of the individual writing the information, where the information is from and when it was written or compiled. When looking the internet it became noticeable that the websites seen only spoke about the signs and symptoms of orthostatic blood pressure and not about how precisely to measure the blood pressure only three websites produced the results required, one produced a useable tool, the other gave a detail by detail explanation on how to do a lying a standing blood pressure, but no other information. The very last website explained the right procedure, discussed the signs or symptoms of orthostatic blood pressure, was written by a qualified medical care personnel, nevertheless the webpage didn't give a time for when it was up to date or due to be assessed only that it was produced in nineteen ninety six. Looking a healthcare facility and school libraries produced one journal which gave the correct method how to measure a lying and standing blood pressure, this was within the Nursing times but was outdated by eighteen years. Looking through the university catalogue yielded several books on blood circulation pressure, all with a section on the cause of orthostatic blood circulation pressure, but nothing at all on the right measurement of lying and standing blood pressure. The hospital library produced one reserve with the right procedure for calculating orthostatic blood pressure. Formulating the search used an amazing timeframe and resources and has became illusive and inconclusive. And discover the correct process of measuring orthostatic blood pressure further research will be required. With an increase of practice on the use of keywords will ideally produce the mandatory results. Formulating this search strategy and report has proven how easy it is to get bogged down with information. Using Boolean logic is incredibly useful in most search criteria's but didn't work for this particular search. Adding conversation marks to measurement of orthostatic blood circulation pressure also did not help, the search tended to concentrate on the words blood circulation pressure, how to evaluate blood pressure or simply orthostatic blood pressure. It has proven that the keywords should also include words such as "how to" or "correct".
This report shows how the use of your spider graph or mind map, can be an extremely useful way of starting the formulation of any search strategy (Cottrell, 2003). It has also confirmed that using Boolean logic can be an efficient tool when searching for information (Freeman and Thompson, 2009). The use of evidence based practice or medication in addition has been talked about by discussing what was bad and the good about the information and the indicators used to determine this, including the three W's, who, when and where to whittle the information down. The web has shown to be the most interesting and time consuming because anything can be keyed in the search club and it'll think of a great amount of results. Using different techniques to try and reduce the information down was frustrating. Using the hospital and college or university was more reliable to find books and journals was less frustrating. They also have librarians that are helpful in times of crisis. Books and publications were the most reliable sources of information because they're generally written by experts in the field being researched. Completing this statement has shown to be a useful way of improving knowledge, skills and a highly effective learning curve. Learning that proof based practice is based on the best available research. Guaranteeing any advice given is research based especially if recommending healthcare products or services and ensuring that any complementary or choice remedies are in the needs of the individual in the healthcare professionals care (NMC, 2008). Concluding this survey has acknowledge that less time is required on the composition of the survey and more time must be spent on the research.
Aveyard, H. (2014) Performing a literature review in health and social care. A Functional guide. 3rd release. Berkshire: Open University Press. www. cdc. gov/homeandrecreationalsafety/. . . /measuring_orthostatic_bp[accessed 20th November 2014]
http://www. cdc. gov/injury/STEADI [accessed 20th November 2014]
Cottrell, S. (2013) The analysis skills handbook. 4th model. Basingstoke: Palgrave Macmillan.
Dougherty, L. Lister, S. (2011) The Royal Marsden Hospital Manual of Clinical Medical Procedures. 8th model. Oxford. U. K: Wiley, John & Sons, Incorporated.
Freeman, B. Thompson, D. (2009) Fundamental aspects of finding and using information. A guide for students of nursing and health. London Quay Books.
Hek, G. Et al (1996) Making sense of research - an intro for nurses. London: Cassell.
O'Dochartaigh, N. (2002) The web research handbook. London. Sage Magazines.
Pear, R. Shields, G. (2013) Cite them right. The fundamental referencing guide. 9th edition. Basingstoke: Palgrave Macmillan.
Sackett, D. L. Et al (2000) Evidence-based medicine. How to practice and educate EBM. London. Churchill Livingston.
http://www. medscape. com/viewarticle/474822_2 [reached 20th November 2014]