February 1st, 2020 
Original posts were in regards to this:
Create a PICO question to research evidence needed to improve a process at your workplace. At least 2 databases should be utilized. Create an outline that includes: a PICO question, search terms used, & Boolean operators used in your literature search. Draft a 1 paragraph narrative of your search conducted (using scholarly writing).
Write a peer reviewed response to both students posts labeled as 1) and 2).
Write them separate from one another with minimum 150 word responses each.
***Use peer reviewed sources written in USA in the last five years.
1)
A literature search was performed to determine if increasing patient empowerment in diabetics leads to a decrease in A1C. The search was performed in PubMED and CINAHL databases using the search term (Diabetes OR Diabetic) AND empowerment AND control AND A1C. The search yielded several relevant papers, and three were chosen based on their relevance to the PICO question, date, and study design. One study found that while an empowerment-based self- management program increased patient empowerment, it did not decrease A1C, but did increase compliance with diabetic plan of care in factors like improved blood sugar monitoring and diet adherence(Cheng et al., 2018). Another study also found that patient empowerment did not decrease A1C during the test period(Fitzgerald et al., 2015). Finally, a nursing-piloted study which involved nursing-led focus groups that helped patients develop skills for diabetic management, featuring one-on-one breakout sessions, found that empowerment increased significantly and while A1C decreased significantly for many patients, the decrease was not statistically significant across the population. It was speculated within the discussion that this could be attributed to some diabetics being close too their target A1C when enrolling in the study(Davis et al., 2019).
While these papers failed to establish a statically significant inverse relationship between patient empowerment and A1C, they certainly also failed to negate the possibility of one, and in doing so highlighted some important lessons about literature search. First, each study used different methods to attain empowerment and two studies used different scales to measure empowerment, while the third did not measure empowerment at all. Truly, the validity of each scale should be examined as well as the effectiveness of each program, and if empowerment is not confirmed by a valid scale, conclusions cannot be drawn about its effects. Additionally, each program lasted between 6-8 weeks, which could be too short of a time to both elicit a change in empowerment and in habits to an extent that alters A1C. The context of data is extremely important to the quality of the research and should be the priority in literature search, particularly when the conclusions are being used to inform healthcare choices.
2)
Finding Evidence:
Violence against healthcare workers by patients and visitors has become a major topic over the past few years. More and more hospital staff are being verbally, physically, and sexually assaulted by patients and/or their visitors. Workers in the healthcare settings are four times more likely to be victimized than workers in private industry (Sentinel Event Alert, 2018). No person should have to endure violence at their place or work. Enduring violence in the workplace has detrimental effects on mental health. Workplace violence has been known to cause missed days of work, thoughts about quitting, staff burnout, and in severe cases PTSD symptoms (Rosenthal, Byerly, Taylor & Martinovich, 2018). The problem continues because staff are afraid that if they speak up, they will be considered as causing the problem or being too sensitive (DEttorre, Pellicani, Mazzotta & Vullo, 2018). Actions need to be taken by management and clinical leaders of hospitals to develop new ways for staff to protect themselves against workplace violence and feel empowered enough to report it.
PICO Question:
Do healthcare professionals with increased training in assessing and deescalating situations have less violent encounters compared to nurses that are not educated in assessing and deescalating situations?
P: Healthcare workers.
I: Training in assessing and deescalating situations
C: Lack of training in assessing and deescalating situations
O: Experiencing violent encounters
Search Terms:
According to Armstrong and Stables-Baus (2020), utilizing keyword searching allows the researcher to search for terms within an article. The researcher used advanced quick search to search terms to ascertain articles that were relevant to the desired topic. Some of those terms included workplace, healthcare professionals, violence, deescalating, encountering, and education. The researcher then added additional parameters that included peer reviewed articles only, full text articles, and articles published between the years of 2015-2020.
Boolean Operators:
Allows the researcher to use AND and OR operators.
Narrative:
The databases utilized in the search for articles on workplace violence experienced by healthcare workers included CINAHL Complete, MeDLINE with full text, and PsycINFO. Developing a PICO question was the first step to the search process. Then searching for the subject headings, and utilizing the Boolean operators there was an abundance of articles associated the topic of interest. Lastly, narrowing down the articles that were the most relevant to the topic.
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