| Course | NURS 6341 Specialty in Clinical Nursing |
|---|---|
| Week | Week 3 |
| Paper type | Search strategy record |
| Length | About 740 words, 5 pages |
| Format | APA 7 student paper |
| School | Walden University |
| Program | Master of Science in Nursing (MSN) |
| Updated | October 2026 |
Free sample paper for NURS 6341 Week 3
Search Strategy Record: Delirium Prevention by Nurses for Older Adults With Hip Fracture
Student Name
College of Nursing, Walden University
NURS 6341: Specialty in Clinical Nursing
Instructor Name
Month Day, Year
Search Strategy Record: Delirium Prevention by Nurses for Older Adults With Hip Fracture
Question and Concepts
Question: among adults 65 and older having surgery for hip fracture on an orthopedic unit, does a nurse-delivered multicomponent nonpharmacologic delirium prevention protocol, compared with usual care, reduce delirium incidence during the hospital stay? The question breaks into four concepts. Table 1 pairs each concept's controlled vocabulary with the free-text words clinicians and authors use, since indexing lags behind publication and misses terms such as acute confusion.
Table 1
Concepts, Subject Headings and Free-Text Terms
| Concept | MeSH (PubMed) | CINAHL headings | Free text |
|---|---|---|---|
| 1. Hip fracture | Hip Fractures | Hip Fractures | hip fracture*, femoral neck fracture*, intertrochanteric fracture* |
| 2. Delirium | Delirium | Delirium | delirium, acute confusion, acute confusional state |
| 3. Nonpharmacologic prevention | (none adequate) | (none adequate) | prevent*, multicomponent, multi-component, nonpharmacologic*, non-pharmacologic*, bundle*, Hospital Elder Life Program |
| 4. Nursing delivery | Nursing | Nursing Care; Nursing Interventions | nurs* |
Databases
Four databases are searched, each for a stated reason. PubMed covers MEDLINE, where the medical and geriatric trials sit. CINAHL covers nursing journals and nursing-intervention indexing that MEDLINE lacks, which matters for concept 4. The Cochrane Central Register of Controlled Trials catches trials in conference records and registries. AgeLine, the specialty index for gerontology, catches aging-focused journals and reports that neither general index covers. Embase was considered and set aside, since its added yield for nursing interventions is mainly pharmacological, which the question excludes.
Strings as Run in PubMed
The PubMed strings below were run on September 29, 2026, without date or language limits. Concept 1: ("Hip Fractures"[Mesh] OR "hip fracture*"[tiab] OR "femoral neck fracture*"[tiab] OR "intertrochanteric fracture*"[tiab]). Concept 2: ("Delirium"[Mesh] OR delirium[tiab] OR "acute confusion"[tiab] OR "acute confusional state"[tiab]). Concept 3: (prevent*[tiab] OR "multicomponent"[tiab] OR "multi-component"[tiab] OR "nonpharmacologic*"[tiab] OR "non-pharmacologic*"[tiab] OR bundle*[tiab] OR "Hospital Elder Life Program"[tiab]). Concept 4: ("Nursing"[Mesh] OR nurs*[tiab]). Design filter: (randomized controlled trial[pt] OR randomi*[tiab] OR "controlled trial"[tiab] OR "quasi-experimental"[tiab]). The CINAHL translation uses MH headings with the same free text and will be run in the same order.
Yield at Each Stage
Table 2 reports each PubMed combination and its yield.
Table 2
PubMed Yields, September 29, 2026
| Combination | Records |
|---|---|
| Concept 1 (hip fracture) | 45,192 |
| Concept 2 (delirium) | 31,186 |
| 1 AND 2 | 1,247 |
| 1 AND 2 AND 3 | 293 |
| 1 AND 2 AND 3 AND design filter | 68 |
| 1 AND 2 AND 3 AND 4 | 50 |
| 1 AND 2 AND 3 AND 4 AND design filter | 8 |
Why Concept 4 Is Not Used as a Restriction
Adding the nursing concept to the filtered set reduced 68 records to 8. Comparing the two sets showed that trials of geriatric consultation and of specialized geriatric wards, whose preventive care was carried out largely by nurses, fell out because they did not use nursing terms in their titles or abstracts. Restricting by concept 4 would therefore discard relevant evidence. The 68 filtered records were screened instead, and nurse delivery is judged at full-text review.
Screening
Title screening of the 68 records removed 45: 15 tested anesthetic, analgesic or transfusion strategies; 14 tested drug or device prophylaxis; 7 were protocols without results; 7 were not prevention intervention studies; and 2 were comments or letters. Abstract review of the remaining 23 removed 12: 5 tested a single component, such as recorded music or a morning routine, 2 were limited to people with dementia, and 5 reported no delirium incidence outcome. Eleven records went forward to full-text review: seven trials or controlled studies, among them a randomized trial of a nurse-delivered protocol (Unal et al., 2022) and the proactive geriatric consultation trial (Marcantonio et al., 2001), and four systematic reviews, including a 2026 review of nurse-led interventions (Kraonual et al., 2026). Two further sources known to the field were added by hand because the hip fracture concept excluded them: the Cochrane review of nonpharmacologic prevention in all hospitalized non-intensive care patients (Burton et al., 2021) and a meta-analysis of multicomponent interventions (Hshieh et al., 2015).
Where the Search Is Thin
The search is thinnest exactly where the question is most specific: randomized trials in which nurses alone delivered a multicomponent protocol to hip fracture patients. Only one such trial, with 84 participants, appeared in the PubMed set. Most evidence comes from geriatrician-led or team-based models, and from mixed hospital populations. The CINAHL and AgeLine searches are the best chance of adding nurse-delivered studies, and the synthesis will have to state clearly how much of its conclusion rests on evidence from models that included a physician.
References
Burton, J. K., Craig, L., Yong, S. Q., Siddiqi, N., Teale, E. A., Woodhouse, R., Barugh, A. J., Shepherd, A. M., Brunton, A., Freeman, S. C., Sutton, A. J., & Quinn, T. J. (2021). Non-pharmacological interventions for preventing delirium in hospitalised non-ICU patients. Cochrane Database of Systematic Reviews, 2021(11), Article CD013307. https://doi.org/10.1002/14651858.CD013307.pub3
Hshieh, T. T., Yue, J., Oh, E., Puelle, M., Dowal, S., Travison, T., & Inouye, S. K. (2015). Effectiveness of multicomponent nonpharmacological delirium interventions: A meta-analysis. JAMA Internal Medicine, 175(4), 512-520. https://doi.org/10.1001/jamainternmed.2014.7779
Kraonual, S., Thongpeth, W., & Thongpet, T. (2026). The effectiveness of nursing interventions for preventing postoperative delirium in older adults undergoing major orthopedic surgery: A systematic review. BMC Nursing, 25, Article 676. https://doi.org/10.1186/s12912-026-04821-7
Marcantonio, E. R., Flacker, J. M., Wright, R. J., & Resnick, N. M. (2001). Reducing delirium after hip fracture: A randomized trial. Journal of the American Geriatrics Society, 49(5), 516-522. https://doi.org/10.1046/j.1532-5415.2001.49108.x
Unal, N., Guvenc, G., & Naharci, M. (2022). Evaluation of the effectiveness of delirium prevention care protocol for the patients with hip fracture: A randomised controlled study. Journal of Clinical Nursing, 31(7-8), 1082-1094. https://doi.org/10.1111/jocn.15973
The Walden NURS 6341 Week 3 instructions
The third NURS 6341 week has students document a literature search. Break the question into concepts, choose databases, record exact strings, report yields and screening decisions and note gaps. Reproducibility is graded, so prose describing a search earns little next to strings someone could paste. Cite search guidance in APA 7. PubMed and CINAHL are standard for nursing questions, with Cochrane for reviews. A flow diagram helps but a yield table can serve. Record the date each search was run. Explain any concept you did not use as a filter. Present the strings in a table or code block so they can be copied exactly. A short yield table at each screening stage, from records found to studies included, makes the process transparent, and a final paragraph on gaps shows honest judgment.
Inside the NURS 6341 Week 3 example
The document reads as a protocol rather than as prose. The question sits at the top broken into concepts, and each concept holds a row of controlled vocabulary terms beside the free text synonyms that catch whatever indexing missed. Databases are listed with a reason apiece, including the specialty index a general search would skip. The strings themselves are reproduced exactly, operators and truncation intact, so anyone could paste them and see the same result. Limits carry justifications, and a date filter that would exclude a foundational paper is flagged rather than quietly applied. Yields are reported at each stage down through screening, with exclusion reasons counted. A short paragraph admits where the search remains weak.
Where the marks sit in the NURS 6341 Week 3 rubric
The row deciding this assignment is reproducibility, which is unusual enough that submissions often aim at the wrong target. Prose about searching earns very little. The example earns the row by printing what was run, in what order, with what came back, which is the difference between documentation and a description of documentation. A second row usually covers appropriateness: whether databases and terms suit the specialty rather than suiting habit. Losses gather wherever the record thins. A strategy with no counts cannot be assessed for rigor. A strategy hiding a filter that removed most of the yield reads as manipulation once a grader recalculates, and unjustified limits cost their own small row.
Common NURS 6341 Week 3 mistakes, and how to avoid them
Search records score poorly when strings are summarized. Paste them exactly. A second weakness is missing yields. Report numbers at each stage. Writers also skip screening rules. State inclusion and exclusion criteria. Avoid limiting by comparison or outcome too early. Explain why. Record dates. A string with subject headings and keywords combined by OR within concepts and AND between them shows the logic clearly. Close with where the search is thin and what you would try next. Run each string twice to confirm the yield before recording it. Note any database you could not access and what it might add.
Get a NURS 6341 Week 3 example written to your instructions
Send the prompt, your section's rubric and the question your search has to serve, and the desk documents a strategy for that question using the databases your library actually licenses. The first sample is free, returned inside 24-48 hours, strings and counts laid out so you can run them yourself and compare what comes back.
More NURS 6341 papers and MSN samples
- NURS 6341 Week 1: Discussion Post
- NURS 6341 Week 2: Topic Proposal
- NURS 6341 Week 4: Annotated bibliography
- NURS 6341 Week 5: Evidence appraisal
- NURS 6341 Week 6: Guideline critique
- NURS 6341 Week 7: Case analysis
- NURS 6341 Week 8: Discussion post
- NURS 6341 Week 9: Practice recommendation
- NURS 6341 Week 10: Scholarly paper
- NURS 6341 Week 11: Professional development plan
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- NURS 6331 Week 3: Modality Comparison
- NURS 6370 Week 3: Syllabus section
- NURS 6321 Week 3: Learning Objectives
NURS 6341 Week 3 questions, answered
Does the desk actually run the searches?
The strategy is written to be run, with strings, headings and limits set out so you can execute them in your own library and see what returns. Yields differ between institutions and shift week to week, so counts in a sample are illustrative rather than fixed, and your own numbers are the ones that belong in a submission.
Which databases belong in a specialty search?
At minimum the general nursing index and the medical one, plus whichever database covers your field, and often a guideline repository as well. The example justifies each choice in a sentence. Where your library lacks one of them, the strategy says so rather than listing a resource you cannot actually reach.
Do I need a flow diagram?
Some sections ask for one and others accept a counted table. The example carries counts in table form and notes the stages a diagram would show, which converts easily if your prompt requires it. What matters either way is that the numbers reconcile from first yield down to included studies.
Where can I find a free NURS 6341 Week 3 sample paper?
The delirium prevention search record is printed here with concepts, databases, exact PubMed strings, yields, screening and gaps.
Where is the search thin in NURS 6341 Week 3?
In studies of nurses delivering the prevention protocol alone, since most trials used geriatric teams.