Reply to this discussion post…Be sure that the responses to the  Post of peers include 2 peer reviewed references with content that demonstrates critical analysis and synthesis of references used. 
The clinical issues of interests that will be used to develop ones PICOT question correlates with the overuse of antibiotics being prescribed and antibiotic stewardship. The formation of the PICOT question includes the population of interests, the issue of interest or intervention, the comparison of interests, the expected outcome, and the time the intervention to achieve (Melnyk & Overholt, 2015). Therefore, the population will be elderly patients residing in long-term care facilities who overuse antibiotics which causes secondary issues and the outcome being the implementation of antibiotic stewardship programs within the timeframe of one month, is an example of a possible PICOT question relating to the topic of interest. 
            The search results from the Walden University library vary when adding words when using the Boolean operators. Examples of some of the databases utilized include CINAHL, MEDLINE, ProQuest, and PubMed. When using CINAHL with full text, the first phrase searched was antibiotic stewardship and overuse of antibiotics. This yielded 35 results correlating with antibiotic stewardship and the over prescribing of antibiotics. The search was further narrowed down by changing the date range to the past five years and checking the box for peer reviewed journal articles, which narrowed down the search yield to 28 results. To narrow down the search to include the specific age population one had in mind, the Boolean phrase of nursing homes or long-term care facilities was included, which yielded 3 results and helps to choose articles specifically related to ones topic. One of the articles found from this search included a study discussing the high rates of inappropriate antibiotic prescribing for presumed urinary tract infections in nursing home patients with the examination of the pathway for prescribing antibiotics and strategies such as antibiotic stewardship as interventions for improvement (Kistler, et al., 2017). Additionally, the other two articles listed discussed strategies to decrease antibiotic overuse in nursing homes and the impact overuse of antibiotics on suspected urinary tract infections in nursing homes have, which further correlates with the topic of choice. 
Strategies to increase the effectiveness of a database during the search related to the overuse of antibiotics being prescribed and antibiotic stewardship programs would be to narrow down the search by further eliminating unwanted factors. An example of this is checking the box for peer-reviewed scholarly journals and full text only. Another strategy is to narrow down the search date so newer information can be accessed and found. Other factors can be included in the search if one is looking for specific studies such as randomized control trials. Utilizing the database to its full potential helps promote the effectiveness on the information that is being searched related to the topic of choice.