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    Respond to your colleague providing further suggestions on how their database search might be improved. At least 2 references in each peer responses!     My PICO(T) question is; In preschool-age children (P), how does receiving the flu vaccine (I) compare to not receiving the vaccine (C) impact the risk of severe illness or death related to flu (O) during the flu season (T)?  The primary databases I used were Pubmed and CINAHL Plus with full text.  The search terms I used were; Flu Vaccine; and Children; Effectiveness of Flu Vaccine and Children; Flu Vaccine and Children and School Age; Effectiveness of Flu Vaccine and Statistics and Children.   When I searched CINAHL, there were 1,798 results.  I narrowed the search to peer-reviewed articles and changed the dates, so they ranged from 2015 to 2020 to show the most recent articles in evidence-based practice.  After adding these Boolean operators, I had 176 peer-reviewed articles.  Walden Library (2020), recommends using Boolean terms to create a more precise search with more relevant results.  A recent study concluded that it is essential to search at least three different databases to retrieve approximately 90% of all the relevant literature on a subject (Ho, Liew, Ng, Shunmugam, & Glasziou, 2016).  A strategy to increase the rigor and effectiveness of a database search is to use alternative terms.  I could try searching alternative words such as “Influenza,” “juvenile,” or “youth” to improve my results.  On PubMed, I used the advanced search filters to narrow my search.  I clicked to view articles that only studied humans and that were published within the past five years.  Another strategy is to utilize a feature on PubMed called Clinical Inquiries.  Clinical Inquiry is designed to improve search results by linking the type of question, therapy, diagnosis, or prognosis to a stored search strategy that retrieves the appropriate research methodology (Schardt, 2007).  Utilizing all of these techniques will help improve my search results to find the most relevant peer-reviewed articles for my topic. 

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