Questions and an Evidence-Based Approach
Create a 3-5-page submission in which you develop a PICO(T) question for a specific care issue and evaluate the evidence you locate, which could help to answer the question. PICO(T) is an acronym that helps researchers and practitioners define aspects of a potential study or investigation. It stands for: P Patient/population/problem. I Intervention. C Comparison (of potential interventions, typically). O – Outcome(s). T – Time frame (if time frame is relevant). The end goal of applying PICO(T) is to develop a question that can help guide the search for evidence (Boswell Cannon, 2015). From this perspective, a PICO(T) question can be a valuable starting point for nurses who are starting to apply an evidence-based model or EBPs. By taking the time to precisely define the areas in which the nurse will be looking for evidence, searches become more efficient and effective. Essentially, by precisely defining the types of evidence within specific areas, the nurse will be more likely to discover relevant and useful evidence during their search. You are encouraged to complete the Vila Health PCI(T) Process activity before you develop the plan proposal. This activity offers an opportunity to practice working through creating a PICO(T) question within the context of an issue at a Vila Health facility. These skills will be necessary to complete Assessment 3 successfully. This is for your own practice and self-assessment and demonstrates your engagement in the course. Demonstration of Proficiency By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria: Competency 1: Interpret findings from scholarly quantitative, qualitative, and outcomes research articles and studies. Explain the findings from articles or other sources of evidence. Competency 2: Analyze the relevance and potential effectiveness of evidence when making a decision. Identify sources of evidence that could be potentially effective in answering a PICO(T) question. Explain the relevance of the findings from chosen sources of evidence to making decision related to a PICO(T) question. Competency 3: Apply an evidence-based practice model to address a practice issue. Define a practice issue to be explored via a PICO(T) approach. Competency 5: Apply professional, scholarly communication strategies to lead practice changes based on evidence. Communicate using writing that is clear, logical, and professional with correct grammar and spelling using current APA style. Reference Boswell, C., Cannon, S. (2015). Introduction to nursing research. Burlington, MA: Jones Bartlett Learning. Professional Context As a baccalaureate-prepared nurse, you will be responsible for locating and identifying credible and scholarly resources to incorporate the best available evidence for the purposes of enhancing clinical reasoning and judgement skills. When reliable and relevant evidence-based findings are utilized, patients, health care systems, and nursing practice outcomes are positively impacted. PICO(T) is a framework that can help you structure your definition of the issue, potential approach that you are going to use, and your predictions related to the issue. Word choice is important in the PICO(T) process because different word choices for similar concepts will lead you toward different existing evidence and research studies that would help inform the development of your initial question. Scenario For this assessment, please use an issue of interest from your current or past nursing practice. If you do not have an issue of interest from your personal nursing practice, then review the optional Case Studies presented in the resources and select one of those as the basis for your assessment. Instructions For this assessment, select an issue of interest an apply the PICO(T) process to define the question and research it. Your initial goal is to define the population, intervention, comparison, and outcome. In some cases, a time frame is relevant and you should include that as well, when writing a question you can research related to your issue of interest. After you define your question, research it, and organize your initial findings, select the two sources of evidence that seem the most relevant to your question and analyze them in more depth. Specifically, interpret each source’s specific findings and best practices related to your issues, as well explain how the evidence would help you plan and make decisions related to your question. If you need some structure to organize your initial thoughts and research, the PICOT Question and Research Template document (accessible from the “Create PICO(T) Questions” page in the Capella library’s Evidence Based Practice guide) might be helpful. In your submission, make sure you address the following grading criteria: Define a practice issue to be explored via a PICO(T) approach. Identify sources of evidence that could be potentially effective in answering a PICO(T) question. Explain the findings from articles or other sources of evidence. Explain the relevance of the findings from chosen sources of evidence to making decision related to a PICO(T) question. Communicate using writing that is clear, logical, and professional with correct grammar and spelling using the current APA style. Example Assessment: You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like: Assessment 3 Example [PDF]. Additional Requirements Your assessment should meet the following requirements: Length of submission: Create a 35-page submission focused on defining a research question and interpreting evidence relevant to answering it. Number of references: Cite a minimum of four sources of scholarly or professional evidence that support your findings and considerations. Resources should be no more than 5 years old. APA formatting: Format references and citations according to the current APA style. PICOT EXAMPLE PLEASE READ Creating a question using the PICOT elements will provide a framework for the research you need to conduct an evidence-based study or to make an evidence-based decision. PICOT Elements: (P) Population, Patients or Problem: The sample of subjects used in a study, or the problem being addressed. (I) Intervention: The treatment that will be provided to subjects enrolled in your study. (C) Comparison or Control: Identifies an alternative intervention or treatment to compare. Many study designs refer to this as the control group. If an existing treatment is considered the gold standard, then it should be the comparison group. A control group is not required for every type of study. (O) Outcome: The clinical outcome that measures the effectiveness of the intervention. (T) Time: Duration of the data collection. Some versions don’t include this element, and time may not be specified in cases where the question is focused on prediction or diagnoses. PICOT Question Formats: Intervention: In _______ (P), how does _______ (I) compared to _______ (C) affect _______ (O) within _______ (T)? Prognosis/Prediction: In _______ (P), how does _______ (I) compared to _______ (C) influence/predict _______ (O) over _______ (T)? Diagnosis or Diagnostic test: In _______ (P) are/is _______ (I) compared to _______ (C) more accurate in diagnosing _______ (O)? Etiology: Are _______ (P), who have _______ (I) compared to those without _______ (C) at _______ risk for/of _______ (O) over _______ (T)? Meaning: How do_______ (P) with _______ (I) perceive _______ (O) during _______ (T)? Example PICOT Questions: In acute care hospitals (P), how does having a rapid response team (I) compared with not having a response team (C) affect the number of cardiac arrests (O) during a three-month period (T)? In women with gestational diabetes (P), how does a monitored diet and exercise program over the course of pregnancy (I &T), compared to the use of metformin only (C) reduce the incidence of high birth weight babies(O)? In patients admitted for acute myocardial infarction (P), how well does the hospital’s new data model created from EMR data (I) compared to current practices (C) predict readmission rates (O) within 30 days after initial discharge (T)? For patients of a rural health clinic (P), does the use of text message reminders (I), compared with telephone calls (C) reduce the number of missed appointments (O) over a six month period (T)?