PICOT is an approach for developing a nursing question in a format allowing users to approach different nursing research questions with a benefit of evidence-based practice. It eliminates the potential to assume various inappropriate and including it in the research as it is likely to skew the results to the extent of making them dysfunctional.
PICOT is an acronym standing for the following: P-Population or patient problem: It describes the patient in terms of health status, sex, age and race etc.
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I-Intervention: These are the plans for attempting to address the health issues of the patient. These actions include specific tests, medications and therapies. C-Comparison: Compares alternatives to the plan such as a different type of treatment or an alternative to treating a patient. O-Outcome- Stands for expected results after an intervention. It might be reducing symptoms, eliminating symptoms or attaining full health. T-The 'T' stands for the time it takes for an intervention to achieve the desired outcome or observation of the patients.
Time is optional as you can decide to concentrate on PICO only. A PICOT question format idea should be a consistent formula to develop researchable and answerable questions. The process of finding and evaluating evidence will be more straightforward when you create a good PICOT question.
PICOT questions should bring multiple concepts that relate to a research topic or a specific clinical situation together. Qualitative questions: Aim at gaining an understanding or discover the meaning of phenomena. These questions ask about the experience of a person or population regarding certain circumstances or situations. Quantitative questions: these are questions that compare two or more individuals sometimes groups based on different outcomes with an aim at discovering the cause and effect relationships.
The results of quantitative questions are associated with interventions or exposures. Forming a question using the PICO framework requires deeper thinking about the type of question to ask.
It should either focus on therapy, diagnosis, prognosis, etiology or prevention to give the question a particular domain. It will be a time-consuming and difficult venture to identify the most appropriate resources and find relevant evidence without a well-focused question.
PICO helps to form a question and facilitate quick and wider literature search. PICO framework helps to identify the main elements of a question and simplify writing a question statement.
These are some examples of PICO questions that fit to the framework. Example Does hand washing by healthcare providers reduce transmission of hospital-acquired infections? C-Alternative to hand washing such as wearing a mask or gloves.
O-reducing infection. Do turning bedridden patients reduce the risk of pressure ulcers than pressure mattresses? P-Pressure ulcers in bedridden patients. O-Prevent pressure ulcers. How do pregnant women diagnosed with obesity prefer dietary changes or workout to reduce weight during pregnancy and six weeks postpartum?
P-women diagnosed with diabetes. Therapy or prevention Diagnosis Prognosis Etiology. Company info nursedepo.A PICOT Question is a question that is formatted in an accepted format, and used to develop answerable, researchable questions, especially in nursing.
PICOT question mainly answers four main areas including populationintervention, control, outcome, and time. The three elements include population, the proposed intervention, the control to compare with the intervention, the expected outcome, and the time within which the intervention will be considered.
In high risk patients, does the use of silver-hydrogel urinary catheters reduce incidences of catheter-associated urinary tract infections compared to using uncoated urinary catheters per 1, patient days?
Owing to their vulnerability, high risk patients are at a higher risk of developing complications if the infections are not addressed. In addition, high-risk patients suffering from conditions such as diarrhoea, and diabetes are at a high risk of developing catheter-associated urinary tract infections CAUTIs. Among the high risk patients, use of normal urinary catheters significantly increases the costs of hospitalization. Moreover, using normal uncoated urinary catheters in high-risk patients increases the levels of morbidity and mortality.
High risk-patients in the intervention group were treated using silver-hydrogel urinary catheters. Following the introduction of the device, the patients were monitored regularly. High risk patients who had a UTI on admission and those who had long-term indwelling urinary catheters were excluded from the study.
In addition, urology patients and those who could not be contacted easily were excluded. High-risk patients in the control group were treated using the normal uncoated catheters. The exclusion criteria used was similar to that one of the intervention group. The patients were monitored through their inpatient stay during which they were evaluated for any symptoms of UTI.
Silver-coated catheters showed a significant reduction in the development of catheter-associated bacteriuria. The rate of non-coated catheter was 4. A study conducted by Gentry supports these results. This study found out that the use of silver-coated catheters led to a The results of these studies indicate that silver-coated catheters are beneficial to high-risk patients, and those requiring an indwelling catheter for longer than 48 hours. The process of writing a PICOT statement example starts with identifying an area of interest in nursing.
Once the area of interest is identified, the next process is to identify an issue that is prevalent in that area and seek to develop solutions towards addressing the problem. To develop the problem background, a thorough analysis of the most recent evidence based studies published in the last five years is important to gain an understanding of what is already covered in that area.
From the nursing literature reviewa gap is identified which forms the basis for formulating a PICOT statement to test a new intervention to address the problem. It is detailed and where possible, give examples. The intervention of interest is the correct hand washing following the laid down standards for the nurses and other medical personnel.
The comparison to this intervention is now washing hands, which include inaccurate hand washing practices. The main outcomes is reduction in the incidence of nosocomial infections, once the patients is admitted to the ICU. Correct hand washing practices during admission should result to lower rates of nosocomial infections once patients have been admitted. This is a crucial moment when most patients are likely to undergo different procedures where medical personnel use their hands.
This starts with doing a background research on a nursing health problem you are aware of, or going through recent health news to brainstorm the best health problem to research about. Then, narrow down to the most affected population and the particular nursing health problem they are facing and do a research on the possible nursing interventions and the timeframe those interventions can be done.
This will help you design the intervention and the time frame.Pssst… we can write an original essay just for you. The management of hypertension across the world still remains poor.
There is need to come up with measures that can effectively control the condition and in this in a bigger extent could significantly help to reduce the immortality rate of hypertension related deaths worldwide.
For effective control and management of hypertension, first, it would be veryvital to identify all the risk factors that arise as a result of lifestyle and those that are directly connected to the condition and device ways to manage these risk factors as this can be one way that may help to lower the blood pressure. Moreover, as an evidence-based practice strategy, it is very important when the following practices are followed: performing regular screening, observing and maintaining effective communication with the patients, coming up with a regular program for monitoring patients, and last but not least is strict adherence to treatment.
Above all, there is a very high likelihood of effective prevention and control of hypertension through implementation and observation of lifestyle change practiceslike eating a balanced and checked diet and engaging in physical exercise regularly as these are some of the strategies that can be uses help tocontrol blood pressure. Will the lifestyle change eating balanced and healthier diets and engaging in regular physical exercise by male patients with hypertension help in regulation of blood pressure and reducing the risk to development of cardiovascular related illnesses?
I — Intervention: The subjects will be subjected to lifestyle change eating balanced and healthier diets and engaging in regular physical exercise. C — Comparison: The patients will be compared to the hypertension patients who manage and treat the condition by using medication.
O — Outcome: The expected changes are regulation of blood pressure and reducing the risk to development of cardiovascular related illnesses. T — Time: The outcome would be assessed within the recovery phase of six months. This research paper gives a quantitative analysis of hypertension prevalence and how it relates with socio-demographics of the patients.
The study was based on a survey conducted on cross-sectional community where 1, respondents all aged above 30 years participated in the survey by engaging in personal interviews and taking of their anthropometric and blood pressure measurements. The results indicate a prevalence of hypertension at I chose this study because it gives statistical analysis, which is research-based, about the prevalence of hypertension among adults.
This research agrees with several other research conducted on different people whose outcome found the hypertension prevalence being higher in males as compared to females. Prevalence also increases as people age.
The study also noted family history of hypertension, obesity, and current diabetic status among others as some of the factors that correlate with hypertension. High blood pressure can be managed effectively if the magnitude of the condition and these correlates are identified and known. This quantitative research paper had the aim of studying the blood pressure and body dimensions and to establish the rate of prevalence of hypertension and obesity among young adults.
The participants were aged between 18 and 50 years of age. The variables that were measured include: weight, pulse rate, height, upper arm circumference, Body mass index BMIfat percentage, skinfold thicknesses, systolic blood pressure SBPand diastolic blood pressure DBP.
The findings of the research indicate that mean value of all the measured variables mentioned were found to be higher for men as compared to the measurements of their female counterpart but with exception of skinfold thicknesses. The Body mass index BMI and fat percentage of females was found to be higher when compared to that of males.
The study suggests that there is a direct correlation between percentage fat, Body mass index and both the systolic blood pressure, and diastolic blood pressures.Exercise-induced Pulmonary Hypertension – Can We Reach a Consensus?
Odds are high for subjects who are obese to develop hypertension as compared to subjects with normal Body mass index.
I chose this study because it quantitatively analyses the correlation between obesity and hypertension. Theprevalence of hypertension is higher in obese people as compared to those with normal weights. Also men are at risk of developing hypertension as compared to females.
There are inconsistencies in the available data that relates the association between tea consumption and the changes in the blood pressure. Consequently, Tong et al. The study was conducted on participants from China of them being men and women. The study period considered was over a five-year period.
The BP of the participants was measured in and The results shows that there existed an inverse proportionality between tea consumption and 5-year diastolic blood pressure but the same did not reflect on systolic blood pressure. When compared with no tea consumption, a daily consumption of at least 10g of team raised the diastolic blood pressure from 2.
I chose this study because it gives statistics on how diet can affect the blood pressure levels.Hypertension has been classified as consistent blood pressure BP equal to or greater than mm Hg systolic or 90 mm Hg diastolic in otherwise healthy adults. Only 34 percent have their BP under control.
In children, hypertension is defined as systolic or diastolic BP that is at or above the 95th percentile for age, sex, and height. Hypertension is a major risk factor for cardiovascular disease and mortality, accounting for an estimated 14 percent of cardiovascular deaths worldwide and 18 percent in high-income countries.
Vasan and colleagues report a lifetime risk of developing hypertension within adults aged 55—65 years in the United States as greater than 90 percent. Strategies aimed at the prevention or control of hypertension continue to be a foremost concern for providers and patients, policymakers and governments. Measuring BP to diagnose hypertension and monitor therapy is problematic. BP as recorded in the office or clinic setting is the most commonly used approach for measurement of BP in routine medical care.
Clinic BP measurements have great variability, which can affect accurate classification of patients. Reliable clinic measurements require adequate rest period prior to measurement, observer training, adjustment of the cuff size to the arm circumference, and slow deflation of the cuff. Even when measured according to established guidelines, clinic BP measurements have several limitations. Clinic BP measurements may not represent the usual BP outside of the clinic setting or the burden of BP throughout a day.
Additional problems with clinic BP measurement include terminal digit bias and variability in a small number of readings. Ambulatory BP monitoring is a noninvasive, fully automated technique in which BP is recorded over an extended period of time, typically 24 hours. A BP cuff is put around the upper arm and a connected monitor is preprogrammed to intermittently record BP, usually every 15 to 20 minutes during daytime hours and every 20 to 30 minutes during nighttime hours.
Patients are instructed to keep an activity log throughout the testing period for evaluation of stress and activity-related BP changes. This method is neither universally available nor practical on a population basis. Ambulatory BP monitoring will not be included in this report since it is not a question of interest and has been studied in a previous report. Devices for self-measured BP SMBP monitoring, also called home BP measurement, provide an opportunity to record BP at home, outside of the artificial setting of the medical office or clinic.
Devices used by patients can range from mechanical aneroid gauges sphygmomanometers that require self-inflation and self-auscultation, to those that require squeezing a bulb to inflate but display readings automatically, to those that automatically inflate the cuff and display the reading. Commonly, patients use SMBP monitoring to self record their BP at home and to provide written lists of readings to their provider at office visits; however, more recent innovations have enhanced the potential utility of SMBP devices to store and download readings that can be sent directly to the provider.Hypertension adds to the passing of many individuals all through the world, yet there is as yet poor administration of the condition.
Setting up compelling control measures could essentially control the quantity of passings around the world. To control and administration hypertension successfully, it is imperative to recognize and deal with the way of life hazard factors related with the condition as that brings down circulatory strain. Specifically, it is conceivable to avert and control the condition viably through way of life changes slim down and frequently captivating in work out as these serves to altogether direct pulse Dua et al, Evidenced based solution for patients with hypertension is to lower DBP and SBP below levels in which medication will be started.
There should be an alternative drug from a different class to take care of a patient. The period will be sufficiently long to make a patient to be capable not to experience the ill effects of hypertension and to likewise lessen the dangers that the people will ordinarily go through Howes, The primary technique for intercession for a patient with hypertension it is with no uncertainty to put them under prescription, so they can get cured.
That is the most secure path as it will influence the patient to have the capacity to deal with themselves as far as how they to think, what they eat and even the exercises that they attempt to participate in Dua et al, The age of the patients will likewise imply that the patients are given solution that can manage them in the most helpful ways and which they can acknowledge all in all. The medication that can be given for this situation is one that can decrease the cruelty of a medication.
The nursing intervention for patients with hypertension is assessing the headache pains that a patient is experiencing and checking the blurred vision in every four hours until it goes away.
Another nursing intervention is for a nurse to educate a patient on how they consult with their doctor before medication is stopped. The fundamental contrasting option to contrast with the mediation will have with do with influencing the patient to get the opportunity to do a considerable measure of activities.
Evidence Based Practice
That is one thing that will make the licenses to have the capacity to manage the issue of hypertension and since practices have been demonstrated that they work, it will then be simple for the patient to recuperate from the hypertension and what will imply that they will get cured from such an infirmity. Toward the end, all will have ended up being sure as the patient will have the capacity to get the coveted medication Howes, Patient care to those with hypertension is to first educate, measure the blood pressure and even give advice Education will entail modifying the behavior of a patient which is related to smoking, alcohol intake and how to manage stress.
In this exploration and managing a patient, it is with most likely that there are things that are being tended to and which are there to have the capacity to manage the way a patient gets the chance to react to pharmaceutical or even exercise.
The cerebral pains that are regularly seen in patients with antagonistic hypertension combined with the measure of considerations are the conditions that are to be wiped out in the patients that have hypertension.
The numerous unfavorable occasions in the patients will get diminished because of the patients having the capacity to be under pharmaceutical or notwithstanding sharing in practices that are useful for their wellbeing Dua et al, Healthcare agency for caring for patients with hypertension can be the likes of Intrepid USA Healthcare Services which gives Hypertension Management Program that helps patients get and have a maintained blood pressure that is healthy.
Nursing practice for patients with hypertension will be the likes of minimizing the cost of therapy, including a patient in making of decision and even implementation of treatment plans step by step. Dua, S. Body Mass Index Relates. Barriers to lifestyle risk factor assessment and management in hypertension: A qualitative study of Australian general practitioners. Journal of Human Hypertension27doi Intervention The primary technique for intercession for a patient with hypertension it is with no uncertainty to put them under prescription, so they can get cured.
Comparison The fundamental contrasting option to contrast with the mediation will have with do with influencing the patient to get the opportunity to do a considerable measure of activities. Outcome In this exploration and managing a patient, it is with most likely that there are things that are being tended to and which are there to have the capacity to manage the way a patient gets the chance to react to pharmaceutical or even exercise.
Order Now.Hypertension contributes to the death of many people throughout the world, yet there is still poor management of the condition.
Establishing effective control measures could significantly help to control the number of deaths worldwide. To control and management hypertension effectively, it is important to identify and manage the lifestyle risk factors associated with the condition as that helps to lower blood pressure.
In addition, it is vital to perform regular screening, communicating effectively with patients, monitoring patients on a regular basis, and adhering to treatment. In particular, it is possible to prevent and control the condition quite effectively through lifestyle changes diet and regularly engaging in exercise as these help to significantly regulate blood pressure.
Dua, S. Background: The blood pressure and anthropometric measurements are important for evaluating the health of children, adolescents as well as adults. Materials and Methods: A cross-sectional study was conducted of all the people belonging to the Punjabi community, residing in Roshanara area and Jaina building in Delhi, for the past 20 years and aged years.
The men were engaged in transport business and women were mainly housewives. Results: Mean values of all the measurements, that is, height, weight, upper arm circumference, pulse rate, systolic blood pressure SBPand diastolic blood pressure DBP were higher among males as compared with females, except skinfold thicknesses.
Body mass index BMI and fat percentage was found to be higher among females as compared with males. Barriers to lifestyle risk factor assessment and management in hypertension: A qualitative study of Australian general practitioners. Journal of Human Hypertension27doi Hypertension is a leading cause of mortality and disease burden worldwide, yet its management remains suboptimal.
Identification and management of lifestyle risk factors should be a clinical priority in all patients because of the beneficial effects of lifestyle intervention on blood pressure. The objective of this qualitative focus group study was to identify barriers to lifestyle management in hypertension in Australian general practice.
Purposeful sampling was used to select large group practices. An iterative thematic analysis was conducted. Overall participants felt they had the required knowledge to provide broad lifestyle advice. However, cynicism dominated due to an overwhelming lack of success in practice. Patient reluctance and ambivalence were identified as major barriers but participants were willing to share the responsibility. Other barriers included time, reduced access to allied health and broader determinants of health.
NSG 607 - Evidence-Based Practice
General practitioners need to be empowered to allow continuation of valuable lifestyle advice and counselling. System issues need to be addressed to provide better streamlined care. Hypertension is a leading cause of premature death worldwide and the most important modifiable risk factor for cardiovascular disease. Effective screening programs, communication with patients, regular monitoring, and adherence to treatment are essential to successful management but may be challenging in health systems facing resource constraints.
We conducted in-depth interviews and focus group discussions with 26 individuals with hypertension and 4 family members in two regions.
Few participants were aware of ways to prevent high blood pressure. Once diagnosed, most reported taking medication but had little information about their condition and had a poor understanding of their treatment regime. The desire for good communication and a trusting relationship with the doctor emerged as key themes in promoting adherence to medication and regular attendance at medical appointments. Barriers to accessing treatment included co-payments for medication; costs of transport to health care facilities; unavailability of drugs; and poor access to specialist care.
Some patients overcame these barriers with support from social networks, family members and neighbours. However, those who lacked such support, experienced loneliness and struggled to access health care services.
The health insurance scheme was frequently described as administratively confusing and those accessing the state subsidized system believed that the treatment was inferior to that provided under the compulsory contributory system.Who is the patient s or population and what is their particular condition or healthcare problem?
Does your question include a "counter intervention" or exposure, e. Outcomes of interest from a clinical and patient perspective; what do you want to accomplish? Every time we see a patient, we need new information about some element of the diagnosis, prognosis or management. Because our time to try to find this information is often limited, we need to be very efficient in our searching.
To achieve this efficiency, we need to become skilled at formulating clinical questions.
Self-Measured Blood Pressure Monitoring
Express your clinical question in the PICO format. Two additional elements of the well-built clinical question are the type of question and the type of study.
This information can be helpful in focusing the question and determining the most appropriate type of evidence or study. How to select treatments that do more good than harm and that are worth the efforts and costs of using them. Example of a Therapy Question. Example of a Diagnosis Question. Worldviews on Evidence-Based Nursing, 2, — Contact the Library Help Desk if you need assistance: E-mail : refdesk nu.
All rights reserved. Start with the patient: clinical problems and questions arise out of patient care Translate the clinical questions into a searchable question using PICOT Decide on the best type of study to address the question Perform a literature search in the appropriate source s.
Is your clinical question answerable? C - Comparison: treatment, placebo, gold standard diagnostic test, absence of risk factor, etc. Questions about the effectiveness of interventions in improving outcomes in sick patients and patients suffering from some condition. Clinician treatments are most likely medications, surgical procedures, exercise, counseling about lifestyle changes.
Randomized controlled trial, cohort study DIAGNOSIS How to select and interpret diagnostic tests Example of a Diagnosis Question Questions about the ability of a test or procedure to differentiate between those with and without a condition or disease.
Example of a Prognosis Question. Example of an Etiology Question. Most frequently asked. Questions about the ability of a test or procedure to differentiate between those with and without a condition or disease. Prospective, blind comparison to a gold standard or cross-sectional. Questions about the harmful effect of an intervention or exposure on a patient.