Nursesteve.weebly.com



PICO PaperSteve RichFerris State UniversityPICO PaperIn the healthcare field standards and best practice is always changing. It is important especially for nurse to maintain adequate knowledge in new practices. The best way to stay informed is through research studies and journals. A PICO paper is used to review research and to show supporting facts on a subject. This form of paper is used to help educate staff, find new and improved protocols, and also stay up to date on new knowledge in the clinical setting. In this PICO paper articles will be reviewed on the subject of what interventions will help decrease pulmonary complications in the hospitalized patients, including incentive spirometer or prophylactic antibiotics. Several articles will be review for the choice of intervention in these patients. “The purpose of this assignment is to reflect how nursing knowledge is disseminated for use in personal and professional practice” (Ferris State University, 2014).Clinical QuestionThe first step to finding useful research is writing a clinical question to help narrow down the results and eliminate unreliable information. The PICO question is a question format that helps the writer form a clinical question correctly. PICO question is an acronym standing for population, intervention, comparison, and outcome. In the population part of the question, this is where the writer chooses if the question is about pediatrics, adults, or any other population that could taper the results. The next section of the question is interventions; interventions are actions that can affect the outcome of the patients. In most cases the question identifies two interventions. Which brings us to the next piece of the question, comparison. In the PICO question, there is the comparison of the two interventions for which one is more effective for the population and which will result in a better outcome for the patient. Outcome is the last portion of the question. This is what the interventions should prevent or help with in these patients.In this paper, the clinical problem discussed is pulmonary complications associated hospitalized patients. Hospitalized patients are at risk for developing these complications because of not moving and laying in bed. This causes respiratory secretions to settle in the lungs and become a good habitat for bacteria growth. This causes the patient to develop pneumonia and possibly prolong the hospital stay. This also affects the overall outcome of the patient. This brings us to the PICO question of, does using an incentive spirometer reduce the risk of pulmonary complications compared to using antibiotics in hospitalized patients? If nurses had interventions that clearly worked the best, it would be easier for nurses to advocate for patients safety and health to help prevent these complications.MethodologyResearching a specific topic can be difficult in finding good reliable information. If the question is to general, the results of the research could be extensive and very difficult to sort through to find good research. Another problem of researching if the question is to the point the results could be limited. When there are too few of articles to choose from, finding good nursing research is difficult. It is important for the researcher to modify the questions being asked in the database to find good research with a good amount of sources.When researching a topic it is important for researcher to identify the authors and pick authors of the same background or credentials. For an example, nurses need to try to find authors that are nurses for their research. Nurses have the same mindset and background of knowledge of other nurses. Doctor or physician articles tend to go to in-depth or are to specific for nursing needs. Many thing discussed in this research is out of a nurses scope of practice. Another item researchers should identify is the level evidence. Which is the type of evidence and where the facts came from. This level of evidence scale range from level 1, which is the best to level 7, which is least reliable. Level 1 is “systematic review & meta-analysis of randomized controlled trials; clinical guidelines based on systematic reviews or meta-analyses” (Melnyk & Fineout-Overholt, 2011). This means it is the best research and will have good finding from this article. Level 7 is an expert opinion. This has some quality information but is not backed by statistical findings. All the levels are capable of having great reliable information for study.Discussion of LiteratureThe first article for discussion, The Efficacy Of Postoperative Incentive Spirometry Is Influenced By The Device-Specific Imposed Work Of Breathing, which is written by two MD’s and was not approved by the IRB, but still have great information. The problem of this study was clearly stated and researched throughout the study. The problem discussed is whether incentive spirometer is affective improving the work of breathing and helping preventing pulmonary complications. This study used “prospective, randomized, single-blind clinical trial” (Weindler, 2001). This organized 30 male patients that elected to have abdominal, thoracic, or both. The study tested whether there was an impact on the device used. This is reliable information because of the article being a level 2 of evidence. This article had good information and supplied facts of the importance of the incentive spirometer.The results from this article proved that the importance of incentive spirometer use in hospital patients. “Incentive spirometers with a low additional WBimp allow improved maximal sustained inspiration and therefore might be more suitable for postoperative respiratory training” (Weindler, 2001). This sustained inspiration is helpful in loosening secretions and preventing stasis of secretions.The next article to be reviewed is Incentive spirometry after abdominal surgery, which was an article presented in the journal . This article discussed the risk of patients developing pulmonary complications as well as the appropriate use. This article was written by a professor at the School of Nursing at the University of North Carolina. The article was not approved by IRB. Problem stated in this article was the amount pulmonary complications as a result of abdominal surgery. The sample was appropriate because it was hospital patients at risk for developing pulmonary complications. The article used references that were creditable. References were a mixture of nursing sources and other researchers data. The data that was collected was level 6 evidence. Which means, “single descriptive or qualitative study” (Melnyk & Fineout-Overholt, 2011). This article had some very good information on incentive spirometer.Results from this article supported the information of importance use of incentive spirometer. “Incen-tive spirometry is beneficial for patients affected in this way as it promotes deep breaths, which will aid their recovery. Nurses play an important role in teaching patients how to use an incentive spirom- eter and the underlying principles” (Davis, 2012). Incentive spirometer is very important in helping prevent pulmonary complications and will help patients to a faster and healthier recovery.The last article, The essentials of hospital-acquired pneumonia, has an author that is an RN and the Director of Infection Control and Infusion Services at the University of Louisville Hospital. This gives great nursing background research. The question that was answered in this article was “how to prevent hospital acquired pneumonia?” The sample of this study was hospital patients that are at risk for developing antibiotics. This article used facts for treatment and well as risk factors for these patients. This article also used level 6 evidence. This article had few statistical facts to support antibiotics and also incentive spirometers. The article suggests that antibiotics should be used once the organism of infection is identified. “The ATS and the Infectious Diseases Society of America updated their con- sensus statement on the consistent and evidence-based treatment of HAP in 2005. This treatment guideline emphasizes using antibiotics that are effective against a wider variety of organisms and changing the antibiotic only when the pathogen has been identified” (Goss, 2008). Once the organism is identified is then, quick choice and change of infusion of the antibiotics is important. This will give the patient the best outcome.Significance to NursingThe finding from this research indicates that incentive spirometer is better used to help prevent pulmonary complications. Incentive spirometers help promote lung expansion to help mobilize secretions and prevent the settling of secretions in the lungs. Antibiotic use is more to treat the complications like pneumonia. Antibiotics are more efficient when the organism causing infection is identified. The use of incentive spirometer is a nursing intervention and should be used in addition to the antibiotic order. The incentive spirometer should be given and instructed on use to any patient with risk of developing pulmonary complications like surgical patients, immobile patients, and the nurse should use their clinical judgment.Nurse’s goals should be centered on the care and safety of out patients. It is important that nurses continue to learn and maintain knowledge to encourage the safety of our patients. The QSEN goal is “comprehensive, competency based resources to empower nurses with knowledge, skills, and attitudes to improve the quality and safety across the healthcare system” (QSEN, 2014). This statement made is showing how following QSEN guidelines could improve nurse’s abilities. Nurses need to continue to strive for better nursing skills to help provide better care to their patients. QSEN is a great resource for nurses in professional values, healthcare policies, and also evidence based practice.The PICO paper and research that was done helped to identify good research with supportive information to help identify the best interventions. Incentive spirometer use is important in preventing pulmonary complications like pneumonia. This device also could be used in helping pneumonia from getting worse or spreading in the lungs. Antibiotic used after an infection is identified. The type of antibiotic that is used to treat pneumonia directly depends on the organism. Incentive spirometer was a clear choice for preventing pulmonary complications like pneumonia.ReferencesDavis, S. Incentive spirometry after abdominal surgery. Nursing Times, 108, 22-23. Retrieved from Ferris State University (2014). NURS 350 research in nursing course syllabus. Retrieved from , L. K. (2008). The essentials of hospital-acquired pneumonia. Nursing made Incredibly Easy!, 32-42. Retrieved from , B.M. & Fineout-Overholt, E. (2011). Evidence-based practice in nursing and healthcare: A guide to best practice. Philadelphia: Lippincott, Williams & Wilkins.QSEN | Quality and Safety Education for Nurses. (2014). QSEN. Retrieved from , J. (2001). The Efficacy Of Postoperative Incentive Spirometry Is Influenced By The Device-Specific Imposed Work Of Breathing. Chest, 1858-1864. Retrieved from ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download