NURSING PICOT QUESTIONS IN PUBLIC HEALTH

[Pages:5]NURSING PICOT QUESTIONS IN PUBLIC HEALTH

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NursingPICOTquestionsinpublichealth ThestudywillconcentrateinexaminingtheapplicationofPICOTformulain thefield ofpublichealth.Someoftheissuesthatwillbeused include Alzheimer'sdisease,vasectomy,furunculosis,premature birth,pregnancy, andtheDown'ssyndrome.Theselectedissueswillbeusedtodiscusshow nurses use PICOT formula to acquire necessary information needed for effective intervention. The PICOT format is often used to formulate questions in Nursing Evidence-Based Practice.PICOT isan acronym,which standsforpatient problem/population,intervention,comparison,outcome,and time (Lipman 35).Thepatientproblem/populationguidesapractitionertounderstandthe patient,sex,age,health status,or the population under consideration. Interventionleadsonetoaskthequestionregardingtheplanforthepatientin question,thatis,specificmedications,therapies,and parison impliestheavailablealternativesforthechosenplan.Inthatcase,therecan be no treatmentorvarioustreatmentoptions.The outcome helpsthe practitionertonarrow downtowhatissought.Thefieldcanincludecertain elementsincluding fullhealth,no symptoms,and lesssymptomsamong others(MateoandMarquis87).Timeisanotherfundamentalcomponentof Evidence-BasedPractice.Thetimeframeforanycaseisalwaysenlisted.In somecases,theTcanalsoimplythetypeofstudy.

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PICOTquestionsfallintofourtypes,namely:prevention/therapy,diagnosis, etiology,andprognosis.ThePICOTformatassistsincreatingausefulclinical questionandsearchingforrelevantpublicationsandstudies.Forinstance,ifa nursedesirestounderstandtheeffectoffluvaccinationontheadvancement ofpneumoniainanoldadult,theprofessionalcanfillintheblankspaceslike this: In------------------(P),how does------------------(I)compareto----------------------(C) effect----------------------(O)over-------------------(T).Thequestionwillthenappear asfollows;inapatientaged65years,howdoestheapplicationofaninfluenza vaccine compare to the failure to receive vaccine influence the risk of contractingpneumoniaduringafluseason?

Inmostcases,questionsmaybeformulatedbasedonthefourcategories. Forintervention,itwillcoverawidespanofactivitiesemanatingfrom drug treatments,clinicaltherapies,socialactivities,andlifestylechangesamong others(Lipman59).Interventionscanencompasseitherpopulationhealth activities or individualpatient care.For example,a 30-year old male experiencesrecurrentfurunculosisforthepastsevenmonths.Theepisodes keep recurring despite being treated with drainage and various courses of antibiotics.Thepatientinquiredwhethertherecurrentskinboilscouldbe prevented.Thecasecanbeconvertedintoananswerablequestion,usingthe PICOT formula as follows:In patient with persistent skin boils,does prophylacticantibiotics,comparedtonotreatment,lessentherecurrence rate? The question effectively satisfied the population, intervention, control, and outcome requirements.

Etiologyandriskfactorsarequestionsthatassistinexaminingpossible causesofillnessordisease(FreshwaterandGary32).Theyaretheopposite ofinterventionquestionssincetheytargetharmfuloutcomesofexposureor activities.

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Suchquestionsoftenemergeregardingpublichealthissues,likeincreased riskofcancerduetoexposuretoanenvironmentalchemicalorincreasedrisk ofheartdiseasebecauseofconsumingcertainfoods.Example:Walterdesires to discussthe possibility ofa vasectomy.He hasbeen informed that vasectomyincreasestheriskoftesticularcancerlaterinlife.Asapractitioner, youunderstandthattheriskislow,butwanttogiveWalteramoreprecise answer.APICOquestionforthecasewillgolike:Inmen,doesundergoinga vasectomy,comparedtonothavingone,heightentheriskofdevelopmentof testicular cancer in the future? Population?adultmales Intervention ? Vasectomy Control?novasectomy Outcome?Testicularcancer

Thequestionsforfrequencyorrateconcernthenumberofpeopleina populationfacingahealthproblem (FreshwaterandGary46).Thequestions mayconcentrate on issues,such asthe rate ofAlzheimer'sdisease in individualsover70yearsorprevalenceofhearingproblemsamonginfants.It becomesaquestionofrateifitincludesatimeperiod,forinstance,thecases ofinfluenzainsummerversuswinter.Example:Dorothyisan8-week-oldbaby undergoing herroutine follow-up.The babywasborn prematurelyat36 weeks.Asaprofessional,youwanttoinformtheparentsaboutherlikelihood ofdevelopinghearingproblems.PICO question:Inprematurelyborninfants, comparedtothosebornnormally,whatistheconsequentialprevalenceof sensory deafness? Population ? infants Intervention ? premature Comparator?full-term Outcome?Sensorydeafness

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Diagnosis questions revolve around the accuracy ofdiagnostic tests in differentpatientgroupsincomparisontootheralternativetests.Theaccuracy oftestsincludesspecificityandsensitivity(Sturmey12).Example:Juneis havinghersecondpregnancy.At33,shehadherfirstbabyandunderwent amniocentesisto establish whetherthe babyhad the Down'ssyndrome. Althoughthetestswerenegative,itwasnotagoodexperiencebecauseshe receiveditat18weeks.Currently,sheisonemonthpregnantattheageof35. Shedesirestohaveatestthatcanproduceanearlierresult.Accordingtoher localhospital,nuchaltranslucencyultrasoundandserumbiochemistryarethe availablefirsttrimestertestsforthedisease.Asaprofessional,youdesireto establishwhethertheoptionsareasreliableasthetraditionalamniocentesis. PICO question:Foraone-monthpregnantwoman,isserum biochemistry testing plus nuchal translucency ultrasound as accurate as the traditional amniocentesisforDown'ssyndrome? Population?pregnantwoman Intervention?Serumbiochemistryplusnuchaltranslucencyultrasound Comparator?Conventionalamniocentesis Outcome ? Accurate diagnosis

WorksCited Freshwater,Dawn,andGaryRolfe.DeconstructingEvidence-BasedPractice.Taylorand Francis,2012. Lipman,Toby."Evidence-based Practice in GeneralPractice and Primary Care." Evidence-basedPractice,9Mar.2014,pp.35-65. Mateo,MagdalenaA,andMarquisD.Foreman.ResearchforAdvancedPracticeNurses: FromEvidencetoPractice.SpringerPub,2014. Sturmey,Peter."Evidence-Based Practice." Evidence-Based Practice and Intellectual Disabilities,2014,pp.1-28.

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