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NRS 433Topic 1 DQ 1 Describe the difference between a nursing practice problem and a medical practice problem

NRS 433Topic 1 DQ 1 Describe the difference between a nursing practice problem and a medical practice problem

Apr 4-6, 2022
PICOT is utilized by the health care community to identify and study a nursing or medical practice
problem. Consequently, PICOT examples that may provide insight into the use of the PICOT process,
may not be relevant to nursing practice as they are based on a medical practice problem.
Describe the difference between a nursing practice problem and a medical practice problem. Provide
one example of each. Discuss why is it important to ensure your PICOT is based on a nursing practice
problem.
Gale Storm-Bryant
Posted Date
Apr 13, 2022, 7:44 PM
Re-Post
Nurses practice revolves around the nursing process (Toney—Butler, Thayer, 2021). Nurses practice
revolves around the improvement of the patient and the care process. It resembles the PICOT in many
ways like the intervention/would be the planning process, the comparison/would be the
implementation and the outcome /would be the evaluation. PICOT is used to develop the question
needed to be researched and answered with evidence (Helbig, 2018) and the nursing process steps
provide answers in the evaluation phase. The difference between a nursing or medical practice problem,
nurses practice works to improve patient care and medical provides the cause or pathology of the
patient. Nurses must practice within their scope of practice (OP, 2010). It is important for nurses to
ensure their PICOT is based on nursing care and not a diagnosis. Nursing diagnosis is different from
diagnosing a patient's health issue for treatment as doctors do. Nurses must remain within their scope
of practice.
PICOT question is the first step in evidence-based practice, and many times the question is written
poorly. It should not be written in past tense, its used to help search for the best evidence to answer the
question (Gallagher Ford, 2019). It has been noted that there is difficulty in finding quality information
and at times we lack the skills to evaluate the literature. There is a evidence-based research tool (EBR)
which improved the ability of nursing students to find and review articles and correctly apply the PICOT
(Long, et al., 2016).

An example of a nursing PICOT:
P: Patient – Adults 65 and over with constipation
I: Intervention – Encourage to exercise 45 min per day
C: Comparison – Patients who do not exercise
O: Outcome – Increased bowel movements in a week

T: Time Frame – 1 month

An example of a medical PICOT:
P: Patient – 65-year-old complaining of knee pain
I: Intervention – MRI
C: Comparison – MRI of normal knee
O: Outcome – Diagnosis of Arthritis
T: Time Frame – 2 weeks

References:

Gallagher Ford, L., & Melnyk, B. M. (2019). The Underappreciated and Misunderstood PICOT Question:
A
Critical Step in the EBP Process. Worldviews on Evidence-Based Nursing, 16(6), 422–423. https://doi-
org.lopes.idm.oclc.org/10.1111/wvn.12408

Helbig, J. (2018). History and Process of Nursing Research, Evidence-Based Nursing Practice, and
Quantitative
and Qualitative Research Process. Grand Canyon University (Eds.), Nursing Research:
Understanding Methods for Best Practices. https://lc.gcumedia.com/nrs433v/nursing-research-
understanding-methods-for-best-practice/v1.1/#/chapter/1

Long, J. D., Gannaway, P., Ford, C., Doumit, R., Zeeni, N., Sukkarieh, H. O., Milane, A., Byers, B., Harrison,
L., Hatch, D., Brown, J., Proper, S., White, P., & Song, H. (2016). Effectiveness of a technology‐based
intervention to teach evidence‐based practice: The EBR tool. Worldviews on Evidence-Based Nursing,
13(1), 59–65. https://doi-org.lopes.idm.oclc.org/10.1111/wvn.12132

Office of Professions (OP), (2010, June 18th). Education Law. Article 139, Nursing
http://www.op.nysed.gov/prof/nurse/article139.htm#sect6902

Toney-Butler TJ, Thayer JM. [Updated 2021 Jul 9]. Nursing Process. StatPearls [Internet].
https://www.ncbi.nlm.nih.gov/books/NBK499937/

Wanda Felder
Posted Date
Apr 10, 2022, 6:59 PM

Remember to complete your PICOT, by including each of the elements listed in the image below.

https://i.pinimg.com/originals/de/67/6d/de676d6fbfc11dfa2e1cacebdb29ae5b.png
Tamara Houston
Posted Date
Apr 7, 2022, 6:19 AM
Replies to Gale Storm-Bryant
PICOT is a method used when developing a quality improvement project or lead to EBP (Helbig, 2018).  It
breaks down to five parts Patients/problem, Intervention, Comparison, Outcome, and Time which is
used to develop a question to hypothesize changes that can be made in nursing or medical practice for
patient improvement. Nursing practice problems are problems that occur during routine nursing
practice as it relates to the patient’s condition. A medical practice problem is one that occurs with the
disease process of a patient involving the medical condition or disease.
An example of a nursing practice problem would be
P: Hospital Staff
I: Hand Sanitizer
C: Handwashing using soap and water
O: Minimize the spread of hospital acquired infection
T:  3 consecutive months

An example of a medical practice problem would be:
P: Post op patient

I: Prophylactic Antibiotic Therapy
C: Pre-Op & Post Op Antibiotic therapy
O: Reduction of Surgical Site infection
T: Three consecutive months

It is important to ensure a PICOT is based on a nursing practice problem to prevent practicing in the
scope of medicine by way of conducting a clinical research study versus an evidence-based practice
project. Research questions are posed with the intention of generating new knowledge or verifying that
published findings are reproducible (Zuzelo, 2018). Nurses use evidence-based practice to provide
patients with safe, quality care and to improve outcomes (Helbig, 2018). The goal is to improve nursing
processes that produce safe patient outcomes during nursing care.

Helbig, J. (2018). History and process of nursing research, evidence-based nursing practice, and
quantitative and qualitative research process. Nursing research: Understanding methods for best
practice. https://lc.gcumedia.com/nrs433v/nursing-research-understanding-methods-for-best-
practice/v1.1/#/chapter/1

Zuzelo, Patti Rager (2018) Evidence-based practice methodology. Holistic Nursing Practice: Volume 32
(6)- p 340-342 doi: 10.1097/HNP.0000000000000297. Retrieved
from https://journals.lww.com/hnpjournal/Citation/2018/11000/Evidence_Based_Practice_Methodolog
y__Use_the.9.aspx


Gale Storm-Bryant
replied toTamara Houston
Apr 7, 2022, 11:35 PM
 Replies to Tamara Houston
Tamara,
Your post was very clear,
Research produces positive and negative outcomes. It does not always produce what the researcher is
looking for. When looking at different processes that can be used for research a pilot came to mind, an
experiment before going live. One issue that will cause research to have a negative outcome would be
inconsistence when not using all parts on all participants (Holt, et al. 2021). You can have positive
outcomes as well but how accurate will your research be. Research in healthcare is to improve patient
outcomes, provide quality care and patient satisfaction, if our evidence is not consistent, we could cause
harm to our patients. Accurate research takes many years and patient consent to participate, time may

NRS 433Topic 1 DQ 1 Describe the difference between a nursing practice problem and a medical practice problem

NRS 433Topic 1 DQ 1 Describe the difference between a nursing practice problem and a medical practice problem

Click here to ORDER an A++ paper from our MASTERS and DOCTORATE WRITERS:NRS 433Topic 1 DQ 1 Describe the difference between a nursing practice problem and a medical practice problem

not always be on our side depending on what the research may be trying to prove or provide
information about. A perfect example is the COVID19 vaccine, who did they get to agree to test the
vaccine before approving it? (not trying to be controversial – just an example). Research needs an
adequate number of participants (Holt, et al. 2021) articles to be substantial. PICOT structure and the
nursing process for patients’ outcomes working together may provide the framework for a shorter time
for review of results (Wikan, et al. 2020).
References:

Richard I. G. Holt, Katharine Barnard-Kelly, Giorgos Dritsakis, Kerensa I. Thorne, Lauren Cohen, Elizabeth
Dixon, Mayank Patel, Philip Newland-Jones, Helen Partridge, Suvitesh Luthra, Sunil Ohri, Kareem
Salhiyyah, Jo Picot, John Niven, Andrew Cook, & on behalf of the OCTOPuS study group. (2021).
Developing an intervention to optimize the outcome of cardiac surgery in people with diabetes: the
OCTOPuS pilot study. Pilot and Feasibility Studies, 7(1), 1–12. https://doi-
org.lopes.idm.oclc.org/10.1186/s40814-021-00887-z

Wikan Purwihantoro Sudarmaji, Sholihin Sholihin, Roby Aji Permana, Agustina Soares, & Yanuar
Aga Nugraha. (2020). A Clinical Decision Support System as a Tool to Improve the Accuracy of Nursing
Diagnoses. Jurnal Ners, 14(3), 388–392. https://doi-org.lopes.idm.oclc.org/10.20473/jn.v14i3.17171

 Natalee Burrell
replied toTamara Houston
Apr 8, 2022, 12:33 PM(edited)
 Replies to Tamara Houston
Hi Tamara thank you for your informative post
The PICOT question format is a standardized "formula" for creating researchable and answered
questions. When you create a good one, the rest of the process of gathering and analyzing evidence
becomes much easier.
Question for PICOT:
Population: Bariatric teens who are contemplating or have had gastric bypass surgery.

Intervention: The nurse's position as a major component of the multidisciplinary team for bariatric
adolescent perioperative care.

Comparison: The nurse's function as a secondary member of the multidisciplinary team is limited to
perioperative care of the bariatric adolescent patient and requires no specific training.

Outcome: The bariatric adolescent patient has greater continuity of treatment when the nurse is
included as one of the major members of the multidisciplinary team approach.

Time frame: perioperative to 6 weeks post-surgery.
PICOT Question: When the nurse is a primary member of the multidisciplinary team, does the bariatric
adolescent patient undergoing gastric bypass have better perioperative and postoperative care than
when the nurse is a secondary member whose only role is to provide perioperative care and has no
specialized training?

Reference:
Nursing : Picot questions. Library Research Guides. (n.d.). Retrieved April 8, 2022, from
https://libguides.ggc.edu/NURS/PICOT
 Jana Garcia
replied toTamara Houston
Apr 8, 2022, 6:12 PM
 Replies to Tamara Houston
HI Tamara,
In To make your case, start with a PICOT question, the author describes two comparing questions when
considering research. I thought it was interesting and very important, so I put it in my notes for future
reference. Comparing questions can be viewed as backward and forward thinking. The backward
question is the generalization of a topic, common knowledge, or information we might find in a nursing
manual. The author explains this common knowledge is a “foundation for the forward question that will
provide evidence for clinical decision making, the PICOT” (Echevarria, 2014). I thought this was worth
considering because some of us students haven’t been in nursing school for several years, and the
"common knowledge” may have changed over time with new EBP. I haven’t been in nursing school for
almost two decades. I think it's important that I review backward questions before I create a
PICOT. Current knowledge on the backward question is important in the "outcome" of the PICOT format
because the expectation may have changed. Respectfully, Jana
Echevarria, I. M., & Walker, S. (2014). To make your case, start with a PICOT question. Nursing, 44(2),
18–19. https://doi.org/10.1097/01.NURSE.0000442594.00242.f9
 Kerri Zepeda
replied toTamara Houston

Apr 9, 2022, 5:12 PM
 Replies to Tamara Houston
Thank you Tamara for your post! Yes, when establishing a quality improvement project or leading to
EBP, the PICOT approach is used. It is divided into five sections: Patients/Problem, Intervention,
Comparison, Outcome, and Time, each of which is used to formulate a question to hypothesize
improvements that might be made in nursing or medical practice to enhance patient outcomes. To avoid
practicing medicine outside of the scope of nursing by undertaking a clinical research study rather than
an evidence-based practice project, make sure the PICOT is based on a nursing practice concern.
Evidence-based practice (EBP) has been shown in research to produce greater treatment quality, better
patient outcomes, lower costs, and more nurse satisfaction than traditional care practices. Nurses have
an important role in detecting patient concerns, whether they are at the bedside or taking care of
patients in an outpatient setting. Nurses have an important role in preventing and minimizing patient
falls in the inpatient setting. In the hospital where I work, and I'm sure in every hospital, there are safety
and fall precautions, such as having x3 side rails up on the patient bed, having the bed locked and in the
lowest position, and having the call light in reach so the patient can receive help instead of getting out of
bed. Nurses do have a great responsibility in ensuring the safety of the patient.
Helbig, J. (2018). History and Process of Nursing Research, Evidence-Based Nursing Practice, and
Quantitative and Qualitative Research Process. Nursing research: Understanding methods for best
practice. Retrieved from https://lc.gcumedia.com/nrs433v/nursing-research-understanding-methods-
for-best-practice/v1.1/#/chapter/1
 Dan Zheng
replied toTamara Houston
Apr 10, 2022, 12:55 PM
 Replies to Tamara Houston
Hi, Tamara,
Good example and clear explanation of the PICOT. Nurses use EBP to provide patients with safe, quality
care and to improve outcomes by first developing a PICOT statement that can be associated with either
a quality improvement project or lead to EBP (Helbig, 2018). The researcher must gather information
through PICOT (problem, intervention, comparison, outcome, and time) to prove why the study should
be performed. The nursing practice problem deals with the person's response to real health problems
that the patient is exhibiting or a potential health problem that may arise from the medical diagnosis.
While medical problem only gives information about the disease pathology, the nursing problem
expresses the impact of the diseases on the patients’ wellbeing and the family. Basing on nursing
practice problem ensures that the PICOT includes the best evidence available from previous studies on
patient care, and values from experts in the field.
Reference:
Helbig, J. (2018). History and process of nursing research, evidence-based nursing practice, and
quantitative and qualitative research process. Nursing research: Understanding methods for best

practice. https://lc.gcumedia.com/nrs433v/nursing-research-understanding-methods-for-best-
practice/v1.1/#/chapter/1
Kelechi Mbalewe
Posted Date
Apr 7, 2022, 12:36 AM
Replies to Gale Storm-Bryant
Hello Class,
A well-constructed PICOT question is essential for research queries in the nursing field. Advanced
studies or nurses in professional settings rely on the PICOT framework in the development of some of
their studies. PICOT is a mnemonic for a clinical question that looks at the aspect of patient,
intervention, comparison, outcome and time. The PICOT process begins with the identification of a
problem or a case scenario, and the question is formulated to elicit an answer (Fnadino, 2019). PICOT
process in the medical aspect might not be similar in the scope of the nursing field. The difference
between medical practice problems and medical practice problems is that medical practice problems
deal with the diagnosis of disease and their treatment while nursing practice problems are concerned
with issues that surround nursing practice, and this involves aspects such as patient’s response to a
health problem or patient-related assessment. Nursing practice problems can take the scope of
evaluation and intervention aspects. Medical practice problem revolves around a medical condition
where prognosis, causes and treatment of the condition are a big aspect of medical practice. Nursing
practice problems deal with modalities such as comfort, health screening, trauma prevention and
promotion of recovery, which are not dealt with in the medical practice scope. The development of a
competent PICOT question help to ensure that the necessary outside sources such as peer-reviewed
journals can be used in the assessment of the problem and intervention.
An example of a nursing practice problem is the patient level of satisfaction. Patient-level of
satisfaction does not revolve around the condition but the ability of the care plan to achieve the desired
health outcomes and adhere to patient beliefs and values. Nursing practice problems can take the shape
of low levels of patient satisfaction in nurses treating immigrant populations (Zhang et al., 2021).
Medical practice problems revolve around treatment options or prognosis of conditions. An example of
medical practice issues is the use of pain medication such as tramadol, morphine and oxycodone for
post-operative patients. Nursing practice problems will involve the evaluation of medication errors and
complications after treatment. It is important that the PICOT is based on the nursing practice problem
because it helps to make it easier to discuss the scope of the issue and identify relevant materials that
can help in the evaluation of the interventions. PICOT questions that revolve around nursing practice
problems will make it easier for me to understand the issue and intervention hence better ability to
comprehend the content in the peer-reviewed articles.

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