NURS-FPX4030 Assessment 3: PICO(T) Questions and an Evidence-Based Approach

NURS-FPX4030 Assessment 3: PICO(T) Questions and an Evidence-Based Approach

A Sample Answer For the Assignment: NURS-FPX4030 Assessment 3: PICO(T) Questions and an Evidence-Based Approach

Title: NURS-FPX4030 Assessment 3: PICO(T) Questions and an Evidence-Based Approach

Practice Issue

Hypertension is a serious issue that affects millions of people worldwide. Hypertension, or high blood pressure, if left uncontrolled can lead to potentially dangerous medical outcomes including stroke, heart attack, and even death. A practice issue to be explored through the PICO(T) approach surrounds the use of telemonitoring systems for patients with hypertension, in order to better track their blood pressure levels and ultimately improve control over this condition (Omboni et al., 2020). Specifically, researching the effect of telemonitoring on blood pressure control following the initiation of medication could reveal valuable insights into risk management and hypertension treatment best practices.

Hypertension (or high blood pressure) is estimated to cause 10 million deaths a year worldwide and is thus an undeniably serious issue that requires research for effective treatments and strategies. Telemedicine offers an innovative solution for combating the burden of hypertension, by providing remote monitoring of blood pressure via specialized equipment to quickly detect any changes in vital health information (Wang et al., 2021). Moreover, using such technologies to collect data can allow medical professionals to be proactive when addressing patients’ health issues. Through automated reminders and biometric monitoring of data, telemedicine interventions can provide powerful support in controlling conditions like hypertension, even enabling health professionals to provide personalized care plans more accurately than ever before. Thus, further research regarding the efficacy of telemonitoring systems for hypertension management is necessary in order to accelerate access and uptake of these advances in healthcare delivery.

PICOT Question and Sources Of Evidence

To assess this topic, one could generate a PICO(T)-formatted research question such as “What is the effect of telemonitoring blood pressure (I) in patients with hypertension (P) within one year after initiation of the medication (T) on blood pressure control (O)?” Such a research question would seek to measure how effective telemonitoring is at controlling hypertensive issues and could potentially provide vital information for healthcare professionals looking at how to best treat these conditions in an efficient manner.

DICE Model

In order to answer a PICO(T) question such as the one mentioned, one must apply the DICE model. This stands for Describe, Investigate, Create, and Evaluate. First, it is important to Describe the population of interest and further define the intervention and comparison if applicable. This can be done through credible sources such as academic journals, scholarly books, and websites or databases that are reputable and based on scientific research such as PubMed or MEDLINE. Furthermore, it is important to Investigate evidence-based resources to find out specific parameters of your PICO(T) question; this may include searching within medical magazines or documents created by experts in the field of study, known as grey literature. It is also beneficial to consider surveys performed in relevant populations when addressing health-related questions (Khalil et al., 2019). By taking a step further into Create mode you can amalgamate all gathered information into connecting ideas about your topic and draw tentative conclusions from what has been identified thus far; this might involve developing a checklist that outlines components you will use while conducting any medical studies related to your topic, like checking ethical requirements that have been met before any data can be collected. Finally came up with an evaluation of your case using various resources including online reviews if necessary; ask yourself ‘what changes could be implemented at this point?’ Considering these components of DICE could prove effective in finding potential answers to your questions like ‘What is the effect of telemonitoring blood pressure in patients with hypertension within one year after initiation of the medication on blood pressure control?’

Staff-Directed Model

Care Staff-Directed Model is a standardized approach to patient-centered care in which an interdisciplinary team of healthcare professionals strives to achieve optimal therapeutic outcomes. Telemonitoring blood pressure is one example of this model, as it can facilitate improved management of hypertension and provide valuable real-time information regarding the ability of medication regimes to reach therapeutic goals. In considering the potential effectiveness of telemonitoring blood pressure, there has been research conducted looking into its effects on blood pressure control in hypertension patients over a one-year follow-up period (Hammersley et al., 2020). Many research databases such as PubMed can provide useful studies that answer the PICO(T) question in order to determine its potential effectiveness. According to a systematic review of relevant studies published in 2019 by Gathered Health, telemonitoring was found to be effective for controlling systolic blood pressure after one year, with reductions ranging from 4 – 16 mmHg greater than in the usual care group. Thus, telemonitoring appears to be an efficacious tool for achieving better-managed hypertension and improved control over a patient’s blood pressure levels.

Individualized Intervention Model

The Individualized Intervention Model has been identified as an effective source of evidence for answering a PICO(T) question. This model utilizes a combination of database hunting, journal searching, website browsing, and other research methods to identify the best solutions to medical questions (Margolis et al., 2020). For example, studies have been conducted on the effect of telemonitoring blood pressure in patients with hypertension within one year after initiation of the medication on blood pressure control. The results of these studies have indicated that this form of monitoring can be highly effective at lowering high blood pressure. Thus, it is possible to utilize an Individualized Intervention Model to better answer questions related to such treatment solutions. The research tools included in this model are invaluable in helping researchers evaluate potential effects and find valid solutions to health issues.

Findings from Articles

Multiple studies including Omboni et al., (2020) have been conducted in order to assess the impact of telemonitoring a patient’s blood pressure in conjunction with starting them on hypertension medication. One year following the initiation of the medication, these studies found that the use of telemonitoring was effective in controlling blood pressure levels for those with hypertension. Researchers discovered that patients who utilized telemonitoring experienced lower systolic and diastolic blood pressures as compared to those who did not take part in any monitoring or tracking practices (Omboni et al., 2020). Furthermore, researchers also found that adding telemonitoring alongside traditional doctor visits was significantly beneficial to the maintenance of controlled blood pressure over a one-year period. All considered results from various studies suggest that implementing telemonitoring offers those with hypertension an effective way to manage their condition and reduce risk factors associated with uncontrolled blood pressure due to a lack of adequate follow-up care.

According to Hammersley et al., (2020), the clinical effectiveness of telemonitoring blood pressure in patients with hypertension has been well studied. Several sources of evidence suggest that telemonitoring can significantly improve blood pressure control and reduce hospitalizations for cardiovascular events over a period of one year. Not only does this lead to a better outcome and cost savings, but it also reduces the stress on those managing hypertension (Hammersley et al., 2020). Furthermore, the collected data from ongoing monitoring can help inform healthcare decision-making and provider education regarding effective management strategies for individual cases of hypertension. The findings from these sources of evidence are extremely relevant to making decisions related to the PICO(T) question as they confirm that telemonitoring is beneficial in managing and eliminating risk factors in patients with hypertension.

NURS-FPX4030 Assessment 3: PICO(T) Questions and an Evidence-Based Approach Conclusion

Telemonitoring blood pressure in patients with hypertension has had a positive effect on blood pressure control within one year of medication initiation according to numerous studies. Researchers suggest telemonitoring is a cost-effective, effective intervention that serves as an example of evidence-based care. Studies have reported that monitoring and providing feedback to patients about their condition through remote devices, decreases the need for visits and office visits, and contributes to better outcomes, improved follow-up, and increased motivation for compliance among hypertensive patients about their medications. Additionally, emergency room visits for hypertensive crises may also be reduced with the proper implementation of telemonitoring solutions. All in all, it appears as though telemonitoring is an effective tool in helping to control hypertension over the long term.

NURS-FPX4030 Assessment 3: PICO(T) Questions and an Evidence-Based Approach

Sample Answer for NURS-FPX4030 Assessment 3: PICO(T) Questions and an Evidence-Based Approach Included

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.

Introduction

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. When applying the PICO(T) approach, the nurse can isolate the interventions of interest and compare to other existing interventions for the evidenced impact on the outcome of the concern.

You are encouraged to complete the Vila Health PICO(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.

Reference

Boswell, C., & Cannon, S. (2015). Introduction to nursing research. 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. When writing a PICO(T)-formatted research question, you want to focus on the impact of the intervention and the comparison on the outcome you desire.

Scenario

For this assessment, please use a health care 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 a health care issue of interest and apply the PICO(T) process to develop the research 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.

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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. Create a PICO(T)-formatted research question
• Identify sources of evidence that could be potentially effective in answering a PICO(T) question (databases, journals, websites, etc.).
• Explain the findings from articles or other sources of evidence as it relates to the identified health care issue.
• 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.

NURS-FPX4030 Assessment 3: PICO(T) Questions and an Evidence-Based Approach

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 3-5-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.

Portfolio Prompt: Remember to save the final assessment to your ePortfolio so that you may refer to it as you complete the final capstone course.

Competencies Measured

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 that are relevant to the health care issue.
• 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 and develop a PICO(T)-formatted research question.
• Competency 5: Apply professional, scholarly communication strategies to lead practice changes based on evidence.
  • Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.
  • Apply APA formatting to in-text citations and references exhibiting nearly flawless adherence to APA format.