Discussion: PICOT Question

Over the course of the next eight weeks, we will be examining concepts related to nursing research and the translation of evidence to practice. To help you better understand the process, you will be identifying a practice issue for nurse practitioners.
 You will develop a PICOT question associated with the issue, find evidence to support a change in practice, and present your recommendations for change to your peers. This week, we will work on helping you refine your area of interest so that you will be able to develop a concise question for next week’s assignment. You are encouraged to use the area of interest you chose for the project in NR500NP and/or NR501NP; however, you may choose a different area if you wish.

Select an issue in nurse practitioner (NP) practice that is of interest to you and in which you would like to see a practice change occur. Conduct a review of literature to see what is currently known about the topic. In 1-2 paragraphs, describe the scope and relevance of the issue and your recommended change. Provide reference support from at least two outside scholarly sources to support your ideas. 
Please pick something you can do as a NP in your practice that is patient focused. Your intervention needs to relate to a measurable patient health outcome. Please avoid anything that would require a policy or law change, such as full-practice authority. Burnout and satisfaction surveys also are not appropriate topics as they are not patient centered. 

Review this 4-minute video to gain a better understanding of the requirements of a PICOT question. The PICOT question is not a research question, but a quality improvement issue that requires a practice change. 

Hello, my name is Dr. Lynch. Hey, I'm an assistant professor a Chamberlain University College of Nursing. Today we're gonna talk about pico questions and best practices in formulating these questions. There are five parts to a pico question. Patient intervention, comparison, outcome in time. The slides subsequently we will discuss each part of this question. The first ingredient for cooking up a pico question is population. Pick a broad topic, drill down, focus down so that then your population is very specific. Type two diabetic female patients age 30 to 40 who consume over 400 g of carbohydrates per day. A bunch more specific population then patients with diabetes intervention. What intervention do you think will make a difference? Is that supported by the scholarly literature? What is being done in clinical practice today? Are there better alternatives? You must use an intervention based on scholarly literature? Remember the definition of scholarly literature is a US based peer reviewed journal article geared for clinicians published in the past five years, or the latest clinical practice guideline. Comparison. So what is the standard of care currently? Patients without the intervention, patients without a condition, patients without risk factor. This part defines another population who will be used as a comparison against the group receiving the intervention. What is your desired outcome? The outcome should relate directly to the intervention and outcomes should be measurable. Time. This is a specific timeframe to demonstrate the outcome. In quality improvement efforts, the timeframe has to be realistic and manageable. Not over years, may not be even over months, but it could be. But it is usually a short timeframe to make an improvement effort. Many students ask what the differences between pico research and quality improvement questions. This chart will help you understand the difference. The pico question used here is in postoperative kidney transplant adults aged 65 to 75, how does a health coach compared with no health coaching affect hospital readmission rates within 90 days of discharge? This is a perfect pico question compared to the research question or QI question that also could be asked about this matter. Here's an example. In real life, you're a nurse practitioner working in a skilled nursing facility, the rate of false as unacceptable. And your care team has come together to discuss what should be done about this. Your pico question is, in elderly patients between age 65.75 residing in a sniff, how do fall prevention programs with risk assessment compared to fall prevention programs without risk assessment effect fall rates within 90 days after the intervention. So you can see how this question will guide how you view the literature on this topic. You will be looking for fall prevention with risk assessment in the scholarly literature to see what has worked in other places. What are the crucial ingredients in an outpatient fall prevention program? The literature holds the key, holds the answer to these questions. If you need further assistance, please contact your instructor directly. You can also contact the librarians at the Chamberlain library who can be accessed through many means, email, chat on real time. This material comes from Malbec and find out overhauled book evidence-based practice in nursing and health care, a guide to best practice, which is a great addition to your library.