PICO-T Formatted Question

PICO-T Formatted Question Order Description Read the assigned Week 1 Case Study for Threaded Discussion and formulate one searchable, clin" rel="nofollow">inical question in" rel="nofollow">in the PICO-T format. There are several potential questions that could be asked. Identify if the focus of your question is assessment, etiology, treatment, or prognosis. Remember to in" rel="nofollow">integrate APA references (References should not be older than 10 years of age, and should not be from India, and should provide a hyperlin" rel="nofollow">ink to where professor may be able to view article if necessary). Week 1 Case Study for Threaded Discussion Mary is a 65-year-old woman with a 3-year history of diabetes is seen in" rel="nofollow">in the hospital for worsenin" rel="nofollow">ing dyspnea and cough. She has had chronic obstructive pulmonary disease (COPD) sin" rel="nofollow">ince age 55. She now has dyspnea with walkin" rel="nofollow">ing one-third of a block and a persistent cough. Her type 2 diabetes has been managed with diet and exercise. She was treated via a three-day stay in" rel="nofollow">in the hospital and sent home with a drug regime and sin" rel="nofollow">ince then has been seen in" rel="nofollow">in the ER two times and now re-hospitalized with shortness of breath and blood sugar of 245. She does not understand why the medications are not workin" rel="nofollow">ing. She needs to be healthy because she is the only caregiver for her ailin" rel="nofollow">ing bed-ridden husband with ALS. Mary is the only caregiver and takes all of her medication but eats on the run when not carin" rel="nofollow">ing for her husband. She now does not exercise and only goes out of the home for doctor visits and grocery shoppin" rel="nofollow">ing. She is always tired and is extremely worried about her husband’s health issue. They are on a fixed in" rel="nofollow">income sin" rel="nofollow">ince retirement. Durin" rel="nofollow">ing the hospital stay she was put on new medications and one of them was Prednisone. The doctor has told her to change her lifestyle, contin" rel="nofollow">inue with meds and to monitor her vital signs at home. He has also suggested a move to an assisted livin" rel="nofollow">ing center. She has many questions about assisted livin" rel="nofollow">ing. She is willin" rel="nofollow">ing to do anythin" rel="nofollow">ing but has no one to help her make this decision. They have no family or close friends near them. The nurse just came in" rel="nofollow">in and told her she is discharged, handed her a bunch of papers about diet, exercise, and diabetes and said a home health nurse would come to the house in" rel="nofollow">in a few days. Directions: Formulate searchable, clin" rel="nofollow">inical questions in" rel="nofollow">in the PICO-T Model format usin" rel="nofollow">ing the material in" rel="nofollow">in this case study. There are several potential questions that could be asked, but you only need to identify one. Determin" rel="nofollow">ine if the focus of each question is assessment, etiology, treatment, or prognosis. Explanation of PICO-T Model: The PICO-(T) format is a way to develop a clin" rel="nofollow">inical question that lends itself to searchin" rel="nofollow">ing for evidence. PICO-(T) is an acronym for P = population of in" rel="nofollow">interest I = in" rel="nofollow">intervention of in" rel="nofollow">interest C = comparison of in" rel="nofollow">interest O = outcome of in" rel="nofollow">interest T = time All of the PICO-(T) elements may not be present in" rel="nofollow">in every clin" rel="nofollow">inical question. For example, the T (time) may not be relevant or there may be no C (comparison of in" rel="nofollow">interest). In quantitative research that has an experimental design, you will fin" rel="nofollow">ind in" rel="nofollow">interventions (I), and perhaps comparisons, (C) that are in" rel="nofollow">independent variables. The outcomes (O) are dependent variables. PICO-T is a model and as mentioned in" rel="nofollow">in the lesson, not every part of the PICO-T fits with every question. Some questions do not have a comparison group, some questions do not have an in" rel="nofollow">intervention. Some questions are not lookin" rel="nofollow">ing at an issue over time so the time will not apply. 1. P= Population you are askin" rel="nofollow">ing the question about. This is almost always a group of patients rather than one person. There are case studies that examin" rel="nofollow">ine one person--you may have experienced rounds where a number of disciplin" rel="nofollow">ines gather and discuss one patient, but generally PICO-T questions are lookin" rel="nofollow">ing at a group. 2. I= Intervention. Here you will be applyin" rel="nofollow">ing an in" rel="nofollow">intervention to help with a patient condition. The in" rel="nofollow">interventions are nursin" rel="nofollow">ing care/education related. Interventions that in" rel="nofollow">involve medication are typically medication clin" rel="nofollow">inical trials and these are most often run by physicians. Our focus is more on nursin" rel="nofollow">ing care. Some questions will not in" rel="nofollow">involve an in" rel="nofollow">intervention if askin" rel="nofollow">ing a descriptive question such as a predictive (risk factor) question or a correlational (relational) question. 3. C= Comparison Group. Here you compare the population to a group of patients that typically have "standard care" in" rel="nofollow">instead of the in" rel="nofollow">intervention. There are ethical issues here where patients must at least be provided care that would be given normally. Not all questions in" rel="nofollow">involve a comparison group. 4. O= Outcome. Here you are generally lookin" rel="nofollow">ing for a positive outcome. This is an improvement in" rel="nofollow">in the patient condition as a result of the in" rel="nofollow">intervention (of course it does not always work this way). If your question is descriptive, then you will be lookin" rel="nofollow">ing at what is happenin" rel="nofollow">ing and not at a change from an in" rel="nofollow">intervention. If risk factors are in" rel="nofollow">involved as in" rel="nofollow">in a predictive question, then the outcome can be negative such as certain" rel="nofollow">in lifestyle behaviors leadin" rel="nofollow">ing to disease. 5. T= Time again" rel="nofollow">in in" rel="nofollow">involves lookin" rel="nofollow">ing at the effects of an in" rel="nofollow">intervention over time. Generally nursin" rel="nofollow">ing studies will take place over a reasonable amount of time due to time and resource considerations. I fin" rel="nofollow">ind that 6 months or a year often works. This could also apply to predictive questions where risk factors are followed over time to see if the negative outcomes appear. (i.e., high cholesterol leadin" rel="nofollow">ing to heart disease). Reference (Chapter 4: Fin" rel="nofollow">indin" rel="nofollow">ing Problems and Writin" rel="nofollow">ing Questions, pp. 77-100) Houser, Janet. (2015). Nursin" rel="nofollow">ing research: Readin" rel="nofollow">ing, usin" rel="nofollow">ing, and creatin" rel="nofollow">ing evidence (3rd ed.). Sudbury, MA: Jones and Bartlett. [VitalSource Bookshelf Onlin" rel="nofollow">ine]. Retrieved from https://bookshelf.vitalsource.com/#/books/9781284055702/ Janet Houser (2015, p. 93) in" rel="nofollow">in the book titled “Nursin" rel="nofollow">ing research: Readin" rel="nofollow">ing, usin" rel="nofollow">ing, and creatin" rel="nofollow">ing evidence” states the followin" rel="nofollow">ing regardin" rel="nofollow">ing the acronym PICO: “Two guides are helpful in" rel="nofollow">in developin" rel="nofollow">ing a good research question. One of them is described by the acronym PICO, which outlin" rel="nofollow">ines the elements of a good quantitative question. PICO stands for population, in" rel="nofollow">intervention, comparison, and outcome. Usin" rel="nofollow">ing preoperative education for short-stay patients undergoin" rel="nofollow">ing prostatectomy as an example, a research question based on PICO might look like this: • Population: In radical prostatectomy patients stayin" rel="nofollow">ing in" rel="nofollow">in the hospital one day after surgery … • Intervention: Does customized preoperative teachin" rel="nofollow">ing … • Comparison: Compared to standard preoperative teachin" rel="nofollow">ing … • Outcomes: Lead to better pain" rel="nofollow">in control as measured by a visual analog scale?”