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Discuss the purpose defining the purpose of the PICO question for the psychiatric mental health nurse practitioner.
Explain the purpose of your selected PICO question advanced practice psychiatric nurses or the patients or the populations they treat.
In adults aged 18–65 diagnosed with obsessive-compulsive disorder (OCD) (P), how does exposure and response prevention therapy (ERP) (I) compared to pharmacotherapy with fluvoxamine (C) affect the reduction of compulsive hand-washing behaviors (O)?
Guiding clinical decisions: By clearly defining the problem and its components, a PICO question directly informs the PMHNP's clinical decision-making. It helps them identify the most effective, safe, and patient-centered interventions based on the best available evidence.
Enhancing professional practice: Using PICO questions promotes a systematic approach to learning and problem-solving. It empowers PMHNPs to stay current with the latest research and to integrate that research into their practice, thereby advancing the profession and improving patient care.
The selected PICO question is:
In adults aged 18–65 diagnosed with obsessive-compulsive disorder (OCD) (P), how does exposure and response prevention therapy (ERP) (I) compared to pharmacotherapy with fluvoxamine (C) affect the reduction of compulsive hand-washing behaviors (O)?
The purpose of this question for advanced practice psychiatric nurses and their patients is to guide a data-driven choice between two primary treatment modalities for OCD.
For the advanced practice psychiatric nurse (PMHNP), the purpose is:
To inform evidence-based prescribing and treatment planning: This question helps the PMHNP determine which intervention—a specific psychotherapy (ERP) or a specific medication (fluvoxamine)—has a better documented effect on a critical symptom of OCD. It moves beyond a general understanding of "therapy vs. medication" to a focused comparison that can directly influence the PMHNP's recommendation.
To support shared decision-making: Having a clear understanding of the evidence for both interventions allows the PMHNP to present the options, benefits, and potential outcomes to the patient in a transparent and informed way. This empowers the patient to participate meaningfully in their treatment plan.
The PICO question framework is a fundamental tool in evidence-based practice (EBP), serving to structure clinical questions into a searchable format. For the psychiatric mental health nurse practitioner (PMHNP), defining a purpose with the PICO format is crucial for several reasons:
Focusing the search: PICO forces the PMHNP to narrow down a broad clinical problem into a specific, answerable question. This precision prevents getting overwhelmed by a massive amount of irrelevant literature. For example, instead of a general search on "OCD treatments," the PICO question pinpoints the specific population (adults with OCD), intervention (ERP), comparison (fluvoxamine), and outcome (reduction in a specific behavior).