Identify a clinical question related to your area of clinical practice and write the clinical foreground question in PICOT format utilizing the worksheet tool
Identify a clinical question related to your area of clinical practice and write
Write a 1000-1500 word essay addressing each of the following points/questions. Be sure to completely answer all the questions for each bullet point. There should be three main sections, one for each bullet below. Separate each section in your paper with a clear heading that allows your professor to know which bullet you are addressing in that section of your paper.
Support your ideas with at least five (5) sources using citations in your essay. Make sure to cite using the APA writing style for the essay. The cover page and reference page in correct APA do not count towards the minimum word amount. Review the rubric criteria for this assignment.
Identify a clinical question related to your work environment, write the question in PICOT format and perform a literature search on the identified topic.
To enable the student to identify a clinical question related to a specified area of practice and use medical and nursing databases to find research articles that will provide evidence to validate nursing interventions regarding a specific area of nursing practice.
Review the Application Case Study for Chapter 3: Finding Relevant Evidence to Answer Clinical Questions as a guide for your literature search.
- Identify a clinical question related to your area of clinical practice and write the clinical foreground question in PICOT format utilizing the worksheet tool provided as a guide.
- Describe why this is a clinical problem or an opportunity for improving health outcomes in your area of clinical practice. Perform a literature search and select five research articles on your topic utilizing the databases highlighted in Chapter 3 of the textbook (Melnyk and Finout-Overholt, 2015).
- Identify the article that best supports nursing interventions for your topic. Explain why this article best supports your topic as you compare the article to the other four found in the literature search.
Expert Answer and Explanation
In the United States (U.S.), hospitals embrace evidence-based practice (EBP) to ease decision-making and develop the protocol for care delivery. Research is the hallmark of EBP because it produces findings that clinicians rely on to make clinical decisions. For a nurse, taking part in an EBP program begins with recognizing the domain of the clinical question. To establish the question, the nurse follows specific procedures, including identifying the patient issue, intervention, and duration of treatment.
A background and a foreground question are the major types of clinical questions, and the two differ in the sense that the former is general while the latter is specific. To generate a particular question, a nurse uses the PICOT framework. It is crucial to examine how this framework can help with research that compares asthma treatment using salbutamol and salmeterol.
The reason why the issue is considered a Clinical Problem or an Opportunity for Improvement
The most effective asthma treatment is a clinical problem for several reasons. Asthma may lead to the patient’s hospitalization, mainly if a patient receives an ineffective intervention. Ineffective therapy, in this case, means administering a different medication other than the required treatment. Hospitalization and increased length of hospital stay can lead to the accumulation of costs of treatment or even cause the use of more medical resources (Nwaru et al., 2020).
Being hospitalized for a long exposes a person to various nosocomial infections, including Urinary Tract Infections (UTIs). The issue is also a clinical problem because it may adversely affect the quality of the patient’s life. Asthma limits the activities that one can perform because it hinders a patient to the level where they cannot work or enjoy certain hobbies. Therefore, the treatment that is effective between salbutamol and salmeterol needs a suitable response to help prevent adverse asthma complications.
The literature search strategy used involves using various terminologies to identify sources from Google database and Cochrane. The keywords used are highlighted in table 1.0.
Layout of the Relevant Terminologies
|Concepts||Keywords||Google Terms||Cochrane Terms|
Adults with asthma
|Adult, middle-aged, women||Middle-aged, 40-50 years.||Middle aged adults: adults living with asthma|
Salbutamol, a short-acting asthma medication.
|Salbutamol (Albuterol); short-acting||Asthmatic patients.||Short-acting asthma medication.|
Salmeterol, a long-acting medication
|Short-acting: salmeterol (fluticasone)||Prevention of asthma symptoms.||Long-acting asthma treatment.|
Affect asthma symptoms
|Quick relief; Reduced emergency room visits; Improvement in lung functioning; Reduce frequency of asthma attacks;||Quick relief for asthma||Prevention of asthma attacks; improved respiratory outcomes.|
The articles were sourced from Google and Cochrane with each database yielding different number of articles.
|Set #||Query||Limiters/Expanders||Results (Google)||Results (for Cochrane)|
|S1 (Keyword that represents population)||Middle-aged||Boolean/Phrase||17,000||12,000|
|S2||Women with asthma||Boolean/Phrase||6,000||4,000|
|S3 (Combine to represent population)||(S1 and S2)||Boolean/Phrase||276||202|
|S4 (Limiting to English)||(S1 and S2)||Boolean/Phrase||56||43|
|S5 (use keyword to represent intervention).||Salbutamol||Boolean/Phrase||8,900||5600|
|S6 (use keyword to represent intervention)||Salmeterol||Boolean/Phrase||7,200||320|
|S7 (Combine the keywords for the intervention and population )||S1 and S2 and S5||Boolean/Phrase||120||23|
The Article that best supports Nursing Interventions for the chosen Topic
The search for the literature yielded five main articles, with one of these articles being more relevant than the other four. The article that seems to answer the question is the article authored by Baggot and colleagues (2020). According to these authors, overreliance on the Short-Acting Beta Agonists (SABAs) is associated with severe health events, including the risk of experiencing frequent attacks.
What, however, makes the article more relevant to the question is that it provides the survey results of the views of a majority of adult woman subjects concerning the various treatments for asthma. Therefore, it meets most of the criteria defined in the PICOT question. The study revealed that most of the participants preferred interventions that would get rid of their asthma instead of the SABAs they are used to.
Comparing the Article to the Other Four found in Literature Search.
What sets apart the study by Baggot et al. (2020) from that of Muneswarao and colleagues (2019) is that the former focuses on a specific adult population while the latter explores the use of the different treatments across various groups, including children. Therefore, Muneswarao et al.’(2019) study do not adequately respond to the research question.
The overuse of the SABA is mainly seen among patients with asthma, which often comes at a cost because it can lead to a rise in the risk of death. Canonica et al.(2021) explore the concerns surrounding the use of the SABA, and they explore the evidence that supports new guidelines established to support asthma treatment.
The difference between Baggot et al. (2020) and Nwaru et al.(2020) is noticeable in the two studies’ population groups. The latter involves a study in which subjects included individuals aged 12-45 years old.
SABA is popular among people with asthma, and while Kaplan and colleagues (2020) recognize the importance of this intervention, they maintain that overreliance on this treatment can lead to adverse clinical events. Their study is different from Baggot et al. (2020) because they explore strategies for reducing asthma exacerbations in children and adults.
Baggott, C., Chan, A., Hurford, S., Fingleton, J., Beasley, R. Hardwood, M…….& Magnus Levack, W.M. (2020). Patient Preferences for Asthma Management: A Qualitative Study. Respiratory Medicine Original Research, 10 (8). Doi: http://dx.doi.org/10.1136/bmjopen-2020-037491.
Canonica, G. W., Paggiaro, P., Blasi, F., Musarra, A., Richeldi, L., Rossi, A., & Papi, A. (2021). Manifesto on the overuse of SABA in the management of asthma: new approaches and new strategies. Therapeutic advances in respiratory disease, 15, 17534666211042534. https://doi.org/10.1177/17534666211042534.
Kaplan, A., Mitchell, P. D., Cave, A. J., Gagnon, R., Foran, V., & Ellis, A. K. (2020). Effective Asthma Management: Is It Time to Let the AIR out of SABA?. Journal of clinical medicine, 9(4), 921. https://doi.org/10.3390/jcm9040921.
Muneswarao, J., Hassali, M. A., Ibrahim, B., Saini, B., Ali, I., & Verma, A. K. (2019). It is time to change the way we manage mild asthma: an update in GINA 2019. Respiratory research, 20(1), 183. https://doi.org/10.1186/s12931-019-1159-y.
Nwaru, B. I., Ekström, M., Hasvold, P., Wiklund, F., Telg, G., & Janson, C. (2020). Overuse of short-acting β2-agonists in asthma is associated with increased risk of exacerbation and mortality: a nationwide cohort study of the global SABINA programme. The European respiratory journal, 55(4), 1901872. https://doi.org/10.1183/13993003.01872-2019.
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Picot Research Question Examples: A Comprehensive Guide
Are you conducting research and struggling to develop a research question that is focused and testable? If yes, you’re not alone. Developing a research question can be a daunting task, and it is critical to ensure that it is well-structured and achievable. In this article, we will delve into the world of PICOT research questions, providing you with 15 PICOT research question examples, and a comprehensive guide to writing a successful PICOT research question.
2. What is a PICOT research question?
PICOT stands for Population, Intervention, Comparison, Outcome, and Timeframe. It is a tool used to develop a well-structured and focused research question in healthcare. A PICOT research question helps to define the parameters of a study, ensuring that it is testable, relevant, and significant.
3. Why are PICOT research questions important?
Developing a PICOT research question is essential in healthcare research because it provides clarity and structure to the research process. It ensures that the research is focused on a specific population, intervention, comparison, outcome, and timeframe, which is crucial for developing a successful study. PICOT research questions are also helpful for systematic reviews, as they provide a framework for identifying and summarizing relevant research.
4. How to develop a PICOT research question
To develop a PICOT research question, you need to identify the following components:
P: Patient population or problem
The first step in developing a PICOT research question is to identify the patient population or problem that you want to study. The population should be well-defined and specific.
I: Intervention or exposure
The intervention or exposure is the treatment or intervention that you are interested in studying. This could be a medication, procedure, or therapy.
C: Comparison intervention or exposure
The comparison intervention or exposure is the alternative intervention that you are comparing to your chosen intervention. This could be a placebo or an alternative treatment.
The outcome is the measure of the effectiveness of the intervention. This could be a physical outcome, such as blood pressure, or a behavioral outcome, such as adherence to a treatment plan.
The timeframe is the duration of the study or the period during which the intervention is being measured.
By combining these five components, you can develop a well-structured PICOT research question that is focused and testable.
5. PICOT research question examples
Example 1: PICO question for qualitative research
- P: Patients with chronic pain
- I: Mindfulness-based stress reduction program
- C: No intervention
- O: Perceived reduction in pain and stress
- T: 12-week program
How do patients with chronic pain perceive the impact of a 12-week mindfulness-based stress reduction program on their pain and stress levels, compared to no intervention?
Example 2: PICO question for quantitative research
- P: Adults with type 2 diabetes
- I: Intermittent fasting
- C: Standard care
- O: Reduction in HbA1c levels
- T: 12 weeks
Does intermittent fasting result in a greater reduction in HbA1c levels among adults with type 2 diabetes, compared to standard care, after 12 weeks?
Example 3: PICO question for systematic review
- P: Children with ADHD
- I: Behavioral interventions
- C: Pharmacological interventions
- O: Improvement in ADHD symptoms
- T: Any duration
What is the comparative effectiveness of behavioral interventions versus pharmacological interventions in improving ADHD symptoms in children?
Example 4: PICO question for case-control study
- P: Patients with lung cancer
- I: History of smoking
- C: No history of smoking
- O: Risk of developing lung cancer
- T: Lifetime exposure to smoking
What is the association between lifetime exposure to smoking and the risk of developing lung cancer in patients with a confirmed diagnosis of lung cancer, compared to patients without lung cancer?
Example 5: PICO question for cohort study
- P: Pregnant women with gestational diabetes
- I: Glycemic control
- C: Poor glycemic control
- O: Risk of adverse pregnancy outcomes
- T: Throughout pregnancy
What is the relationship between glycemic control during pregnancy and the risk of adverse pregnancy outcomes in women with gestational diabetes?
Example 6: PICO question for cross-sectional study
- P: Elderly residents in long-term care facilities
- I: Participation in physical activity
- C: No participation in physical activity
- O: Physical function
- T: At the time of the study
What is the association between participation in physical activity and physical function among elderly residents in long-term care facilities?
Example 7: PICO question for randomized controlled trial
- P: Patients with chronic low back pain
- I: Yoga therapy
- C: Physical therapy
- O: Reduction in pain and disability
- T: 12 weeks
What is the comparative effectiveness of yoga therapy versus physical therapy in reducing pain and disability in patients with chronic low back pain, after 12 weeks of treatment?
Example 8: PICO question for before-and-after study
- P: Patients undergoing cardiac surgery
- I: Implementation of a cardiac rehabilitation program
- C: No cardiac rehabilitation program
- O: Improvement in cardiac function
- T: 6 months
What is the impact of implementing a cardiac rehabilitation program on improving cardiac function in patients undergoing cardiac surgery, compared to no program, over a 6-month period?
Example 9: PICO question for observational study
- P: Adults with hypertension
- I: Alcohol consumption
- C: No alcohol consumption
- O: Blood pressure control
- T: 6 months
What is the relationship between alcohol consumption and blood pressure control in adults with hypertension, over a 6-month period?
Example 10: PICO question for survey research
P: Population – What is the target population or sample for the survey?
I: Intervention – What type of survey is being conducted (e.g. cross-sectional, longitudinal)?
C: Comparison – Is there a comparison group being surveyed (e.g. a control group or a group with a different intervention)?
O: Outcome – What is the main outcome of interest for the survey (e.g. prevalence of a certain condition, attitudes towards a specific issue)?
Example PICO question: In a population of adults aged 18-65, does a cross-sectional survey using a validated questionnaire result in a higher reported prevalence of depression compared to a longitudinal survey, and what are the factors associated with reporting depression in both survey types?
Example 11: PICO question for diagnostic study
P: Population – What is the target population or sample for the diagnostic test?
I: Intervention – What is the diagnostic test being used and how is it being administered?
C: Comparison – Is there a comparison group being diagnosed with a different test or using a different diagnostic criteria?
O: Outcome – What is the main outcome of interest for the diagnostic study (e.g. sensitivity, specificity, accuracy)?
Example PICO question: In a population of children aged 5-10 presenting with symptoms of attention deficit hyperactivity disorder (ADHD), does a computerized test for ADHD diagnosis using a specific set of criteria have higher sensitivity and specificity compared to a traditional clinical diagnosis by a licensed mental health professional?
Example 12: PICO question for prognostic study
P: Population – What is the target population or sample for the prognostic study?
I: Intervention – What is the prognostic factor being studied (e.g. age, gender, genetic marker)?
C: Comparison – Is there a comparison group with a different prognostic factor or no prognostic factor?
O: Outcome – What is the main outcome of interest for the prognostic study (e.g. mortality, disease progression)?
Example PICO question: In a population of elderly individuals with a history of falls, does a positive test for the Timed Up and Go test predict higher risk of future falls compared to a negative test result, and what are the factors associated with higher risk of falls in this population?
Example 13: PICO question for economic evaluation study
P: Population – What is the target population or sample for the economic evaluation study?
I: Intervention – What is the intervention being evaluated (e.g. a new drug, a new medical device, a new surgical procedure)?
C: Comparison – Is there a comparison group with a different intervention or a no-intervention group?
O: Outcome – What is the main outcome of interest for the economic evaluation study (e.g. cost-effectiveness, cost-utility, cost-benefit)?
Example PICO question: In a population of patients with chronic kidney disease, does a new drug for managing blood pressure result in higher quality-adjusted life years (QALYs) compared to the current standard of care, and what are the cost implications of using this new drug?
Example 14: PICO question for intervention study
P: Population – What is the target population or sample for the intervention study?
I: Intervention – What is the intervention being tested (e.g. a new drug, a new behavioral intervention, a new surgical procedure)?
C: Comparison – Is there a comparison group receiving a different intervention or a placebo group?
O: Outcome – What is the main outcome of interest for the intervention study (e.g. improvement in symptoms, reduction in disease progression)?
Example PICO question: In a population of overweight and obese adults, does a 12-week exercise intervention result in greater weight loss compared to a control group receiving
Tips for Writing a Successful PICOT Research Question
Developing a research question is one of the most critical steps in research. A well-written research question can guide the entire research process, and a poorly formulated one can lead to inadequate findings. The PICOT framework is a useful tool for developing a research question. Here are some tips to help you write a successful PICOT research question:
- Start with the patient or problem: Begin by identifying the patient or problem that you want to investigate. Be specific about the population you are interested in, such as age, gender, or health status.
- Use precise and specific terms: Use clear and concise language in your research question. Avoid vague or ambiguous terms that can lead to confusion.
- Incorporate a comparison: Your research question should include a comparison. The comparison may be between different interventions, diagnostic tests, or populations.
- Use measurable outcomes: Identify measurable outcomes that you want to investigate. Your outcomes should be specific, measurable, and relevant to your research question.
- Establish a timeframe: Consider the timeframe for your research question. The timeframe may be related to the onset of symptoms, the duration of treatment, or the follow-up period.
- Consult with colleagues and mentors: Seek feedback from colleagues and mentors on your research question. They can provide valuable input and help you refine your question.
By following these tips, you can develop a successful PICOT research question that will guide your research and help you answer important questions in your field.
In conclusion, developing a PICOT research question is an important step in conducting research. The PICOT framework can help researchers develop a well-structured and focused research question that addresses a specific patient or problem, includes a comparison, identifies measurable outcomes, and establishes a timeframe. By following the tips provided, researchers can develop successful PICOT research questions that guide their research and lead to meaningful findings.
Why is it Important to Ensure Your PICOT is Based on a Nursing Practice Problem?
As a nursing student or practitioner, it is essential to understand the significance of having a clearly defined PICOT question that is based on a nursing practice problem. PICOT stands for Population, Intervention, Comparison, Outcome, and Timeframe, and it is a framework that helps nurses formulate research questions that are both relevant and answerable. In this article, we will explore why it is essential to ensure your PICOT is based on a nursing practice problem.
Nursing research is an essential aspect of improving patient outcomes and healthcare delivery. PICOT is a framework that helps to formulate relevant and answerable research questions. It is important to ensure that your PICOT question is based on a nursing practice problem to ensure that the research is relevant to nursing practice and addresses a significant issue.
2. What is PICOT?
PICOT is a framework that helps to formulate research questions for evidence-based practice. The components of the framework are as follows:
- Population: This refers to the patients or population of interest.
- Intervention: This refers to the intervention or treatment being studied.
- Comparison: This refers to the alternative intervention or treatment being compared.
- Outcome: This refers to the outcome being measured or evaluated.
- Timeframe: This refers to the timeframe over which the intervention is being evaluated.
3. Why is PICOT important in nursing research?
PICOT is essential in nursing research because it helps to ensure that the research question is relevant, answerable, and important to nursing practice. It helps to narrow down the research question and focus on a specific issue that needs to be addressed. PICOT also helps to ensure that the research is evidence-based and contributes to improving patient outcomes.
4. The Importance of a Nursing Practice Problem in PICOT
A nursing practice problem is a clinical issue or problem that is encountered in nursing practice. It can be a problem related to patient care, healthcare delivery, or nursing education. A nursing practice problem is important in PICOT because it provides the context for the research question. It helps to ensure that the research is relevant to nursing practice and addresses a significant issue.
5. How to Develop a Nursing Practice Problem for PICOT
Developing a nursing practice problem for PICOT involves the following steps:
- Identify a clinical issue or problem in nursing practice.
- Conduct a literature review to determine if the issue has been studied before.
- Refine the issue based on the literature review and determine if it is relevant to nursing practice.
- Use the PICOT framework to formulate a research question that addresses the nursing practice problem.
6. Examples of Nursing Practice Problems for PICOT
Examples of nursing practice problems for PICOT include:
- Inadequate pain management in hospitalized patients
- Hand hygiene compliance among healthcare workers
- Fall prevention in elderly patients
- Effectiveness of nursing interventions for reducing medication errors
- Nursing interventions for reducing hospital readmissions in heart failure patients
In conclusion, ensuring that your PICOT is based on a nursing practice problem is crucial for conducting evidence-based research that is relevant to nursing practice. The PICOT framework helps to narrow down the research question and focus on a specific issue that needs to be addressed. By using a nursing practice problem in PICOT, you ensure that the research is relevant, important, and contributes to improving patient outcomes.