NUR 550 Evidence-Based Practice Project Proposal: PICOT Assignment
NUR 550 Evidence-Based Practice Project Proposal: PICOT Assignment
NUR 550 Evidence-Based Practice Project Proposal: PICOT Assignment
PICOT Draft
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Part 1:
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The selected nursing problem for the project is catheter-associated urinary tract infections (CAUTIs). CAUTIs are infections that patients develop following their insertion with urinary catheters. The issue was selected because of it is a safety and quality issue in nursing practice that is preventable (Smith et al., 2019). Statistics shows that CAUTIs affect about 11 million people in America and 150 million people globally annualy. The statistics make CAUTIs the leading type of hospital-acquired infection globally (Flores-Mireles et al., 2019). CAUTIs have adverse health effects. They act as a source of immense disease burden to the population due to their associated costs. CAUTs prolonge the patients’ hospital stay, demand for specialized care, which increase unnecessary costs for them. CAUTIs may also result in complications such as septicemia, which can lead to death. The risk factors associated with CAUTIs include the use of septic techniques, prolonged catheterization, and poor catheter care by the nurses and other healthcare providers. The topic of CAUTIs is relevant to nursing practice because nurses are primarily involved urinary catheter insertion, care, and removal. The actions they take determine the predisposition of patients to urinary tract infections following catheterization (Podkovik et al., 2019). Therefore, the problem should examined to inform the utilization of best practices in catheter insertion, care, and removal.
Part II: In the table below, describe the population and the intervention. (You will continue drafting the PICOT, completing the shaded areas in Topic 3.)
| PICOT Question | ||
| P | Population | Patients being catheterized |
| I | Intervention | Use of bundled intervention |
| C | Comparison | Usual care |
| O | Outcome | Reduction in CAUTIS rate by at least 50% |
| T | Timeframe | Eight months |
| PICOT | Among patients requiring urinary catheterization in the medical and surgical ward, does the use of bundled intervention as compared to usual care result in at least 50% reduction in CAUTIs within eight months? | |
| Problem Statement | CAUTIs are among the crucial hospital acquired infections with a high prevalence in hospitalized patients. According to evidence, CAUTIs account for 40% of the hospital acquired infections globally. CAUTIs is a considerable public health problem in the USA, with more than 30 million Foley catheters being used annually in hospitals and other healthcare settings (Flores-Mireles et al., 2019). The risk of patients developing CAUTIs largely depend on the duration of catheterization. The risk increses by 3-7% each day following the insertion of a urinary catheter. CAUTIs are associated with adverse health outcomessuch as bacteremia, bladder changes, squamous carcinoma, and cystitis granularis. Patients also incus significant healthcare costs due to prolonged hospitalization and complex care needs (Podkovik et al., 2019). The practice site has experience a rise in CAUTIs. However, an evidence-based intervention has not been adopted for use in CAUTIs prevention and minimization in the organization. The use of bundled interventions have gained popularity over the past years in preventing and minimizing CAUTIs among hospitalized patients. The interventions promote the consistent use of best practices to optimize outcomes such s safety and quality in catheter insertion, care, and removal (Shadle et al., 2021). Despite this, the organization has not considered such an intervention, hence, the focus of the proposed project. | |
References
Flores-Mireles, A., Hreha, T. N., & Hunstad, D. A. (2019). Pathophysiology, Treatment, and Prevention of Catheter-Associated Urinary Tract Infection. Topics in Spinal Cord Injury Rehabilitation, 25(3), 228–240. https://doi.org/10.1310/sci2503-228
Podkovik, S., Toor, H., Gattupalli, M., Kashyap, S., Brazdzionis, J., Patchana, T., Bonda, S., Wong, S., Kang, C., Mo, K., Wacker, M. R., Miulli, D. E., & Wang, S. (2019). Prevalence of Catheter-Associated Urinary Tract Infections in Neurosurgical Intensive Care Patients—The Overdiagnosis of Urinary Tract Infections. Cureus, 11(8), e5494. https://doi.org/10.7759/cureus.5494 https://doi.org/10.1016/j.jhin.2019.04.010
Shadle, H. N., Sabol, V., Smith, A., Stafford, H., Thompson, J. A., & Bowers, M. (2021). A Bundle-Based Approach to Prevent Catheter-Associated Urinary Tract Infections in the Intensive Care Unit. Critical Care Nurse, 41(2), 62–71. https://doi.org/10.4037/ccn2021934
Smith, D. R. M., Pouwels, K. B., Hopkins, S., Naylor, N. R., Smieszek, T., & Robotham, J. V. (2019). Epidemiology and health-economic burden of urinary-catheter-associated infection in English NHS hospitals: A probabilistic modelling study. The Journal of Hospital Infection, 103(1), 44–54.
PICOT (Population/Problem, Intervention, Comparison, Outcome, and Time to achieve the outcome) is a method that helps clarify the qualities needed to create a good question out of a practice issue or problem affecting a population of focus.
The purpose of this assignment is to complete your PICOT for your selected nursing practice problem. Refer to your “Evidence-Based Practice Project Proposal: Identification of Nursing Practice Problem” assignment from Topic 1 to complete this assignment. If your nursing practice problem or PICOT required revision, include those revisions in this assignment. The final PICOT you develop in this assignment will provide the framework for developing your evidence-based practice project proposal. Use the “PICOT-Final” template to complete this assignment.
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Refer to the “Evidence-Based Practice Project Proposal – Assignment Overview” document for an overview of the evidence-based practice project proposal assignments.
You are required to cite at least four peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.
While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center. NUR 550 Evidence-Based Practice Project Proposal: PICOT Assignment
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are not required to submit this assignment to LopesWrite.
AttachmentsNUR-550-RS1-EBP-PICOT Draft.docx
PICOT Final
Complete your PICOT using your approved proposed nursing practice problem. If they were approved, you may use the population and intervention developed in your Topic 1 assignment. Include any necessary revisions in this submission. Refer to the “Example PICOT” below as needed for guidance on how to complete the PICOT.
PICOT Question
P Population
I Intervention
C Comparison
O Outcome
T Timeframe
PICOT
Create a complete PICOT statement.
Problem Statement
Create a problem statement for your PICOT. You will use this problem statement throughout your final written paper.
NUR 550 Evidence-Based Practice Project Proposal: PICOT Assignment References
Example PICOT: Delete this example page prior to submitting your PICOT.
EXAMPLE PICOT
PICOT Question
P Population Adult patients with hypertension, Spanish primary language
I Intervention Written education in Spanish
C Comparison Teaching using an interpreter
O Outcome Improved BP control
T Timeframe 6 months
PICOT
In adult patients with hypertension, for whom Spanish is their primary language (P), does providing written education in Spanish (I) when compared to using an interpreter (C) lead to improved blood pressure control (O) over the course of 6 months (T)?
Problem Statement
The problem statement is a scholarly statement that justifies or rationalizes that this is problem. A problem statement must include literature for support and justification. Hispanics are more likely to have uncontrolled, untreated, or even undiagnosed hypertension when compared to other ethnic groups (Rodriguez et.al., 2015). Incidences of misinformation can occur when patients and providers do not share a common language. There is a lack of understanding or the inability to ask questions on the patient’s part. In addition, many Spanish-speaking patients find that the translation services, when available, are not adequate. These patients often do not trust the information received from providers, which can lead to unintentional noncompliance (Rodriguez et.al., 2015). NUR 550 Evidence-Based Practice Project Proposal: PICOT Assignment
NUR 550 Evidence-Based Practice Project Proposal: PICOT Assignment References
Rodriguez, C. J., Allison, M., Daviglus, M. L., Isasi, C. R., Keller, C., Leira, E. C., Palaniappan, L., Piña, I. L., Ramirez, S. M., Rodriguez, B., & Sims, M. (2014). Status of cardiovascular disease and stroke in Hispanics/Latinos in the United States: a science advisory from the American Heart Association. Circulation, 130(7), 593–625. doi:10.1161/CIR.0000000000000071
Course Code Class Code Assignment Title Total Points
NUR-550 NUR-550-O503 Evidence-Based Practice Project Proposal: PICOT 75.0
Criteria Percentage Unsatisfactory (0.00%) Less Than Satisfactory (80.00%) Satisfactory (88.00%) Blank (92.00%) Blank (100.00%)
Content 100.0%
Population (Revision) 7.0% The population is not described, or the required revisions were not made for the population description. NA Revisions were made accordingly for the population description, but some information or detail is needed for accuracy or clarity. NA The population is thoroughly and accurately described. No revision was needed.
Intervention (Revision) 8.0% The proposed intervention is not described, or the required revisions were not made for the described intervention. NA Revisions were made accordingly for the proposed intervention, but some information or detail is needed for accuracy or clarity. NA The proposed intervention is clearly described and relevant to the nursing practice problem and population. No revision was needed.
Comparison 10.0% A description of the comparison information is not included. A description of the comparison information is incomplete or incorrect. A description of the comparison information is included but lacks evidence and measurable outcomes. A description of the comparison information is complete and includes sufficient evidence and measurable outcomes. A description of the comparison information is extremely thorough with substantial evidence and measurable outcomes.
Outcome 10.0% A description of the outcome is not included. A description of the outcome is not included. A description of the outcome is included but lacks evidence. A description of the outcome is complete and includes sufficient evidence. A description of the outcome is extremely thorough with substantial evidence
Timeline 10.0% A description of the timeline is not included. A description of the timeline is incomplete or incorrect. A description of the timeline is included but lacks evidence. A description of the timelines is complete and includes sufficient evidence. A description of the timeline is extremely thorough with substantial evidence.
PICOT 20.0% The PICOT statement is omitted. The PICOT statement is incomplete. The PICOT statement is presented but there some inaccuracies. The PICOT statement is presented. Some detail is needed. The PICOT statement concisely and accurately describes the problem.
Problem Statement 20.0% A problem statement is not included. The problem statement is incomplete. The problem statement is generally presented. There are some inaccuracies. More support is needed to justify or rationalize the problem. The problem statement is presented. Adequate support is provided to justify or rationalize the problem. The problem statement concisely describes the issue using strong support to rationalize and justify the problem.
Required Sources 5.0% Sources are not included. Number of required sources is only partially met. Number of required sources is met, but sources are outdated or inappropriate. Number of required sources is met. Sources are current, but not all sources are appropriate for the assignment criteria and nursing content. Number of required resources is met. Sources are current and appropriate for the assignment criteria and nursing content.
Mechanics of Writing (includes spelling, punctuation, grammar, and language use) 5.0% Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is employed. Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) or word choice are present. Sentence structure is correct but not varied. Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct and varied sentence structure and audience-appropriate language are employed. Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech. The writer is clearly in command of standard, written, academic English.
Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style) 5.0% Sources are not documented. Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors. Sources are documented, as appropriate to assignment and style, although some formatting errors may be present. Sources are documented, as appropriate to assignment and style, and format is mostly correct. Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.
Topic 1 DQ 1
Identify the different levels of translational research. Explain how translational research is different from evidence-based practice and discuss application to population health management.
Re: Topic 1 DQ 1
Translational research is form of clinical research that was first seen around 1993 (Rubio et al, 2010). So as far as research goes this is a fairly new was to look into things. There is also no clear definition of translational research, but essentially it encompasses two areas of translation one being the information obtained in pre-clinical studies, lab research and the other being the adaptation of best practices in the community with their cost effectiveness (Rubio et al, 2010).
There are three levels of translational research, starting with T1, which involves the beginning research or development of an intervention, including the lab research, observational research and phase I and II clinical trials (Translational Research, n.d.). The second level is T2 the translation to patients, testing these interventions and their efficacy on the patient populace, including phase III clinical trials, studying how these new interventions work with disease processes and creating new guidelines with up-to-date information (Translational Research, n.d.). The third level is T3 disseminating and implementation of all the research into daily practice, creating the research evidence found into evidence-based practices across the profession (Translational Research, n.d.).
From this information there isn’t a difference between evidence-based practice and translational research, it is just a way to get to evidence based practice. By following the ‘three T’s’, the final step is to put all of this research into practice, as evidence-based practice. For public health this means the most up to date care and information as the natural progression of translational practice ends with practice. If there is no research being done in the area however, this has a negative impact on the population, as there is not up to date EPB related to that disease process and/or its co morbidities.
Rubio, D. M., Schoenbaum, E. E., Lee, L. S., Schteingart, D. E., Marantz, P. R., Anderson, K. E., Platt, L. D., Baez, A., & Esposito, K. (2010). Defining translational research: implications for training. Academic medicine : journal of the Association of American Medical Colleges, 85(3), 470–475. https://doi.org/10.1097/ACM.0b013e3181ccd618
Translational Research – Defining the “T’s” | Translational Cancer Research Network. (n.d.). Www.Tcrn.Unsw.Edu. Retrieved June 18, 2021, from http://www.tcrn.unsw.edu.au/translational-research-definitions
PICOT Final
PICOT Question
Population School-age children with obesity
Obesity among school-age children has reached epidemic levels in the United States. De Lorenzo et al. (2019) described obesity as significant public health concern since it affects the physical, psychological, and cardiovascular health of the affected populations. Data from 2015-2016 shows that 1 in 5 children in the United States aged 6 to 19 years has obesity, and the rate has tripled since the 1970s (Centers for Disease Control and Prevention, 2018). Risk factors include poor eating habits, lack of physical activity, genetics, and negative childhood events. Therefore, immediate, evidence-based, and population-driven interventions are necessary to reduce the surging rates.
I Intervention Educating parents and children
Parents can help to reduce obesity rates by modeling healthy living among children. The outcomes can be improved when children understand the risks and can actively participate in obesity prevention activities. Educating parents and children on the benefits of reducing screen time is a practical nursing intervention since its goal is to promote healthy living by keeping children free from sedentary living. Parents and children should understand the risks that too much screen time poses and the need to be more physically active.
C Comparison No education
The comparison considered is no education for parents and children on the need to minimize screen time and regulation strategies. In this case, parents will apply self-taught strategies or knowledge acquired from social and mainstream media to control obesity. In this case, the difference in outcomes after educating parents and children, if any, would be primarily attributed to the nursing intervention.
O Outcome Reduced obesity rates
Educating parents and children on the implications of too much screen time is expected to be the foundation of behavior change. As a nursing intervention, the education program will improve knowledge on the connection between obesity in children and screen time as a risk factor. Minimizing screen time will lead to a proportional reduction in obesity rates among children, which has become a public health concern since its trend has taken an upward trajectory in the past decade (Skinner et al., 2018). Reducing obesity rates will also improve productivity in children and reduce overall health care costs since obesity is a leading cause of psychological and cardiovascular health problems (Sanyaolu et al., 2019). The overall outcome is creating a healthy populace by reducing obesity rates among school-age children.
T Timeframe Six months
It is possible to achieve the targeted outcome in six months. Parents are expected to start implementing the knowledge acquired immediately, and children are expected to change their behaviors instantly as far as screen time is concerned.
PICOT
Create a complete PICOT statement. In school-age children with obesity (P), can educating parents and children (I) compared to no education (C) reduce obesity rates (O) in six months (T)?
Problem Statement
Create a problem statement for your PICOT. You will use this problem statement throughout your final written paper.
School-age children are a vulnerable population at high risk of obesity. A significant proportion spends a lot of time on screens watching television, gaming, and social interaction, among other ways. Increased screen time is a leading cause of obesity due to intake of too much energy and lack of physical activity (Fang et al., 2019). Obesity puts children at risk of diabetes and cardiovascular, physical, and mental health problems. The increased illness burden increases health care costs and nurses’ workload, and evidence-based interventions are necessary.
NUR 550 Evidence-Based Practice Project Proposal: PICOT Assignment References
Centers for Disease Control and Prevention. (2018, Sep 18). Obesity. https://www.cdc.gov/healthyschools/obesity/index.htm
De Lorenzo, A., Gratteri, S., Gualtieri, P., Cammarano, A., Bertucci, P., & Di Renzo, L. (2019). Why primary obesity is a disease? Journal of Translational Medicine, 17(1), 1-13. https://link.springer.com/article/10.1186/s12967-019-1919-y
Fang, K., Mu, M., Liu, K., & He, Y. (2019). Screen time and childhood overweight/obesity: A systematic review and meta‐analysis. Child: Care, Health and Development, 45(5), 744-753. https://doi.org/10.1111/cch.12701
Sanyaolu, A., Okorie, C., Qi, X., Locke, J., & Rehman, S. (2019). Childhood and adolescent obesity in the United States: A public health concern. Global Pediatric Health, 6, 2333794X19891305. https://doi.org/10.1177/2333794X19891305
Skinner, A. C., Ravanbakht, S. N., Skelton, J. A., Perrin, E. M., & Armstrong, S. C. (2018). Prevalence of obesity and severe obesity in US children, 1999–2016. Pediatrics, 141(3). https://doi.org/10.1542/peds.2017-3459
System-wide quality improvement (QI) initiatives offer opportunities to advance population health strategies, change perspectives and language, and eventually impact organizational culture. Lessons learnt are applied to health promotion practitioners trying to attract healthcare partners, and for health systems deliberately investing to improve population health. Population health safety and quality improvement include cultural safety, patient-centeredness, and health equity to other dimensions of healthcare quality (Kryzanowski, et al., 2019).
An example is the adoption of Lean as a QI strategy by the former Saskatoon Health Region1 in 2010 committing to the Quadruple Aim (“Better Health, Better Care, Better Teams, and Better Value”) in 2013. A report in 2014 on population health status showed extensive and continuing disparities in health status and healthcare utilization among Saskatoon residents living in areas of highest and lowest deprivation. The Chief Medical Health Officer’s report recommended for the Region to entrench equity as a dimension of healthcare quality within its Lean QI system. The goal of the Region’s 2015 Safety intervention was to prevent harm to patients, staff, and physicians through innovative approaches to safety. A health equity and cultural safety team was formed from public and private health organizations to serve in an advisory role to the Hoshin leadership team.
The team involved patient representatives, QI experts, and organizational leaders and ethics consultants and assembled individuals from various departments whose works incorporate similar principles towards a collective vision for population health and equity, but hitherto, used different approaches and language. This deliberate decision to incorporate population health promotion efforts into QI led to the adoption of equity and cultural safety as priorities for the entire health system with public commitments (Kryzanowski, et al., 2019).
Since the activities of translational research span across the basic-to-applied continuum, translational research contributed to the studies that identified the existence of health disparities in the Saskatoon province through to the evaluation of the interventions.
Reference
Kryzanowski, J., Bloomquist, C. D., Dunn-Pierce, T., Murphy, L., Clarke, S., & Neudorf, C. (2019). Quality improvement as a population health promotion opportunity to reorient the healthcare system. Canadian Journal of Public Health, 110(1), 58-61. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6964622/
REPLY
NUR-550 Topic 5: Translating Evidence into Practice to Improve Safety and Quality and Eliminate Barriers
| EXAMPLE PICOT | ||
| PICOT Question | ||
| P | Population | Adult patients with hypertension, Spanish primary language |
| I | Intervention | Written education in Spanish |
| C | Comparison | Teaching using an interpreter |
| O | Outcome | Improved BP control |
| T | Timeframe | 6 months |
| PICOT | In adult
| |