NR 505 Week 2: PICOT/PICo and Practice Questions Discussion

NR 505 Week 2: PICOT/PICo and Practice Questions Discussion

NR 505 Week 2: PICOT/PICo and Practice Questions Discussion

For week 1, my research question in the PICo format was:  “What are NP’s experiences in providing care to patients who have fallen in an LTC and fractured bones in the United States?” After doing some research on this topic, I think qualitative is the best approach to use. A qualitative approach is categorical measurement used to describe findings in words versus a quantitative data approach, which is used to define in terms of numbers like quantity or amount. Qualitative research is very important in nursing research because it serves to find answers to the “how” and “why” of the nursing profession and aids in a meaningful understanding of nurse and patient experiences and context (Cleland, 2017). I also think qualitative research is more appropriate for my research since it provides a format that allows me to ask questions that cannot be easily put into numbers. Conducting qualitative research on health-related topics will enlighten nurses on the everyday realities of nursing experiences and how external factors like social phenomenon and clinical knowledge lead to better patient care. Nurses must learn the philosophical perspectives of qualitative research and nursing theories to develop comprehensive research question, study design, data collection methods and data analysis (Cleland, 2017). The qualitative research design that I have chosen was hard to decide. I struggled choosing between grounded theory, phenomenology, and historical study since each of them provides a workable format for me to gather and analyze collected data. Although ethnography, phenomenology, and grounded theory are the most common qualitative research designs to choose from, I would like to use the historical studies research design. It concerns the identification, location, evaluation, and synthesis of data from the past (Korstjens & Moser, 2017), and my goal is to compile and analyze NP’s experiences in treating patients who have fallen in an LTC and fractured bones. The historical research design gives me an opportunity to objectively construct an opinion (Korstjens & Moser, 2017). Another thing I like about the historical research design is that it allows me to focus on discovering NPs past experiences and relate them to the present and future. The past helps us associate meaning with the present and develop goals that work.

The outline of my PICo question is as follows:

• Phenomenon or concept of interest: Falling in the LTC and fracturing bones
  • Group or population of interest: Elderly patients
  • Suggestion of which qualitative research design is being used: Historical research design

My practice PICo question is:

“Using a historical research design as a format guide, what are nurse practitioners experiences and processes in providing care for elderly patients who have fallen in the LTC setting and fractured bones?”

References:

Cleland, J. A. (2017). The qualitative orientation in medical education research. Korean Journal of Medical Education, 29(2), 61–71. http://doi.org/10.3946/kjme.2017.53

Korstjens, I., & Moser, A. (2017). Series: Practical guidance to qualitative research. Part 2: Context, research questions and designs. European Journal of General Practice, 23(1), 274-279. Retrieved from https://doi.org/10.1080/13814788.2017.1375090

Chronic pain and it’s management can be a challenging task.  Chronic pain is a part of an assessment that can be measured with a pain tool that is approved by a facility.  After which a complete drug history is nessesary to avoid drug interactions.  Lastly, and most importantly a pain management plan is developed starting with the less invasive intervention and progressing to an more invasive interventions as needed (Smith & Pravikoff, 2018).  Just recently, my friend and I was discussing  her increase back pain, which is now chronic in nature.  She spoke about how she has learned to cope with the pain most days, but as a family nurse practitioner herself decided to forego treatment due to her busy schedule.  We spoke about some options that were noninvasive that she has recently started and physical therapy was one of her top interventions that she has credited to be the most effective in decreasing her discomfort.  While physical therapy may cause some increase time away from her only engagements, it has been proven to be the most effective intervention for her chronic back pain for her.  Now instead of suggesting pain medications to her patients she is offering physical therapy as an additional intervention.  This in itself is an evidence -based practice that has been proven to be effective for chronic back pain.  Deisi, thanks for your post.

Reference:

Smith, N. & Pravikoff, D . 2018).  Pain: Managing in Older Adults.  Nursing Practice and Skill.  Retrieved from:  eds.b.ebscohost.com.proxy.chamberlain.edu

The focus for Week 2 is on questions: PICOT/PICo and practice questions.

• Using the area of interest from Week 1, identify the following.
  • Will you be using a quantitative or qualitative approach for your EBP project proposal?
  • Explain why this approach is the best one to provide information for your area of interest.
  • Create a PICOT/PICo question using the PICOT/PICo format for quantitative and PICo for qualitative approaches.
  • Identify your practice question, being sure to include the following.
    • For a quantitative approach
      • A questioning part such as “what is,” “what are,” “is there,” or “are there”
      • Population being studied
      • Variables being studied
      • Suggestion of the relationship between variables
    • For a qualitative approach
      • Phenomenon or concept of interest
      • Group or population of interest
      • Suggestion of which qualitative research design is being used

Quantitative Approach

Initially, I thought that the qualitative approach would be a better approach for my evidence-based project proposal.  After further review, I now am convinced that the quantitative approach is a better approach for my evidence-based Practice (EBP) project proposal. Evidence-based practice is aimed at hardwiring current knowledge into common care decisions to improve care processes and patient outcomes (Stevens, 2013).   Evidence-based practice also unifies research evidence with clinical expertise and encourages through individualization of care through inclusion of patient preferences (Stevens, 2013).

Why the Quantitative Approach is best for rural populations’ unplanned healthcare (Area of Interest)

Because of my clinical experience with my area of interest in the rural population, this approach will allow

a collection of opinions, facts, attitudes, and behaviors to be analyzed.  The quantitative approach will also allow results to be generalized from a larger population such as the rural population.  With the use of the quantitative approach, this population will have the opportunity to reveal their needs and causes of lack of healthcare.  This research approach will be beneficial in order to decrease the incidence of unplanned healthcare, which is one of the biggest healthcare challenges that this population continues to face.  With the use of the quantitative research method, data can be collected from various forms such as: online surveys, paper surveys, telephone interviews, and face to face interviews.  The collection of this data will allow comparison of opinions and further investigation toward a resolution.   As exploration of the chosen population occurs with the combination of clinical experiences, an advancement of the proposed EBP will promote the intended outcome of better healthcare strategies.

PICO Quantitative Question

In the rural population (P) does health education, early diagnosis, and healthcare programs (I) compared to deploying health resources geographically (C) reduce the incidence of unplanned healthcare (O).

Quantitative Practice Question

Is there a link between the lack of healthcare education, early diagnosis, healthcare programs and unplanned healthcare?

Stevens, K.R. (2013).  The Impact of Evidence-based Practice in Nursing and the Next big Ideas.  Online Journal Issues in Nursing, 18(2), 1.  doi: 10.3912/OJIN18No02MAN04

As our weekly lesson discusses, identifying an area of interest is the first step in evidence based practice (CCN, 2018).  I am embarking on the family nurse practitioner track. There are numerous areas on interest in the family nurse practitioner field. My personal area of interest is healthcare-related phenomenon. Healthcare has transitioned towards patient centered care. Healthcare providers have a responsibility to help their patients maintain healthy lifestyles. The one thing that is imperative to keep in mind is that each patient is different. With that being said, I am a firm believer in individualizing a plan of care to meet my patient’s needs.

When developing a proposal for evidence based practice project it is important to decide whether you will use a qualitative or quantitative approach. According to researchers Jennifer Yates and Tricia Leggett (2016) quantitative studies examine relationships between and among variable where qualitative studies understand the how and the why of the story (p. 225). As I examine the approach used in my personal proposal, I think a quantitative approach would be most appropriate. As Yates and Leggett discuss (2016) quantitative studies are effective in testing effects of treatment or intervention on an outcome (p. 225). I would like to determine the effect of Individualized Diabetic Care Model in newly diagnosed diabetics. A quantitative approach would help determine if the intervention was successful or not. The PICOT question of my evidence based project is: In newly diagnosed diabetics, can participation in an Individualized Diabetic Care Model reduce resistance to life style changes as opposed to generalized information about the diagnosis?

If a PICOT question cannot be answered a research study will need to be designed. When developing a research study, a research question is also developed. As mentioned in our weekly lesson, a research study question will guide research and the data collected will answer the research question (CCN, 2018). My research question for a quantitative approach is: Is there a correlation between utilizing Individualized Diabetic Care Model for newly diagnosed diabetics and necessary lifestyle changes to reduce complications?

References:

Chamberlain College of Nursing. (2018). Week two lesson: Framing the question and locating evidence. Retrieved from: https://chamberlain.instructure.com/courses/27019/pages/week-2-lesson?module_item_id=3114395

Yates, J., & Leggett, T. (2016). Qualitative research: An introduction. Radiologic Technology, 88(2), 225-231.