PICOT Statement
Pressure ulcer is one of the major health issue found mostly in sub-acute center and in the hospital. Pressure ulcer usually affects adults. There are many preventive measures available for pressure ulcer such as multidisciplinary team role. Nurses play very important roles for pressure ulcer prevention. Per many studies, to advance health care quality by adapting various strategies, problem solving evidence based practice in the nursing practice plays an important role (Melnyk, Gallagher, Long, L. E., & Fineout‐Overholt, 2014). Pressure ulcer usually affects young adults, especially in acute care and hospital setting affects quality of health due to poor mobility. Therefore, this paper will discuss about establishing a PICOT
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statement that will be used in formulating a relevant research question on the issue of pressure related ulcers in acute care centers among adults. Evidence Based Solution To prevent increasing cases of pressure ulcer in young adults in hospitals or in acute settings, primary nurses must implement various interventions. Therefore, nurses need to adopt different policies and procedures which includes programs for pressure ulcer prevention (Melnyk et al., 2014). Though, to competently implement this policies and programs, nurses must appraise different preventive approaches that they can adopt in acute care settings or hospitals. Health Care Agency According to health care agency on quality and research (2012), every year three million people get affected by pressure ulcer.
In most of the patient’s pressure ulcer resulted in to patient’s health deterioration and increases chances of infection. Therefore it is very critical to formulate PICOT statement as it provides comprehensive analysis of the issue (Boswell & Cannon, 2012). PICOT can be described as below. P represents the patient’s population (P), I represent intervention or issue (I), and C refers to comparison of different intervention related to issue. O refers to the expected outcome of interest and, T refers to the time that is going to be use for targeted result of …show more content…
research. Patient Care As we compare PICOT to this case the patient’s population is adults in acute care center. Mostly these patients depend on nurses or family members for care and treatment. In this center, patients with pressure ulcer are usually transferred from either ICU or unconscious patients with critical conditions (Cox, 2011). These patients required constant maximum care and attention. The reason for patients having pressure ulcer in this facility is due to neglect and offering poor quality of care. Nursing Intervention There many different strategies that can be used for pressure ulcer treatment or prevention, such as turning and repositioning every two hours or pressure alternative mattresses. These strategies are especially important while the patient is in acute rehab center and immobile to ensure the patient is provided with a comfortable environment for full recovery (Soban, S., Munjas, B. A., Miles, & Rubenstein, L. V., 2011). Therefore, nurses need to pay special attention to the use of appropriate mattress to decrease the speeding process of pressure ulcer. Nursing Practice To successfully accomplish the above stated nursing interventions, nursing school needs to look into their program or change their program by providing more teaching and training to nurses on the best way of providing turning and repositioning.
The outcome of interest in adoption of these two actions of intervention is to help to decrease chances of occurrence of pressure ulcer and also will help to prevent pressure ulcer. A nursing assessment and plan can help to determine the patient’s essential need for treatment. Many different studies have been done which is evident based research, which shows the positive effect of implementing all these interventions including nutrition and high protein diet (Soban et al., 2011). Therefore, implementing this intervention can significantly decrease occurrence of pressure ulcer within two weeks or up to six months. The ideal PICOT statement for this study subject can be "in acute care centers, does pressure mattresses compared to regular turning of patients, reduce the pressure ulcers occurrences among the adult patients within two weeks or up to six
months?" Conclusively, to prevent or even to decrease chances of pressure ulcer needs more evidence based research material to provide more information to health care members. Acquired pressure ulcer either in hospitals or sub-acute facilities affects patient’s recovery process by increasing chances of infection and sepsis. Therefore, it is very important for all the health care providers, especially nurses, to use the different techniques such as an effectively proven intervention in decreasing occurrence or prevention of pressure ulcer.
The Braden risk assessment tool was deemed to be appropriate due to the patient’s comorbidity’s of peripheral vascular disease and lymphoedema with the addition of an arterio-venous leg ulcer of the right leg. This scale is universally accepted as a tool to help identify those most at risk with a goal of allowing health care providers to use their experience and judgement to consistently reduce the risk or to ensure preventive care is appropriately prescribed (Guy, 2012). Pressure ulcers are a risk factor for those who suffer from
Risk assessment scales have been in situ for over 50 years within the adult sector. These scales consist of several categories, which are thought to be associated with the potential occurrence of a pressure ulcer. Factors such as mobility and incontinence etc. are considered. Each category of the assessment is added up to give a total. The score then suggests whether a patient is at low, medium or high risk of developing a pressure ulcer. Higher-risk patients are therefore more susceptible to develop pressure ulcers and interventions are implemented such as, Air mattresses or nutritional support which is hoped to reduce the occurrence of pressure
In conclusion, I believe that formulating a PICOT question can be an effective way for nurses to find pertinent information quicker and easier with increased relevance to the intended subject. It can assist with finding stronger supporting evidence that can help nurses make better clinical decisions and bring about change where needed for patient safety and satisfaction. By utilizing the PICOT format, nurses can help formulate new interventions that will lead to better outcomes for the patients.
...ssure ulcers can be preventable if there is a systemic and multi-professional approach to their prevention and continuing assessment of skin integrity. Mary was determined and worked well with the physiotherapist; she was up and on her feet within a week of returning. Staff had to prompt her to move around the ward, which at times was hard for her due to her anxiety. Mary was deemed high risk for falls, so was put on a prevention of falls chart in conjunction with the pressure area chart and repositioning chart.
When performing evidence based practice research, the Iowa Model uses a team or individual approach to assist nurses in the journey to quality care. The Iowa Model begins by offering a process of selecting a proper clinical topic, which is often a recurring problematic issue (Polit & Beck, 2012). This topic is formulated as a question to improve a technique or procedure. Once the researcher determines that an ample amount of reported investigation exists on the desired question, information may be gathered and presented for approval (Polit & Beck, 2012). The research may lead to a gradual change in nursing practice.
The current patient may be experiencing a range of traumatic injuries after his accident, the injuries that the paramedic will focus on are those that are most life threatening. These injuries include: a possible tension pneumothroax or a haemothorax, hypovolemic shock, a mild or stable pelvic fracture and tibia fibula fracture.
Gastrointestinal tract (GIT) is the portal through which nutritive substances; vitamins, minerals and fluids enter the body. The digestive tract is more than 10 metres long from one end to the other. It is continuous starting from the mouth, passing through the pharynx and the oesophagus, to the stomach, the small and large intestines, ending in the rectum, and finally into the anus. The GI tract is divided into two main sections: the upper GI tract and the lower GI tract. Upper GIT includes the mouth, pharynx, oesophagus and stomach. The lower GI tract includes the small and large intestines and anus. The accessory organs of digestions are the gallbladder, liver and pancreas. Diseases that may occur in upper and lower GIT can be divided as oesophageal diseases, gastric diseases and intestinal diseases.
As an ICU nurse I constantly watch how patients develop pressure ulcers, a pressure ulcer is an area of skin that breaks down due to having constant friction and pressure, also from having limited movement and being in the same position over a prolonged period of time. Pressure Ulcers commonly occur in the buttocks, elbows, knees, back, shoulders, hips, heels, back of head, ankles and any other area with bony prominences. According to Cox, J. (2011) “Pressure ulcers are one of the most underrated conditions in critically ill patients. Despite the introduction of clinical practice guidelines and advances in medical technology, the prevalence of pressure ulcers in hospitalized patients continues to escalate” (p. 364). Patients with critical conditions have many factors that affect their mobility and therefore predispose them to developing pressure ulcers. This issue is significant to the nursing practice because nurses are the main care givers of these patients and are the ones responsible for the prevention of pressure ulcers in patients. Nurses should be aware of the tools and resources available and know the different techniques in providing care for the prevention of such. The purpose of this paper is to identify possible research questions that relate to the development of pressure ulcers in ICU patients and in the end generate a research question using the PICO model. “The PICO framework and its variations were developed to answer health related questions” (Davies, K., 2011).
Evidence-based practice integrates best current evidence with clinical expertise and patient/family preferences and values for the delivery of optimal health care (qsen.org). Like most medical professions, nursing is a constantly changing field. With new studies being done and as we learn more about different diseases it is crucial for the nurse to continue to learn even after becoming an RN. Using evidence-based practice methods are a great way for nurses and other medical professionals learn new information and to stay up to date on new ways to practice that can be used to better assess
Quality improvement issues in healthcare focus on the care that patients receive and the outcomes that patients experience. Nurses play a major advocacy role for ensuring safe and quality care to all patients. Also, nurses share the responsibility in leading the efforts in improving patient care in all settings (Berwick, 2002). One of the ongoing problems plaguing hospitals and nursing homes is the development of new pressure ulcers in patients after admission. A pressure ulcer can be defined as a localized area of necrotic tissue that is likely to occur after soft tissue is compressed between a bony prominence and a surface for prolonged periods of time (Andrychuk, 1998). According to the Centers for Medicare and Medicaid, patients should never develop pressure ulcers while under the supervision of any medical institution because they are totally preventable (Berwick, 2002). The purpose of this paper is to discuss the problems associated with pressure ulcers, examine the progress on improving this specific issue, and explain the Plan, Do, Study, Act cycle that I would use to improve patient care in this area.
Problem solving is when there is a problem or issue that needs to be resolved. When there is a problem with a patient the nursing staff needs to try and resolve it to make all parties satisfied. When trying to solve a problem, keep in mind about the core attribute safeguarding patients autonomy. In this core attribute, it involves the patient wanting to be involved in their health care plan, as well as make their own decisions as long as they are competent. (Bu & Jezewski, 2006) Once the problem is identified the nursing staff along with the patient, need to form a plan or possible goals that will help solve the problem. There will be many problems that can’t be complete...
Compartment Syndrome occurs when too much pressure builds up inside a closed space in the body. This usually happens when there is bleeding or swelling after an injury. The pressure in compartment syndrome delays the flow of blood to the affected tissues. It can be an emergency, needing surgery to prevent permanent injury.
One feature of evidence based practice is a problem-solving approach that draws on nurses’ experience to identify a problem or potential diagnosis. After a problem is identified, evidence based practice can be used to come up with interventions and possible risks involved with each intervention. Next, nurses will use the knowledge and theory to do clinical research and decide on the appropriate intervention. Lastly, evidence base practice allows the patients to have a voice in their own care. Each patient brings their own preferences and ideas on how their care should be handled and the expectations that they have (Fain, 2017, pg.
Our approach in managing wounds was far from being optimal in our own setting. After having read the article of Sibbald et al (1) and assisting to presentations during the first residential week-end, our approach at St. Mary 's Hospital Center 's Family Medicine Clinic must change. We were not classifying wounds as healable, maintenance or non-healable. We were always considering the wounds in our practice as healable despite considering the system 's restraints or the patients ' preferences. In the following lines, I will define and summarize the methods one should use in order to initial management of wounds and how to integrate it better to our site. The first goal we need to set is to determine its ability to heal. In order to ascertain if a wound is healable, maintenance or a non-healable wound.
PICO questions are important because it allows nurses to continue to provide safe, effective patient care by formulating clinical questions that can be answered through research of published studies and clinical expertise to improve patient outcomes by improving nursing standards, protocols, and policies (LoBiondo-Wood, & Haber, 2014). Each element of the PICO question is important because it provides a framework for nurses to develop the clinical question. Identifying the population allows the nurse to pinpoint the patient population or primary problem (McKeon, & McKeon, 2015). The intervention identifies the what is the main component that needs to be addressed for the patient, such as diagnostic test, treatments, therapies, medications