NR 505 Week 2 Assignment: PICOT Question Worksheet

Assignment

Purpose

Evidence-based practice is initiated by nurses and other healthcare professionals who identify questions about specific health-related interventions and the outcomes of those interventions on individuals and populations. The creation of a PICOT question helps guide evidence-based initiatives. The purpose of this worksheet is to provide an opportunity to explore the development of a PICOT question as a foundation for evidence-based practice.

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Course Outcomes

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This assignment enables the student to meet the following course outcomes:

CO1: Integrate evidence-based practice and research to support advancement of holistic nursing care in diverse healthcare settings. (PO 1, 4)

CO2: Integrate knowledge related to evidence-based practice and person-centered care to improve healthcare outcomes. (PO 1, 2)

CO3: Demonstrate professional and personal growth through a spirit of inquiry, scholarship, and service in diverse healthcare settings. (PO 3, 4)

CO4: Develop knowledge related to research and evidence-based practice as a basis for designing and critiquing research studies. (PO 1, 2, 5)

Due Date

The assignment should be submitted to the Week 2 PICOT Question Worksheet dropbox by Sunday 11:59 p.m. MST at the end of Week 2. This assignment will follow the late assignment policy specified in the course syllabus.

Students are expected to submit assignments by the time they are due. Assignments submitted after the due date and time will receive a deduction of 10% of the total points possible for that assignment for each day the assignment is late. Assignments will be accepted, with penalty as described, up to a maximum of three days late, after which point a zero will be recorded for the assignment

In the event of a situation that prevents timely submission of an assignment, students may petition their instructor for a waiver of the late submission grade reduction. The instructor will review the student’s rationale for the request and make a determination based on the merits of the student’s appeal. Consideration of the student’s total course performance to date will be a contributing factor in the determination. Students should continue to attend class, actively participate, and complete other assignments while the appeal is pending.

Total Points Possible

This assignment is worth 100 points.

Preparing the Assignment

Review the elements included in PICOT questions to guide evidence-based nursing practice.

Respond to the questions below using the PICOT Question Worksheet Template

Links to an external site. Download PICOT Question Worksheet Template.

Using a minimum of 3 scholarly nursing sources, current within 5 years:
Identify and describe one practice-related issue or concern. You may choose to build on the practice issue you identified in NR500NP/NR501NP.

Explain why the issue/concern is important to nurse practitioner practice and its impact on health outcomes.

Describe each element of your PICOT question in one or two sentences, being sure to address all of the following:

P-Population and problem– What is the nursing practice concern or problem and whom does it affect?

I–Intervention– What evidence-based solution for the problem would you like to apply?

C–Comparison– What is another solution for the problem? Note that this is typically the current practice, no intervention at all, or alternative solutions.

O–Outcome– Very specifically, how will you know that the intervention worked? Think about how you will measure the outcome.

T–Time frame– What is the Timeframe involved for the EBP initiative or the target date of completion?

Construct your PICOT question in the standard PICOT question format (narrative) and define each letter separately, such as:

P =

I =

C =

O =

T =

PICOT question written in full =
Abide by the Chamberlain College of Nursing Academic Integrity Policy.

At the graduate level, we like to see you synthesizing your ideas into your own words. No direct quotes may be used in this worksheet.

Use APA formatting guidelines for references and citations.

Submit your worksheet using the PICOT Worksheet Template as a Word document to the Week 2 Dropbox

ASSIGNMENT CONTENT

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Please read the assignment guidelines and rubric. Provide answers to the following:

1) Identify and describe one practice-related issue or concern. You may choose to build on the practice issue you identified in NR500NP/NR501NP. Provide support for the issue from scholarly nursing sources current within the last 5 years.

The identified NP practice-related issue is surgical site infections (SSIs). An SSI is an infection associated with an operative procedure that develops at or near the surgical incision within 30 days of the operative procedure or 90 days if prosthetic material was implanted at surgery. According to Walker (2023), SSIs are frequently reported healthcare-acquired infections (HAIs) that account for 14% − 25% of the total HAIs. SSIs are a major healthcare burden as they contribute to prolonged hospitalization, increased medical costs, high morbidity and mortality rates, and poor patient satisfaction. However, various studies have looked into the issue and proposed different measures that can be used to address SSIs in the hospital setting. Seidelman et al. (2023) identified several strategies linked with reduced SSI rates. One of the measures is using chlorhexidine gluconate and alcohol-based skin preparation. Jalalzadeh et al. (2022) found that in adult patients undergoing a surgical procedure, skin preparation using 2·0–2·5% chlorhexidine in alcohol or 1·5% olanexidine is effective in preventing SSIs.

2) Explain why the issue/concern is important to nurse practitioner practice and the issue’s impact on health outcomes. Provide support for the importance of the issue from scholarly nursing sources current within the last 5 years.

SSIs are important to NP practice since NPs manage care for pre-operative and post-operative patients. NPs are required to predict SSIs and diagnose them early to provide timely and effective treatment and accelerate the recovery of affected patients. Avsar et al. (2021) explain that increased incidences of SSIs in a hospital setting tend to raise questions about the quality of care provided to patients by the healthcare team, which includes NPs and other medical professionals. NPs play an essential role in patient care, and those who integrate best practice standards can help to lower the morbidity and mortality related to SSIs significantly.

SSIs often have a negative effect on health outcomes, including patients’ outcomes and quality of life. Hughes et al. (2023) explain that an increasing percentage of SSIs are detected after discharge. Of the 500,000 SSIs that are diagnosed in the U.S. annually, approximately 69% of SSIs occur after hospital discharge. SSIs are linked with extended periods of hospitalization, high medical costs, poor patient satisfaction, and increased patient morbidity and mortality (Costabella et al., 2023). Seidelman et al. (2023) found that patients who develop SSI have a longer hospital stay of 7 to 11 days compared with patients who undergo surgery and do not develop SSI. Therefore, a rigorous approach is needed to identify and manage the risk of infection across the pre-operative, intra-operative, and post-operative phases of care.

3) Define each element of your PICOT question in one or two sentences.

P-Population and problem- The target population is pre-operative patients who face adverse effects of surgical site infections (SSIs), as a well as prolonged hospitalization, high medical costs, high morbidity and mortality rates, and poor patient satisfaction. According to Seidelman et al. (2023), approximately 0.5%- 3% of patients undergoing surgery experience infection at or near the surgical incision site.
I–Intervention: The proposed intervention is using chlorhexidine gluconate and alcohol-based skin preparation. Jalalzadeh et al. (2022) found that in adult patients undergoing a surgical procedure, skin preparation using 2•0–2•5% chlorhexidine in alcohol or 1•5% olanexidine is effective in preventing SSIs.
C–Comparison: Skin preparation with chlorhexidine gluconate and alcohol-based solution will be compared with sterile saline. Sterile saline does not have any antimicrobial activity (Droll et al., 2022).
O–Outcome: The expected outcome is to lower the rate of SSIs by 50%.
T–Timeframe: The impact of the proposed intervention will be evaluated after six months.

Construct your PICOT question in the standard PICOT question format (narrative) and define each letter separately, such as:

P = Pre-operative patients.
I = Chlorhexidine gluconate and alcohol-based skin preparation.
C = Skin preparation with sterile saline
O = Lower the rate of SSIs by 50%.
T = Six months.

In preoperative patients (P), does chlorhexidine gluconate and alcohol-based skin preparation (I) compared to skin preparation with sterile saline (C) lower the risk of SSIs by 50% (O) within six months (T)?

References

Avsar, P., Patton, D., Ousey, K., Blackburn, J., O’Connor, T., & Moore, Z. (2021). The Impact of Surgical Site Infection on Health-related Quality of Life: A Systematic Review. Wound Management & Prevention, 67(6), 10–19.

Costabella, F., Patel, K. B., Adepoju, A. V., Singh, P., Attia Hussein Mahmoud, H., Zafar, A., Patel, T., Watekar, N. A., Mallesh, N., Fawad, M., Sathyarajan, D. T., & Abbas, K. (2023). Healthcare Cost and Outcomes Associated With Surgical Site Infection and Patient Outcomes in Low- and Middle-Income Countries. Cureus, 15(7), e42493. https://doi.org/10.7759/cureus.42493

Droll, K. P., Abouassaly, M., Cullinan, C., Puskas, D., & Dubois, S. (2022). Efficacy of surgical skin preparation solutions in hip arthroplasty: a prospective randomized trial. Canadian Journal of Surgery. Journal Canadien de Chirurgie, 65(6), E756–E762. https://doi.org/10.1503/cjs.017221

Hughes, C. M. L., Jeffers, A., Sethuraman, A., Klum, M., Tan, M., & Tan, V. (2023). The detection and prediction of surgical site infections using multi-modal sensors and machine learning: Results in an animal model. Frontiers in Medical Technology, 5, 1111859. https://doi.org/10.3389/fmedt.2023.1111859

Jalalzadeh, H., Groenen, H., Buis, D. R., Dreissen, Y. E., Goosen, J. H., IJpma, F., Van der Laan, M. J., Schaad, R. R., Segers, P., Van der Zwet, W. C., Griekspoor, M., Harmsen, W., Wolfhagen, N., & Boermeester, M. A. (2022). Efficacy of different preoperative skin antiseptics on the incidence of surgical site Infections: A systematic review, GRADE assessment and network meta-analysis. SSRN Electronic Journal. https://doi.org/10.2139/ssrn.4047135

Seidelman, J. L., Mantyh, C. R., & Anderson, D. J. (2023). Surgical site infection prevention: a review. JAMA, 329(3), 244-252. https://doi.org/10.1001/jama.2022.24075

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NR 505 Week 2 Assignment: PICOT Question Worksheet

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NR 505 Week 2 Assignment: PICOT Question Worksheet