PICOT Question and Evidence-Based Approach Paper

PICOT Question and Evidence-Based Approach Paper

PICOT Question and Evidence-Based Approach Paper

The never-ending need for better patient outcomes implies that healthcare providers are always looking to explore strategies that can improve the outcomes, for instance, using research. Research can be key in revealing the best strategies that can be applied in patient care. One of the tools that have been used in nursing research is PICOT, which is a question formulated in a well-defined way to guide the researcher in the search for evidence. Through the PICOT question, nurses can also apply evidence-based practice or the evidence-based model (Zuzelo, 2018). Therefore, the purpose of this latest write-up is to formulate a PICOT question related to caring for patients with Guillain-Barré syndrome. In addition, the paper will explore relevant sources of evidence, describe some of the main findings from the explored sources, and explain these key findings.

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Caring for Patients With Guillain-Barré syndrome: A PICOT Approach

Guillain-Barré syndrome is a rare condition yet can be fatal. As such, nurses should be competent in caring for patients with the condition by using effective strategies to enhance nurse knowledge and performance regarding Guillain-Barré syndrome care. Therefore, the PICOT question formulated is as follows: Among nurses attending to patients in the neurosurgical unit, what is the efficacy of a teach-back education method as compared to traditional methods in improving nurses’ competence in Guillain-Barré syndrome care in six months?

The intervention approach identified is a teach-back method used in training nurses to be more competent in caring for patients with Guillain-Barré syndrome, ranging from describing the condition, associated symptoms, and nursing care strategies. The population in this PICOT question are nurses working in the neurosurgical unit who need to be more competent in caring for these patients. The identified intervention will be compared to the traditional teaching used in improving nurses’ competency. The outcome is improved nurses’ knowledge and performance concerning the condition. The targeted time is six months. As part of the plan, this time will be used in literature critique and evaluation as well as the implementation of the intervention. This clinical issue can benefit from the PICOT approach since the best evidence supporting the intervention can be located and used to improve patient outcomes.

Identifying Sources of Evidence

Sources of evidence can effectively be explored to support a specific intervention to be used in patient care. Therefore, various sources of evidence are targeted that support the use of education to improve nurses’ knowledge and competencies in caring for patients with Guillain-Barré syndrome. The CRAAP method is to be applied for locating relevant research. When using the method, the research articles are evaluated for currency, relevance, authority, and purpose (Owens et al., 2022). The sources that can be used in effectively answering the PICOT questions are peer-reviewed journals. The sources with the evidence include CINHAL, PubMed Central, Medscape, and Cochrane library.

Findings From the Articles

 The effort to identify the sources led to the location of the articles that support the PICOT question. Teach-back training is a method where a knowledgeable individual trains the trainee on a concept and confirms whether the trainee has understood the concept by asking them to describe it in their own words or practically demonstrate what has been learned. In one of the pieces of evidence, Morony et al. (2018) conducted a study on the implementation of a teach-back method in child and maternal health. A total of sixteen nurses involved in child and maternal care took part in the study, and where some were made to take part in self-reflection teaching, while others were recruited to take part in teach-back skills workshop. However, all of them participated in teach-back and self-reflection to different extents. Analysis of the data indicated that the nurses were able to develop teach-back skills effectively, which was also important in patient care since they developed better communication strategies with the patients.

In another study, MacLean et al. (2018) conducted a study to examine the use of the teach-back method as part of simulation training to help improve discharge communication practices among nursing students. Using a quasi-experimental control group design, the researchers put the nursing students in the groups. The groups included interaction-based, information, and control groups. After using the teach-back method, the quality of discharge delivery and content was explored across the groups. The researchers noted the existence of a more pronounced improvement in discharge communication skills among nurses who participated in the teach-back method as a way of training. The findings in this evidence source indicate that the teach-back method can be effective in making nurses understand the discharge instructions for better patient outcomes.

Recently, Feinberg et al. (2020) conducted a study on the use of teach-back training for first-year students. The study aimed at measuring the medical students’ knowledge and beliefs regarding health literature communication with a major focus on evaluating the use of teach-back skills when taking the patient history and exam. The researchers used pre- and post-knowledge and belief surveys to assess the use of the teach-back method and skills among the students. A total of thirty-six students took part in the study. Before the intervention, the mean knowledge scores among the participants was 8.08, a figure which increased to 10.42 after implementing the intervention giving a p-value of less than 0.01. Therefore, there was a significant improvement. It was also observed that upon using the teach-back method, over thirty percent of the students were able to successfully use the teach-back methods when working with patients.

The Relevance of the Findings

From the search done, it was noted that the teach-back method has widely been used among the patient population to enhance discharge instructions. In addition, fewer sources document the use of the teach-back method among nurses to improve their competency, knowledge, skills, and performance in improving patient outcomes. Therefore, the findings from the sources are relevant and significant to the PICOT question. The findings showed that using the teach-back method improves the nurses’ knowledge in offering various care actions to patients. For example, the method was found to improve nurses’ communication skills in delivering discharge instructions to patients for better outcomes (MacLean et al. et al., 2018). This research is the most relevant and is likely to lead to a more significant outcome. Even though none of the sources was directly related to the improvement of outcomes among patients with Guillain-Barré syndrome, it is worth noting that the teach-back method was so effective in other conditions. As such, there are higher chances of the method being effective in improving the patients’ outcomes.

Conclusion

Improving patient outcomes is key in any patient care environment. Therefore, appropriate strategies should be applied or implemented by healthcare professionals to help improve patient conditions. As such, a PICOT question has been formulated, and evidence will be key in appropriately answering the question. The sources of evidence, the findings from the obtained evidence, and the relevance of the evidence have all been explored in this write-up. The highlight of the findings is that the teach-back method as a training strategy for nurses can be key in improving the nurses’ competencies as far as patient care practices are concerned.

References

Feinberg, I., Moradi, A., Ogrodnick, M. M., Tighe, E., & Reed, T. (2020). Health Literate Communication: Teach-Back Training for First-Year Medical Students. Medical Research Archives, 8(5). https://esmed.org/MRA/mra/article/view/2100/193545571

MacLean, S., Kelly, M., Geddes, F., & Della, P. (2018). Evaluating the use of Teach-Back in simulation training to improve discharge communication practices of undergraduate nursing students. Clinical Simulation in Nursing, 22, 13-21. https://doi.org/10.1016/j.ecns.2018.06.005

Morony, S., Weir, K., Duncan, G., Biggs, J., Nutbeam, D., & Mccaffery, K. J. (2018). Enhancing communication skills for telehealth: development and implementation of a Teach-Back intervention for a national maternal and child health helpline in Australia. BMC Health Services Research, 18(1), 1-9. https://doi.org/10.1186/s12913-018-2956-6

Owens, J. K., Nicoll, L. H., Carter Templeton, H., Chinn, P., Oermann, M. H., Edie, A. H., & De Gagne, J. C. (2022). Addressing nursing scholarship: a framework for currency and number of references. Canadian Journal of Nursing Research, 54(1), 40-50. https://doi.org/10.1177%2F0844562120977410

Zuzelo, P. R. (2018). Evidence-based practice methodology: use the correct approach. Holistic Nursing Practice, 32(6), 340-342. Doi:  10.1097/HNP.0000000000000297

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Create a 3-5 page submission in which you develop a PICO(T) question for a specific care issue and evaluate the evidence you locate, which could help to answer the question.

Introduction
PICO(T) is an acronym that helps researchers and practitioners define aspects of a potential study or investigation.

It stands for:

P – Patient/population/problem.
I – Intervention.
C – Comparison (of potential interventions, typically).
O – Outcome(s).
T – Time frame (if time frame is relevant).
The end goal of applying PICO(T) is to develop a question that can help guide the search for evidence (Boswell & Cannon, 2015). From this perspective, a PICO(T) question can be a valuable starting point for nurses who are starting to apply an evidence-based model or EBPs. By taking the time to precisely define the areas in which the nurse will be looking for evidence, searches become more efficient and effective. Essentially, by precisely defining the types of evidence within specific areas, the nurse will be more likely to discover relevant and useful evidence during their search. When applying the PICO(T) approach, the nurse can isolate the interventions of interest and compare to other existing interventions for the evidenced impact on the outcome of the concern.

You are encouraged to complete the Vila Health PICO(T) Process activity before you develop the plan proposal. This activity offers an opportunity to practice working through creating a PICO(T) question within the context of an issue at a Vila Health facility. These skills will be necessary to complete Assessment 3 successfully. This is for your own practice and self-assessment and demonstrates your engagement in the course.

Reference
Boswell, C., & Cannon, S. (2015). Introduction to nursing research. Jones & Bartlett Learning.

Professional Context
As a baccalaureate-prepared nurse, you will be responsible for locating and identifying credible and scholarly resources to incorporate the best available evidence for the purposes of enhancing clinical reasoning and judgement skills. When reliable and relevant evidence-based findings are utilized, patients, health care systems, and nursing practice outcomes are positively impacted.

PICO(T) is a framework that can help you structure your definition of the issue, potential approach that you are going to use, and your predictions related to the issue. Word choice is important in the PICO(T) process because different word choices for similar concepts will lead you toward different existing evidence and research studies that would help inform the development of your initial question. When writing a PICO(T)-formatted research question, you want to focus on the impact of the intervention and the comparison on the outcome you desire.

Scenario
For this assessment, please use a health care issue of interest from your current or past nursing practice.

If you do not have an issue of interest from your personal nursing practice, then review the optional Case Studies presented in the resources and select one of those as the basis for your assessment.

Instructions
For this assessment, select a health care issue of interest and apply the PICO(T) process to develop the research question and research it.

Your initial goal is to define the population, intervention, comparison, and outcome. In some cases, a time frame is relevant and you should include that as well, when writing a question you can research related to your issue of interest. After you define your question, research it, and organize your initial findings, select the two sources of evidence that seem the most relevant to your question and analyze them in more depth. Specifically, interpret each source’s specific findings and best practices related to your issues, as well explain how the evidence would help you plan and make decisions related to your question.

If you need some structure to organize your initial thoughts and research, the PICOT Question and Research Template document (accessible from the “Create PICO(T) Questions” page in the Capella library’s Evidence Based Practice guide) might be helpful.

In your submission, make sure you address the following grading criteria:

Define a practice issue to be explored via a PICO(T) approach. Create a PICO(T)-formatted research question
Identify sources of evidence that could be potentially effective in answering a PICO(T) question (databases, journals, websites, etc.).
Explain the findings from articles or other sources of evidence as it relates to the identified health care issue.
Explain the relevance of the findings from chosen sources of evidence to making decision related to a PICO(T) question.
Communicate using writing that is clear, logical, and professional with correct grammar and spelling using the current APA style.
Example Assessment: You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like:

Assessment 3 Example [PDF].
Additional Requirements
Your assessment should meet the following requirements:

Length of submission: Create a 3-5-page submission focused on defining a research question and interpreting evidence relevant to answering it.
Number of references: Cite a minimum of four sources of scholarly or professional evidence that support your findings and considerations. Resources should be no more than 5 years old.
APA formatting: Format references and citations according to the current APA style.
Portfolio Prompt: Remember to save the final assessment to your ePortfolio so that you may refer to it as you complete the final capstone course.

Competencies Measured
By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:

Competency 1: Interpret findings from scholarly quantitative, qualitative, and outcomes research articles and studies.
Explain the findings from articles or other sources of evidence that are relevant to the health care issue.
Competency 2: Analyze the relevance and potential effectiveness of evidence when making a decision.
Identify sources of evidence that could be potentially effective in answering a PICO(T) question.
Explain the relevance of the findings from chosen sources of evidence to making decision related to a PICO(T) question.
Competency 3: Apply an evidence-based practice model to address a practice issue.
Define a practice issue to be explored via a PICO(T) approach and develop a PICO(T)-formatted research question.
Competency 5: Apply professional, scholarly communication strategies to lead practice changes based on evidence.
Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.
Apply APA formatting to in-text citations and references exhibiting nearly flawless adherence to APA format.