NRS 433 Topic 1 DQ 1.docx - NRS 433 Topic 1 DQ 1 PICOT is...

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NRS 433 Topic 1 DQ 1PICOT is utilized by the health care community to identify and study a nursing or medical practiceproblem. Consequently, PICOT examples that may provide insight into the use of the PICOT process,may not be relevant to nursing practice as they are based on a medical practice problem.Describe the difference between a nursing practice problem and a medical practice problem. Provideone example of each. Discuss why is it important to ensure your PICOT is based on anursingpracticeproblem.A nursing practice problem deals with the human response and actual or potential health problems andlife processes that affect people. A nursing practice problem looks at the clinical judgement about andindividual patient, a family, or a community and how they respond to an actual or potential problemsthat they are exposed to. In nursing practice, the objective is not about diagnosing a medical problem,but analyzing a situation and determinig the relevant care or action. A nursing practice problem, thus,provides nurses with a basis from which they select appropriate nursing interventions to achieve aparticular outcome and for which a nurse is accountable. These problems include but are not limited toAcute pain, Infection to a surgical site, Fluid volume deficit or excess, and Constipation (Majid T.Mragyan, 2007). For example, the complimentary nursepractice problems of Impaired verbalcommunication, interrupted family processes, the risk for falls, and powerlessness, provides a generaland more holistic understanding of the impacts of a condition on a particular patient and their family.On the other hand, the model of medical practice focuses on a disease-model that appears to be wellillustrated with pathology, clinical medicine, pharmacology, pathophysiology, and treatment.Specifically, it emphasizes on anatomical, physiological and bio-chemical malfunction as the causes ofill health and by so doing encourages a disease-oriented approach to the patient (Jillian M. MacGuire,2006). For instance, a patient complains of incessant headaches over a period of time. The physicianutilizing the medical practice model will order tests to determine the cause of these headches. Thatpatient may undergo such diagnostic tests such as an MRI or CT-scan in an effort to rule out ananeurysm or something worse. The nurse on the other hand, may assess the patient and considerother reasons for the constant migraines such as it being stress related etc.PICOT is a mnemonic used to describe elements of a good clinical question and guide the search forevidence-based theories that can be utilized in our everyday nursing practice. To me, it is just like thenursing process as it helps narrow down a search, clarifies unanswered questions, which in turn makesit easier to find an answer. It stands for:P - patient/ population/ problemI - interventionC - comparisonO - outcomeT- time it took for the intervention ( Jillian M. MacGuire, 2006)For instance, P (patient/population/problem) could be hospital acquired infections like CAUTI with theintervention being frequent handwashing before patient care, in-between patient care and after eachpatient care. The comparison would be other solutions to reducing the incidence of hospital acquiredinfections such as the alcohol hand sanitizer when your hands are not visibly soaked with blood, or nohandwashing. The overall outcome will be the decline of incidence of hospital acquired infections.

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