NRS 433 Topic 1 DQ 1 Describe the difference between a nursing practice problem and a medical practice problem

NRS 433 Topic 1 DQ 1 Describe the difference between a nursing practice problem and a medical practice problem

NRS 433 Topic 1 DQ 1 Describe the difference between a nursing practice problem and a medical practice problem

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PICOT is used in the health care community to identify and examine nursing or medical practice problems. As a result, PICOT examples that may provide insight into the usage of the PICOT method may be irrelevant to nursing practice because they are focused on a medical practice problem.

The nursing process is essential to nurses’ practice (Toney—Butler, Thayer, 2021). A nurse’s profession is focused on the betterment of the patient and the care process. In many aspects, it is comparable to the PICOT in that the intervention is the planning process, the comparison is the implementation, and the outcome is the evaluation. The PICOT method is used to establish research questions that must be supported by evidence (Helbig, 2018), and the nursing process steps offer responses during the assessment phase. The difference between a nursing and a medical practice problem is that nursing seeks to enhance patient care, whereas medical gives the cause or pathology of the patient. Nurses may only practice within the limits of their license (OP, 2010). Nurses must ensure that their PICOT is based on nursing care rather than a diagnosis. Nursing diagnosis differs from doctor-diagnosed health problems for therapy. Nurses must practice within their area of practice.

The PICOT question is the first stage in evidence-based practice, and it is usually wrongly written. It should not be written in the past tense, but rather to aid in the hunt for the best evidence to answer the issue (Gallagher Ford, 2019). It has been found that finding quality information can be difficult, and that we sometimes lack the abilities necessary to evaluate the literature. There is an EBR that has increased nursing students’ ability to discover and study publications as well as correctly use the PICOT (Long, et al., 2016).

Topic 1 DQ 1

Apr 4-6, 2022

PICOT is utilized by the health care community to identify and study a nursing or medical practice problem. 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. Provide one example of each. Discuss why is it important to ensure your PICOT is based on a nursing practice problem.

Posted Date

Apr 13, 2022, 7:44 PM

Re-Post

The nursing process is central to the practice of nurses (Toney—Butler, Thayer, 2021). The practice of a nurse is centered on the improvement of the patient and the care process. It is similar to the PICOT in many ways, such as the intervention being the planning process, the comparison being the implementation, and the outcome being the evaluation. PICOT is used to develop the research questions that must be answered with evidence (Helbig, 2018), and the nursing process steps provide answers during the evaluation phase. The distinction between a nursing and a medical practice problem is that nursing works to improve patient care while medical provides the patient’s cause or pathology. Nurses must practice only within the scope of their license (OP, 2010). It is critical for nurses to ensure that their PICOT is based on nursing care rather than a diagnosis. Nursing diagnosis differs from doctors’ diagnosis of a patient’s health problem for treatment. Nurses must stay within the scope of their practice.

The PICOT question is the first step in evidence-based practice, and it is frequently written incorrectly. It should not be written in the

NRS 433 Topic 1 DQ 1 Describe the difference between a nursing practice problem and a medical practice problem
NRS 433 Topic 1 DQ 1 Describe the difference between a nursing practice problem and a medical practice problem

past tense; rather, it is used to assist in the search for the best evidence to answer the question (Gallagher Ford, 2019). It has been observed that finding quality information is difficult, and that we sometimes lack the skills to evaluate the literature. There is an evidence-based research tool (EBR) that has improved nursing students’ ability to find and review articles as well as correctly apply the PICOT (Long, et al., 2016).

An example of a nursing PICOT:

P: Patient – Adults 65 and over with constipation

I: Intervention – Encourage to exercise 45 min per day

C: Comparison – Patients who do not exercise

O: Outcome – Increased bowel movements in a week

T: Time Frame – 1 month

An example of a medical PICOT:

P: Patient – 65-year-old complaining of knee pain

I: Intervention – MRI

C: Comparison – MRI of normal knee

O: Outcome – Diagnosis of Arthritis

T: Time Frame – 2 weeks

References:

 

Gallagher Ford, L., & Melnyk, B. M. (2019). The Underappreciated and Misunderstood PICOT Question: A

Critical Step in the EBP Process. Worldviews on Evidence-Based Nursing, 16(6), 422–423. https://doi-

org.lopes.idm.oclc.org/10.1111/wvn.12408

 

Helbig, J. (2018). History and Process of Nursing Research, Evidence-Based Nursing Practice, and Quantitative

and Qualitative Research Process. Grand Canyon University (Eds.), Nursing Research:

Understanding Methods for Best Practices. https://lc.gcumedia.com/nrs433v/nursing-research-

understanding-methods-for-best-practice/v1.1/#/chapter/1

 

Long, J. D., Gannaway, P., Ford, C., Doumit, R., Zeeni, N., Sukkarieh, H. O., Milane, A., Byers, B., Harrison,

L., Hatch, D., Brown, J., Proper, S., White, P., & Song, H. (2016). Effectiveness of a technology‐based

intervention to teach evidence‐based practice: The EBR tool. Worldviews on Evidence-Based Nursing,

13(1), 59–65. https://doi-org.lopes.idm.oclc.org/10.1111/wvn.12132

 

Office of Professions (OP), (2010, June 18th). Education Law. Article 139, Nursing

http://www.op.nysed.gov/prof/nurse/article139.htm#sect6902

 

Toney-Butler TJ, Thayer JM. [Updated 2021 Jul 9]. Nursing Process. StatPearls [Internet].

https://www.ncbi.nlm.nih.gov/books/NBK499937/

Remember to complete your PICOT, by including each of the elements listed in the image below.

https://i.pinimg.com/originals/de/67/6d/de676d6fbfc11dfa2e1cacebdb29ae5b.png

PICOT is a method used when developing a quality improvement project or lead to EBP (Helbig, 2018).  It breaks down to five parts Patients/problem, Intervention, Comparison, Outcome, and Time which is used to develop a question to hypothesize changes that can be made in nursing or medical practice for patient improvement. Nursing practice problems are problems that occur during routine nursing practice as it relates to the patient’s condition. A medical practice problem is one that occurs with the disease process of a patient involving the medical condition or disease.

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An example of a nursing practice problem would be

P: Hospital Staff

I: Hand Sanitizer

C: Handwashing using soap and water

O: Minimize the spread of hospital acquired infection

T:  3 consecutive months

 

An example of a medical practice problem would be:

P: Post op patient

I: Prophylactic Antibiotic Therapy

C: Pre-Op & Post Op Antibiotic therapy

O: Reduction of Surgical Site infection

T: Three consecutive months

 

It is important to ensure a PICOT is based on a nursing practice problem to prevent practicing in the scope of medicine by way of conducting a clinical research study versus an evidence-based practice project. Research questions are posed with the intention of generating new knowledge or verifying that published findings are reproducible (Zuzelo, 2018). Nurses use evidence-based practice to provide patients with safe, quality care and to improve outcomes (Helbig, 2018). The goal is to improve nursing processes that produce safe patient outcomes during nursing care.

 

Helbig, J. (2018). History and process of nursing research, evidence-based nursing practice, and quantitative and qualitative research process. Nursing research: Understanding methods for best practice. https://lc.gcumedia.com/nrs433v/nursing-research-understanding-methods-for-best-practice/v1.1/#/chapter/1

 

Zuzelo, Patti Rager (2018) Evidence-based practice methodology. Holistic Nursing Practice: Volume 32 (6)- p 340-342 doi: 10.1097/HNP.0000000000000297. Retrieved from https://journals.lww.com/hnpjournal/Citation/2018/11000/Evidence_Based_Practice_Methodology__Use_the.9.aspx

Your post was very clear,

Positive and negative outcomes are produced by research. It does not always produce the results that the researcher desires. When considering different research processes, a pilot, or an experiment before going live, came to mind. One issue that will lead to a negative outcome in research is inconsistency when not using all parts on all participants (Holt, et al. 2021). Positive outcomes are possible, but how accurate will your research be? The goal of healthcare research is to improve patient outcomes, provide quality care, and increase patient satisfaction; however, if our evidence is inconsistent, we may endanger our patients. Accurate research takes many years and patient consent to participate; however, depending on what the research is attempting to prove or provide information about, time may not always be on our side. The COVID19 vaccine is a prime example; who did they convince to agree to test the vaccine before it was approved? (I’m not trying to be controversial; this is just an example.) To be significant, research articles require a sufficient number of participants (Holt, et al. 2021). Working together, the PICOT structure and the nursing process for patient outcomes may provide the framework for a shorter time for reviewing results (Wikan, et al. 2020).

References:

 

Richard I. G. Holt, Katharine Barnard-Kelly, Giorgos Dritsakis, Kerensa I. Thorne, Lauren Cohen, Elizabeth Dixon, Mayank Patel, Philip Newland-Jones, Helen Partridge, Suvitesh Luthra, Sunil Ohri, Kareem Salhiyyah, Jo Picot, John Niven, Andrew Cook, & on behalf of the OCTOPuS study group. (2021). Developing an intervention to optimize the outcome of cardiac surgery in people with diabetes: the OCTOPuS pilot study. Pilot and Feasibility Studies, 7(1), 1–12. https://doi-org.lopes.idm.oclc.org/10.1186/s40814-021-00887-z

 

Wikan Purwihantoro Sudarmaji, Sholihin Sholihin, Roby Aji Permana, Agustina Soares, & Yanuar

Aga Nugraha. (2020). A Clinical Decision Support System as a Tool to Improve the Accuracy of Nursing Diagnoses. Jurnal Ners, 14(3), 388–392. https://doi-org.lopes.idm.oclc.org/10.20473/jn.v14i3.17171

Hi Tamara thank you for your informative post

The PICOT question format is a standardized “formula” for creating researchable and answered questions. When you create a good one, the rest of the process of gathering and analyzing evidence becomes much easier.

Question for PICOT:

Population: Bariatric teens who are contemplating or have had gastric bypass surgery.

Intervention: The nurse’s position as a major component of the multidisciplinary team for bariatric adolescent perioperative care.

Comparison: The nurse’s function as a secondary member of the multidisciplinary team is limited to perioperative care of the bariatric adolescent patient and requires no specific training.

Outcome: The bariatric adolescent patient has greater continuity of treatment when the nurse is included as one of the major members of the multidisciplinary team approach.

Time frame: perioperative to 6 weeks post-surgery.

PICOT Question: When the nurse is a primary member of the multidisciplinary team, does the bariatric adolescent patient undergoing gastric bypass have better perioperative and postoperative care than when the nurse is a secondary member whose only role is to provide perioperative care and has no specialized training?

Reference:

Nursing : Picot questions. Library Research Guides. (n.d.). Retrieved April 8, 2022, from https://libguides.ggc.edu/NURS/PICOT

In To make your case, start with a PICOT question, the author describes two comparing questions when considering research. I thought it was interesting and very important, so I put it in my notes for future reference. Comparing questions can be viewed as backward and forward thinking. The backward question is the generalization of a topic, common knowledge, or information we might find in a nursing manual. The author explains this common knowledge is a “foundation for the forward question that will provide evidence for clinical decision making, the PICOT” (Echevarria, 2014). I thought this was worth considering because some of us students haven’t been in nursing school for several years, and the “common knowledge” may have changed over time with new EBP. I haven’t been in nursing school for almost two decades. I think it’s important that I review backward questions before I create a PICOT. Current knowledge on the backward question is important in the “outcome” of the PICOT format because the expectation may have changed. Respectfully, Jana

Echevarria, I. M., & Walker, S. (2014). To make your case, start with a PICOT question. Nursing44(2), 18–19. https://doi.org/10.1097/01.NURSE.0000442594.00242.f9

Thank you Tamara for your post! Yes, when establishing a quality improvement project or leading to EBP, the PICOT approach is used. It is divided into five sections: Patients/Problem, Intervention, Comparison, Outcome, and Time, each of which is used to formulate a question to hypothesize improvements that might be made in nursing or medical practice to enhance patient outcomes. To avoid practicing medicine outside of the scope of nursing by undertaking a clinical research study rather than an evidence-based practice project, make sure the PICOT is based on a nursing practice concern. Evidence-based practice (EBP) has been shown in research to produce greater treatment quality, better patient outcomes, lower costs, and more nurse satisfaction than traditional care practices. Nurses have an important role in detecting patient concerns, whether they are at the bedside or taking care of patients in an outpatient setting. Nurses have an important role in preventing and minimizing patient falls in the inpatient setting. In the hospital where I work, and I’m sure in every hospital, there are safety and fall precautions, such as having x3 side rails up on the patient bed, having the bed locked and in the lowest position, and having the call light in reach so the patient can receive help instead of getting out of bed. Nurses do have a great responsibility in ensuring the safety of the patient.

Helbig, J. (2018). History and Process of Nursing Research, Evidence-Based Nursing Practice, and Quantitative and Qualitative Research Process. Nursing research: Understanding methods for best practice. Retrieved from https://lc.gcumedia.com/nrs433v/nursing-research-understanding-methods-for-best-practice/v1.1/#/chapter/1

Good example and clear explanation of the PICOT. Nurses use EBP to provide patients with safe, quality care and to improve outcomes by first developing a PICOT statement that can be associated with either a quality improvement project or lead to EBP (Helbig, 2018). The researcher must gather information through PICOT (problem, intervention, comparison, outcome, and time) to prove why the study should be performed. The nursing practice problem deals with the person’s response to real health problems that the patient is exhibiting or a potential health problem that may arise from the medical diagnosis. While medical problem only gives information about the disease pathology, the nursing problem expresses the impact of the diseases on the patients’ wellbeing and the family. Basing on nursing practice problem ensures that the PICOT includes the best evidence available from previous studies on patient care, and values from experts in the field.

Reference:

Helbig, J. (2018). History and process of nursing research, evidence-based nursing practice, and quantitative and qualitative research process. Nursing research: Understanding methods for best practice. https://lc.gcumedia.com/nrs433v/nursing-research-understanding-methods-for-best-practice/v1.1/#/chapter/1

A well-constructed PICOT question is essential for research queries in the nursing field. Advanced studies or nurses in professional settings rely on the PICOT framework in the development of some of their studies. PICOT is a mnemonic for a clinical question that looks at the aspect of patient, intervention, comparison, outcome and time. The PICOT process begins with the identification of a problem or a case scenario, and the question is formulated to elicit an answer (Fnadino, 2019). PICOT process in the medical aspect might not be similar in the scope of the nursing field. The difference between medical practice problems and medical practice problems is that medical practice problems deal with the diagnosis of disease and their treatment while nursing practice problems are concerned with issues that surround nursing practice, and this involves aspects such as patient’s response to a health problem or patient-related assessment. Nursing practice problems can take the scope of evaluation and intervention aspects. Medical practice problem revolves around a medical condition where prognosis, causes and treatment of the condition are a big aspect of medical practice. Nursing practice problems deal with modalities such as comfort, health screening, trauma prevention and promotion of recovery, which are not dealt with in the medical practice scope. The development of a competent PICOT question help to ensure that the necessary outside sources such as peer-reviewed journals can be used in the assessment of the problem and intervention.

An example of a nursing practice problem is the patient level of satisfaction. Patient-level of satisfaction does not revolve around the condition but the ability of the care plan to achieve the desired health outcomes and adhere to patient beliefs and values. Nursing practice problems can take the shape of low levels of patient satisfaction in nurses treating immigrant populations (Zhang et al., 2021). Medical practice problems revolve around treatment options or prognosis of conditions. An example of medical practice issues is the use of pain medication such as tramadol, morphine and oxycodone for post-operative patients. Nursing practice problems will involve the evaluation of medication errors and complications after treatment. It is important that the PICOT is based on the nursing practice problem because it helps to make it easier to discuss the scope of the issue and identify relevant materials that can help in the evaluation of the interventions. PICOT questions that revolve around nursing practice problems will make it easier for me to understand the issue and intervention hence better ability to comprehend the content in the peer-reviewed articles.