NUR 550 Evidence-Based Practice Project Proposal: PICOT Assignment

NUR 550 Evidence-Based Practice Project Proposal: PICOT Assignment

NUR 550 Evidence-Based Practice Project Proposal: PICOT Assignment

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Science teaches us to inquire and investigate. The same is true in medicine. There is always something to investigate in medicine, whether it is to improve interventions or learn more about complex conditions. As a nurse and nursing student, I was constantly told that I would need to participate in continuing education for the rest of my life in order to be a good nurse. We should always strive for continuous education in order to achieve personal development and growth. In order to make decisions about patient care, interventions, leadership, and public health, nurses will need to question, investigate, and take the initiative in the future. “Explain the importance of an inquiry-based culture in an evidence-based culture, and what you can do as an advanced registered nurse to promote it in your practice or organization.” “In response to questions from colleagues, compare the role and implementation of EBP in your specialized field to another advanced registered nursing specialty” (National League of Nursing, 2014, para. 1). The COVID-19 outbreak served as a wake-up call for the country to prioritize nursing practice improvement. Nurses must be encouraged and propelled into positions of leadership, senior management, and R&D. Many nurses stepped up to save their patients and hospitals as the pandemic wreaked havoc on hospitals across the country.

People were also more eager to learn how to become doctors (particularly in nursing and nursing research). People and nurses became interested in epidemiology, public health, and medical research after learning about vaccine manufacturing and how disease and viral outbreaks occur. As an advanced registered nurse, I would promote an evidence-based culture by explaining how to use EBP and involving other staff members in the implementation of EBP research. When other therapies and procedures failed during the pandemic’s peak, EBP research was used to treat patients.

PICOT (Population/Problem, Intervention, Comparison, Outcome, and Time to achieve the outcome) is a method that helps clarify the qualities needed to create a good question out of a practice issue or problem affecting a population of focus.

The purpose of this assignment is to complete your PICOT for your selected nursing practice problem. Refer to your “Evidence-Based Practice Project Proposal: Identification of Nursing Practice Problem” assignment from Topic 1 to complete this assignment. If your nursing practice problem or PICOT

NUR 550 Evidence-Based Practice Project Proposal PICOT Assignment
NUR 550 Evidence-Based Practice Project Proposal PICOT Assignment

required revision, include those revisions in this assignment. The final PICOT you develop in this assignment will provide the framework for developing your evidence-based practice project proposal. Use the “PICOT-Final” template to complete this assignment.

ALSO CHECK OUT: NURS 8114 Applying Interdisciplinary Theories to Nursing Practice 

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Refer to the “Evidence-Based Practice Project Proposal – Assignment Overview” document for an overview of the evidence-based practice project proposal assignments.

You are required to cite at least four peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center. NUR 550 Evidence-Based Practice Project Proposal: PICOT Assignment

NUR 550 Evidence-Based Practice Project Proposal: PICOT Assignment

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are not required to submit this assignment to LopesWrite.

AttachmentsNUR-550-RS1-EBP-PICOT Draft.docx

PICOT Final
Name_____________________________________

Complete your PICOT using your approved proposed nursing practice problem. If they were approved, you may use the population and intervention developed in your Topic 1 assignment. Include any necessary revisions in this submission. Refer to the “Example PICOT” below as needed for guidance on how to complete the PICOT.
PICOT Question
P Population
I Intervention
C Comparison
O Outcome
T Timeframe
PICOT
Create a complete PICOT statement.

Problem Statement
Create a problem statement for your PICOT. You will use this problem statement throughout your final written paper.

References

Example PICOT: Delete this example page prior to submitting your PICOT.
EXAMPLE PICOT
PICOT Question
P Population Adult patients with hypertension, Spanish primary language
I Intervention Written education in Spanish
C Comparison Teaching using an interpreter
O Outcome Improved BP control
T Timeframe 6 months
PICOT
In adult patients with hypertension, for whom Spanish is their primary language (P), does providing written education in Spanish (I) when compared to using an interpreter (C) lead to improved blood pressure control (O) over the course of 6 months (T)?

Problem Statement
The problem statement is a scholarly statement that justifies or rationalizes that this is problem. A problem statement must include literature for support and justification. Hispanics are more likely to have uncontrolled, untreated, or even undiagnosed hypertension when compared to other ethnic groups (Rodriguez et.al., 2015). Incidences of misinformation can occur when patients and providers do not share a common language. There is a lack of understanding or the inability to ask questions on the patient’s part. In addition, many Spanish-speaking patients find that the translation services, when available, are not adequate. These patients often do not trust the information received from providers, which can lead to unintentional noncompliance (Rodriguez et.al., 2015). NUR 550 Evidence-Based Practice Project Proposal: PICOT Assignment

References
Rodriguez, C. J., Allison, M., Daviglus, M. L., Isasi, C. R., Keller, C., Leira, E. C., Palaniappan, L., Piña, I. L., Ramirez, S. M., Rodriguez, B., & Sims, M. (2014). Status of cardiovascular disease and stroke in Hispanics/Latinos in the United States: a science advisory from the American Heart Association. Circulation, 130(7), 593–625. doi:10.1161/CIR.0000000000000071

Translational research is a type of clinical research that first appeared in 1993. (Rubio et al, 2010). So, in terms of research, this is a relatively new way of looking into things. There is no clear definition of translational research, but it essentially includes two areas of translation: the information obtained in pre-clinical studies, lab research, and the adaptation of best practices in the community with their cost effectiveness (Rubio et al, 2010). T1 translational research entails the initial research or development of an intervention, including lab research, observational research, and phase I and II clinical trials. T2 translational research entails the development of an intervention, including phase I and II clinical trials (Translational Research, n.d.). The second level is T2, which is the translation to patients, which includes testing these interventions and their efficacy on the patient population, including phase III clinical trials, studying how these new interventions interact with disease processes, and developing new guidelines based on the most recent data (Translational Research, n.d.). The third level is T3, which is the dissemination and implementation of all research findings into daily practice, transforming research evidence into evidence-based practices across the profession (Translational Research, n.d.).

According to this information, there is no distinction between evidence-based practice and translational research; it is simply a pathway to evidence-based practice. The final step is to put all of this research into practice as evidence-based practice by following the “three T’s.” As the natural progression of translational practice concludes with practice, this means the most up-to-date care and information for public health. However, if no research is conducted in the area, the population suffers as there is no up-to-date EPB related to that disease process and/or its co morbidities.

Timeline 10.0% A description of the timeline is not included. A description of the timeline is incomplete or incorrect. A description of the timeline is included but lacks evidence. A description of the timelines is complete and includes sufficient evidence. A description of the timeline is extremely thorough with substantial evidence.

PICOT 20.0% The PICOT statement is omitted. The PICOT statement is incomplete. The PICOT statement is presented but there some inaccuracies. The PICOT statement is presented. Some detail is needed. The PICOT statement concisely and accurately describes the problem.

Problem Statement 20.0% A problem statement is not included. The problem statement is incomplete. The problem statement is generally presented. There are some inaccuracies. More support is needed to justify or rationalize the problem. The problem statement is presented. Adequate support is provided to justify or rationalize the problem. The problem statement concisely describes the issue using strong support to rationalize and justify the problem.

Required Sources 5.0% Sources are not included. Number of required sources is only partially met. Number of required sources is met, but sources are outdated or inappropriate. Number of required sources is met. Sources are current, but not all sources are appropriate for the assignment criteria and nursing content. Number of required resources is met. Sources are current and appropriate for the assignment criteria and nursing content.

Mechanics of Writing (includes spelling, punctuation, grammar, and language use) 5.0% Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is employed. Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) or word choice are present. Sentence structure is correct but not varied. Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct and varied sentence structure and audience-appropriate language are employed. Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech. The writer is clearly in command of standard, written, academic English.

Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style) 5.0% Sources are not documented. Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors. Sources are documented, as appropriate to assignment and style, although some formatting errors may be present. Sources are documented, as appropriate to assignment and style, and format is mostly correct. Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.

Topic 1 DQ 1

Identify the different levels of translational research. Explain how translational research is different from evidence-based practice and discuss application to population health management.

 

PICOT Question
P Population School-age children with obesity
Obesity among school-age children has reached epidemic levels in the United States. De Lorenzo et al. (2019) described obesity as significant public health concern since it affects the physical, psychological, and cardiovascular health of the affected populations. Data from 2015-2016 shows that 1 in 5 children in the United States aged 6 to 19 years has obesity, and the rate has tripled since the 1970s (Centers for Disease Control and Prevention, 2018). Risk factors include poor eating habits, lack of physical activity, genetics, and negative childhood events. Therefore, immediate, evidence-based, and population-driven interventions are necessary to reduce the surging rates.
I Intervention Educating parents and children
Parents can help to reduce obesity rates by modeling healthy living among children. The outcomes can be improved when children understand the risks and can actively participate in obesity prevention activities. Educating parents and children on the benefits of reducing screen time is a practical nursing intervention since its goal is to promote healthy living by keeping children free from sedentary living. Parents and children should understand the risks that too much screen time poses and the need to be more physically active.
C Comparison No education
The comparison considered is no education for parents and children on the need to minimize screen time and regulation strategies. In this case, parents will apply self-taught strategies or knowledge acquired from social and mainstream media to control obesity. In this case, the difference in outcomes after educating parents and children, if any, would be primarily attributed to the nursing intervention.
O Outcome Reduced obesity rates
Educating parents and children on the implications of too much screen time is expected to be the foundation of behavior change. As a nursing intervention, the education program will improve knowledge on the connection between obesity in children and screen time as a risk factor. Minimizing screen time will lead to a proportional reduction in obesity rates among children, which has become a public health concern since its trend has taken an upward trajectory in the past decade (Skinner et al., 2018). Reducing obesity rates will also improve productivity in children and reduce overall health care costs since obesity is a leading cause of psychological and cardiovascular health problems (Sanyaolu et al., 2019). The overall outcome is creating a healthy populace by reducing obesity rates among school-age children.
T Timeframe Six months
It is possible to achieve the targeted outcome in six months. Parents are expected to start implementing the knowledge acquired immediately, and children are expected to change their behaviors instantly as far as screen time is concerned.
PICOT
Create a complete PICOT statement. In school-age children with obesity (P), can educating parents and children (I) compared to no education (C) reduce obesity rates (O) in six months (T)?
Problem Statement
Create a problem statement for your PICOT. You will use this problem statement throughout your final written paper.
School-age children are a vulnerable population at high risk of obesity. A significant proportion spends a lot of time on screens watching television, gaming, and social interaction, among other ways. Increased screen time is a leading cause of obesity due to intake of too much energy and lack of physical activity (Fang et al., 2019). Obesity puts children at risk of diabetes and cardiovascular, physical, and mental health problems. The increased illness burden increases health care costs and nurses’ workload, and evidence-based interventions are necessary.

References
Centers for Disease Control and Prevention. (2018, Sep 18). Obesity. https://www.cdc.gov/healthyschools/obesity/index.htm
De Lorenzo, A., Gratteri, S., Gualtieri, P., Cammarano, A., Bertucci, P., & Di Renzo, L. (2019). Why primary obesity is a disease? Journal of Translational Medicine, 17(1), 1-13. https://link.springer.com/article/10.1186/s12967-019-1919-y
Fang, K., Mu, M., Liu, K., & He, Y. (2019). Screen time and childhood overweight/obesity: A systematic review and meta‐analysis. Child: Care, Health and Development, 45(5), 744-753. https://doi.org/10.1111/cch.12701
Sanyaolu, A., Okorie, C., Qi, X., Locke, J., & Rehman, S. (2019). Childhood and adolescent obesity in the United States: A public health concern. Global Pediatric Health, 6, 2333794X19891305. https://doi.org/10.1177/2333794X19891305
Skinner, A. C., Ravanbakht, S. N., Skelton, J. A., Perrin, E. M., & Armstrong, S. C. (2018). Prevalence of obesity and severe obesity in US children, 1999–2016. Pediatrics, 141(3). https://doi.org/10.1542/peds.2017-3459

Topic 3 DQ 2

Discuss the role of the Institutional Review Board. Discuss ethical research considerations specific to population health. How are respect for the persons, potential benefits and burdens of the research, and justice kept in balance? Provide an example.

NGOZI

Re: Topic 3 DQ 2

Under FDA regulations, an Institutional Review Board is group that has been formally designated to review and monitor biomedical research involving human subjects. The purpose of IRB review is to assure, both in advance and by periodic review, that appropriate steps are taken to protect the rights and welfare of humans participating as subjects in the research. To accomplish this purpose, IRBs use a group process to review research protocols and related materials (e.g., informed consent documents and investigator brochures) to ensure protection of the rights and welfare of human subjects of research (FDA, n.d).

From a public health perspective, it is important to recognize an ethical standard that respects community autonomy. This standard can be achieved by requiring community collaboration (ie, at a minimum, establishing a community advisory board) to protect against exploiting vulnerable populations, to ensure fair terms of cooperation, to ratify that the interventions to be tested are acceptable to community members, and to minimize potential misunderstandings about the research. Such community advisory boards should have responsibility for determining whether the research goals are valuable to local community members and the methods are acceptable before the research is allowed to proceed (Buchanan & Miller, 2006).

In this era of translational research, social injustice is one of the crucial ethical concerns. Resource-rich countries conducting translational medical research in resource-poor countries are common and if the results of the research are not expected to be beneficial/less beneficial to the resource-poor country, then arises the issue of social injustice and disparity. Examples include research undertaken on diseases that are rare or the resulting intervention/product is too expensive to implement, in developing countries (Mandal et al., 2017).

References

Buchanan, D. R., & Miller, F. G. (2006). A public health perspective on research ethics. Journal of medical ethics32(12), 729–733. https://doi.org/10.1136/jme.2006.015891

Mandal, J., Ponnambath, D. K., & Parija, S. C. (2017). Ethics of translational medical research. Tropical parasitology7(2), 62–64. https://doi.org/10.4103/tp.TP_47_17

FDA (n.d). Institutional Review Boards (IRBs) and Protection of Human Subjects in Clinical Trials. Retrieved from https://www.fda.gov/about-fda/center-drug-evaluation-and-research-cder/institutional-review-boards-irbs-and-protection-human-subjects-clinical-trials

 

RESPOND HERE (150 WORDS, 2 REFERENCES)

Hello Ngozi,

I agree with you that it the institutional review board (IRB) is mandated to carry out assessment and standardization of any biomedical or biotechnological research that works with human subjects. One of the key pillars considered by the IRB is the autonomy of the subjects. It is imperative to have a research framework that is built on community engagement and participation at free will without coercion or intimidation (Das & Sil, 2017). The information shared to the subjects should be truthful and no crucial information should be obstructed or hidden from them. Additionally, the research project should be of general good and valuable to the entire pubic. Clinical trials procedure should be strictly adhered to and the human trials should only be used at the appropriate stage and only on volunteers who have not been pushed to take part because of being taken advantage of or being paid in order to take part. It should be out of their self-consciousness and willingness (Landray et al., 2017).

References

Landray, M. J., Bax, J. J., Alliot, L., Buyse, M., Cohen, A., Collins, R., Hindricks, G., James, S. K., Lane, S., Maggioni, A. P., Meeker-O’Connell, A., Olsson, G., Pocock, S. J., Rawlins, M., Sellors, J., Shinagawa, K., Sipido, K. R., Smeeth, L., Stephens, R., & Stewart, M. W. (2017). Improving public health by improving clinical trial guidelines and their application. European Heart Journal, 38(21), 1632–1637. https://doi.org/10.1093/eurheartj/ehx086

Das, N., & Sil, A. (2017). Evolution of ethics in clinical research and ethics committee. Indian Journal of Dermatology, 62(4), 373. https://doi.org/10.4103/ijd.ijd_271_17

Course Code Class Code Assignment Title Total Points
NUR-550 NUR-550-O503 Evidence-Based Practice Project Proposal: PICOT 75.0

Criteria Percentage Unsatisfactory (0.00%) Less Than Satisfactory (80.00%) Satisfactory (88.00%) Blank (92.00%) Blank (100.00%)
Content 100.0%
Population (Revision) 7.0% The population is not described, or the required revisions were not made for the population description. NA Revisions were made accordingly for the population description, but some information or detail is needed for accuracy or clarity. NA The population is thoroughly and accurately described. No revision was needed.

Intervention (Revision) 8.0% The proposed intervention is not described, or the required revisions were not made for the described intervention. NA Revisions were made accordingly for the proposed intervention, but some information or detail is needed for accuracy or clarity. NA The proposed intervention is clearly described and relevant to the nursing practice problem and population. No revision was needed.

Comparison 10.0% A description of the comparison information is not included. A description of the comparison information is incomplete or incorrect. A description of the comparison information is included but lacks evidence and measurable outcomes. A description of the comparison information is complete and includes sufficient evidence and measurable outcomes. A description of the comparison information is extremely thorough with substantial evidence and measurable outcomes.

Outcome 10.0% A description of the outcome is not included. A description of the outcome is not included. A description of the outcome is included but lacks evidence. A description of the outcome is complete and includes sufficient evidence. A description of the outcome is extremely thorough with substantial evidence

Timeline 10.0% A description of the timeline is not included. A description of the timeline is incomplete or incorrect. A description of the timeline is included but lacks evidence. A description of the timelines is complete and includes sufficient evidence. A description of the timeline is extremely thorough with substantial evidence.

PICOT 20.0% The PICOT statement is omitted. The PICOT statement is incomplete. The PICOT statement is presented but there some inaccuracies. The PICOT statement is presented. Some detail is needed. The PICOT statement concisely and accurately describes the problem.

Problem Statement 20.0% A problem statement is not included. The problem statement is incomplete. The problem statement is generally presented. There are some inaccuracies. More support is needed to justify or rationalize the problem. The problem statement is presented. Adequate support is provided to justify or rationalize the problem. The problem statement concisely describes the issue using strong support to rationalize and justify the problem.

Required Sources 5.0% Sources are not included. Number of required sources is only partially met. Number of required sources is met, but sources are outdated or inappropriate. Number of required sources is met. Sources are current, but not all sources are appropriate for the assignment criteria and nursing content. Number of required resources is met. Sources are current and appropriate for the assignment criteria and nursing content.

Mechanics of Writing (includes spelling, punctuation, grammar, and language use) 5.0% Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is employed. Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) or word choice are present. Sentence structure is correct but not varied. Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct and varied sentence structure and audience-appropriate language are employed. Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech. The writer is clearly in command of standard, written, academic English.

Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style) 5.0% Sources are not documented. Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors. Sources are documented, as appropriate to assignment and style, although some formatting errors may be present. Sources are documented, as appropriate to assignment and style, and format is mostly correct. Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.

Re: Topic 1 DQ 1

As nurses, we all have heard about evidence-based practice and Florence Nightingale. Although back then, the term evidence-based practice was not a common phrase, that is exactly what Florence Nightingale was doing back then. She would examine and experiment with the sanitary conditions of the facilities and look at how it affected the patient’s outcomes (Mackey & Bassendowski, 2017). Translational research is more of a newer terminology. Although it can be confused with evidence-based practice, there is a key distinction. Evidence-based practice is the act of applying the evidence into everyday practice, whereas translational research is more the act of conducting the studies to find the best evidence (Titler, 2018).

There are strict guidelines when conducting translational research or what many of us know as clinical trials. There is phase process where in order to progress to the next phase of clinical trials, they must meet certain criteria. New drugs must undergo in vitro preclinical trials where they are testing it in a laboratory setting instead of human trials. Then they can proceed to in vivo studies where they are studying it in animals and small sample size of human trials (Eske, 2020). Once it has proven to be safe, then they can progress to a phase two or three trial increasing the sample size and comparing it to common treatments or sometimes placebos. Once it has shown safety and efficacy in a phase two or three trial, it can then go for Food and Drug Administration (FDA) approval. There are also phase four and five trials that help with translating the evidence into practice and community settings (Titler, 2018).

In my specialty area of oncology, we are constantly hearing about clinical trials and new therapies coming to market. It is critical to have a good understanding of what each phase of the trial consists of and what the outcomes really mean to the patient.

References

Eske, J. (2020, August 31). In vivo vs. in vitro: What is the difference? Medical News Today. Retrieved June 17, 2021, from https://www.medicalnewstoday.com/articles/in-vivo-vs-in-vitro

Mackey, A., & Bassendowski, S. (2017). The history of evidence-based practice in nursing education and practice. Journal of Professional Nursing33(1), 51–55. https://doi.org/10.1016/j.profnurs.2016.05.009

Titler, M. G. (2018). Translation Research in Practice: An Introduction. Online Journal of Issues in Nursing23(2). https://doi.org/10.3912/OJIN.Vol23No02Man01

 

RESPOND HERE (150 W0ORDS, 2 REFERENCES)

This is insightful Kelli, translational research is a new concept in my view of the world, it is a fairly new concept, as nurses we hear the term evidence-based practice (EBP) and research. Translational research is critical in the research processes as they involve translation of what have been found in other studies (Eske, 2020). Most researcher prefer to apply translational research processes to influence different study outcomes. The application of different levels of research processes T1, T2, and T3 depend on the methodologies that have been applied as well as the research objectives. Translational research is a new concept in my view of the world, it is a fairly new concept, as nurses we hear the term evidence-based practice (EBP) and research (Woolf, 2018). There are three major components of translation research including T1, T2, and T3. These translational research are important in ensuring that every study outcomes are done in line with the research objectives.

References

Eske, J. (2020, August 31). In vivo vs. in vitro: What is the difference? Medical News Today. Retrieved June 17, 2021, from https://www.medicalnewstoday.com/articles/in-vivo-vs-in-vitro

Woolf, S. H. (2018). The meaning of translational research and why it matters. Jama299(2), 211-213. https://jamanetwork.com/journals/jama/article-abstract/1149350