Discussion: PICOT Question

Over the course of the next eight weeks, we will be examining concepts related to nursing research and the translation of evidence to practice. To help you better understand the process, you will be identifying a practice issue for nurse practitioners.
 You will develop a PICOT question associated with the issue, find evidence to support a change in practice, and present your recommendations for change to your peers. This week, we will work on helping you refine your area of interest so that you will be able to develop a concise question for next week’s assignment. You are encouraged to use the area of interest you chose for the project in NR500NP and/or NR501NP; however, you may choose a different area if you wish.

Select an issue in nurse practitioner (NP) practice that is of interest to you and in which you would like to see a practice change occur. Conduct a review of literature to see what is currently known about the topic. In 1-2 paragraphs, describe the scope and relevance of the issue and your recommended change. Provide reference support from at least two outside scholarly sources to support your ideas. 
Please pick something you can do as a NP in your practice that is patient focused. Your intervention needs to relate to a measurable patient health outcome. Please avoid anything that would require a policy or law change, such as full-practice authority. Burnout and satisfaction surveys also are not appropriate topics as they are not patient centered. 

Review this 4-minute video to gain a better understanding of the requirements of a PICOT question. The PICOT question is not a research question, but a quality improvement issue that requires a practice change. 

Hello, my name is Dr. Lynch. Hey, I'm an assistant professor a Chamberlain University College of Nursing. Today we're gonna talk about pico questions and best practices in formulating these questions. There are five parts to a pico question. Patient intervention, comparison, outcome in time. The slides subsequently we will discuss each part of this question. The first ingredient for cooking up a pico question is population. Pick a broad topic, drill down, focus down so that then your population is very specific. Type two diabetic female patients age 30 to 40 who consume over 400 g of carbohydrates per day. A bunch more specific population then patients with diabetes intervention. What intervention do you think will make a difference? Is that supported by the scholarly literature? What is being done in clinical practice today? Are there better alternatives? You must use an intervention based on scholarly literature? Remember the definition of scholarly literature is a US based peer reviewed journal article geared for clinicians published in the past five years, or the latest clinical practice guideline. Comparison. So what is the standard of care currently? Patients without the intervention, patients without a condition, patients without risk factor. This part defines another population who will be used as a comparison against the group receiving the intervention. What is your desired outcome? The outcome should relate directly to the intervention and outcomes should be measurable. Time. This is a specific timeframe to demonstrate the outcome. In quality improvement efforts, the timeframe has to be realistic and manageable. Not over years, may not be even over months, but it could be. But it is usually a short timeframe to make an improvement effort. Many students ask what the differences between pico research and quality improvement questions. This chart will help you understand the difference. The pico question used here is in postoperative kidney transplant adults aged 65 to 75, how does a health coach compared with no health coaching affect hospital readmission rates within 90 days of discharge? This is a perfect pico question compared to the research question or QI question that also could be asked about this matter. Here's an example. In real life, you're a nurse practitioner working in a skilled nursing facility, the rate of false as unacceptable. And your care team has come together to discuss what should be done about this. Your pico question is, in elderly patients between age 65.75 residing in a sniff, how do fall prevention programs with risk assessment compared to fall prevention programs without risk assessment effect fall rates within 90 days after the intervention. So you can see how this question will guide how you view the literature on this topic. You will be looking for fall prevention with risk assessment in the scholarly literature to see what has worked in other places. What are the crucial ingredients in an outpatient fall prevention program? The literature holds the key, holds the answer to these questions. If you need further assistance, please contact your instructor directly. You can also contact the librarians at the Chamberlain library who can be accessed through many means, email, chat on real time. This material comes from Malbec and find out overhauled book evidence-based practice in nursing and health care, a guide to best practice, which is a great addition to your library.

Please see the attachment

See attachment for instructions 

A little about myself

I am behavioral health nurse for 6 years, I am currently doing my masters in psychiatric nursing. 

Submit your 20-25 page final capstone project that synthesizes the work you completed in the previous four assessments

You will also be required to submit your completed practicum hours using CORE ELMS. You must submit a minimum of 20 hours with each assessment deliverable to receive a grade for the entire assessment.

Introduction

Note: Each assessment in this course builds on the work you completed in the previous assessment. Therefore, you must complete the assessments in this course in the order in which they are presented.

Your final submission for your capstone project will bring together all of the sections you have worked on throughout this course, as well as the relevant revisions you have made to those sections based on feedback from your instructor, as well as feedback you have received or observations you may have made during your practicum experience. True professionals can learn to strive for continuous improvement in their work and incorporate feedback from colleagues and leaders to help scaffold improvement efforts. As a master’s-level nurse you will be expected to create and implement plans and evaluate their outcomes. Being able to envision a pathway for a project to move from the idea phase all the way through the evaluation phase is a critical skill. By successfully synthesizing the various sections of this project together into one final artifact, you will have demonstrated your competence in this essential skill.

Preparations

• Read Guiding Questions: Final Project Submission [DOC]. This document is designed to give you questions to consider and additional guidance to help you successfully complete this assessment.
• As you prepare to complete this assessment, you may want to think about other related issues to deepen your understanding or broaden your viewpoint. You are encouraged to consider the questions below and discuss them with a fellow learner, a work associate, an interested friend, or a member of your professional community. Note that these questions are for your own development and exploration and do not need to be completed or submitted as part of your assessment.
  • What is the most useful skill or concept you learned while pursuing your MSN degree?
  • How will you leverage your degree to help you reach your ideal practice career path?
  • How will you be able to apply the work you have done on your capstone project to improve your personal practice?

Instructions

Note: The assessments in this course are sequenced in such a way as to help you build specific skills that you will use throughout your program. Complete the assessments in the order in which they are presented.

For your final capstone project submission you will synthesize the work you completed in the previous four assessments. Please make sure that you have made relevant revisions as suggested by your instructor, as well as relevant additions that you uncovered during your practicum experience. The only brand-new content that you will need to create for this assessment is an Abstract and an Introduction.

This final submission will be graded using the seven program outcomes (POs) for the Master’s of Science in Nursing program. As a reminder they are:

1. Lead organizational change to improve the experience of care, population health, and professional work life while decreasing cost of care.
2. Evaluate the best available evidence for use in clinical and organizational decision making.
3. Apply quality improvement methods to impact patient, population, and systems outcomes.
4. Design patient- and population-centered care to improve health outcomes.
5. Integrate interprofessional care to improve safety and quality and to decrease cost of care.
6. Evaluate the ability of existing and emerging information, communication, and health care technologies to improve safety and quality and to decrease cost of care.
7. Defend health policy that improves the experience of care, population health, and professional work life while decreasing cost of care.

In addition, you will be assessed on how well you incorporated the feedback you received from your instructor on your previous work in this course via the following criterion:

• Integrate writing feedback to improve the clarity and quality of final product.

You will also be assessed on the completion of hours toward your practicum experience.

• Demonstrate completion of hours toward the practicum experience.

See the scoring guide for specific grading criteria related to these requirements.

Abstract

• Summarize the purpose, approach, and any relevant findings of the final capstone project submission (PO #1).

Introduction

• Summarize your need, target population, and setting (PO #1).
• Provide a high-level overview of your intervention plan (PO #4).
• Justify the importance of your need and intervention plan (PO #1).
• Provide a high-level overview of your implementation plan (PO #4).
• Provide a high-level over view of your evaluation plan (PO #4).

Reminder: these instructions are an outline. Your heading for this this section should be Problem Statement and not Part 1: Problem Statement.

Part 1: Problem Statement

Need Statement

• Analyze a health promotion, quality improvement, prevention, education or management need (PO #1).

Population and Setting

• Describe a target population and setting in which an identified need will be addressed (PO #4).

Intervention Overview

• Explain an overview of one or more interventions that would help address an identified need within a target population and setting (PO #3).

Comparison of Approaches

• Analyze potential interprofessional alternatives to an initial intervention with regard to their possibilities to meet the needs of the project, population, and setting. (PO #5).

Initial Outcome Draft

• Define an outcome that identifies the purpose and intended accomplishments of an intervention for a health promotion, quality improvement, prevention, education or management need (PO #4).

Time Estimate

• Propose a rough time frame for the development and implementation of an intervention to address and identified need (PO #1).

Part 2: Literature Review

• Analyze current evidence to validate an identified need and its appropriateness within the target population and setting (PO #2).
• Evaluate and synthesize resources from diverse sources illustrating existing health policy that could impact the approach taken to address an identified need (PO #7).

PART 3: INTERVENTION PLAN

Intervention Plan Components

• Define the major components of an intervention plan for a health promotion, quality improvement, prevention, education, or management need (PO #4).
• Explain the impact of cultural needs and characteristics of a target population and setting on the development of intervention plan components (PO #4).

Theoretical Foundations

• Evaluate theoretical nursing models, strategies from other disciplines, and health care technologies relevant to an intervention plan (PO #6).
• Justify the major components of an intervention by referencing relevant and contemporary evidence from the literature and best practices (PO #2).

Stakeholders, Policy, and Regulations

• Analyze the impact of stakeholder needs, health care policy, regulations, and governing bodies relevant to health care practice and specific components of an intervention plan (PO #7).

Ethical and Legal Implications

• Analyze relevant ethical and legal issues related to health care practice, organizational change, and specific components of an intervention plan (PO #1).

Part 4: Implementation Plan

Management and Leadership

• Propose strategies for leading, managing, and implementing professional nursing practices to ensure interprofessional collaboration during the implementation of an intervention plan (PO #5).
• Analyze the implications of change associated with proposed strategies for improving the quality and experience of care while controlling costs (PO #1).

Delivery and Technology

• Propose appropriate delivery methods to implement an intervention which will improve the quality of the project (PO #3).
• Evaluate the current and emerging technological options related to the proposed delivery methods (PO #6).

Stakeholders, Policy, and Regulations

• Analyze stakeholders, regulatory implications, and potential support that could impact the implementation of an intervention plan (PO #5).
• Propose existing or new policy considerations that would support the implementation of an intervention plan (PO #7).

Timeline

• Propose a timeline to implement an intervention plan with reference to specific factors that influence the timing of implementation (PO #1).

Part 5: Evaluation of Plan

• Define the outcomes that are the goal of an intervention plan (PO #4).
• Create an evaluation plan to determine the impact of an intervention for a health promotion, quality improvement, prevention, education, or management need (PO #3).

Part 6: Discussion

Advocacy

• Analyze the nurse’s role in leading change and driving improvements in the quality and experience of care (PO #1).
• Explain how the intervention plan affects nursing and interprofessional collaboration, and how the health care field gains from the plan (PO #5).

Future Steps

• Explain how the current project could be improved upon to create a bigger impact in the target population as well as to take advantage of emerging technology and care models to improve outcomes and safety (PO #6).

Reflection on Leading Change and Improvement

• Reflect on how the project has impacted your ability to lead change in personal practice and future leadership positions (PO #1).
• Reflect on the ways in which the completed intervention, implementation, and evaluation plans can be transferred into your personal practice to drive quality improvement in other contexts (PO #3).

Address Generally Throughout

• Integrate resources from diverse sources that illustrate support for all aspects of the project as appropriate throughout the final submission (PO #2).
• Clearly, concisely, and cohesively articulate a health care need, population, setting, stakeholders, supporting evidence, intervention, and evaluation (PO #6).
• Integrate writing feedback to improve the clarity and quality of final product.

Practicum Hours Submission

You have been tracking your completed practicum hours each week using the CORE ELMS. By placing the hours into CORE ELMS, you will ensure you are accumulating all hours that are needed to meet the requirements for your specialization and degree.

For this assessment, submit your final CORE ELMS practicum hours tracking log showing all confirmed hours earned at your site during the course. All 100 hours must be documented and confirmed in the CORE ELMS practicum hours tracking log.

You will not receive a grade for this assessment without a practicum hours log showing a minimum of 100 confirmed hours for the time period of this course. Your faculty instructor will review your hours to date and will contact you if he or she has any questions or concerns.

Note for Nursing Informatics learners: Although you will complete your capstone project in this course, your specialization requires 200 hours of practicum, so that work will continue beyond this course. You cannot carry over any hours from NURS-FPX6030. Your final 100 hours of practicum will be completed in NURS-FPX6025.

Additional Requirements

• Length of submission: 20–25 pages (including references).
• Written communication: Written communication is free of errors that detract from the overall message.
• Number of resources: 12–18 resources.
• APA formatting: Resources and citations are formatted according to current APA style.
• Font and font size: Times New Roman, 12 point.

Competencies Measured

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

• Competency 1: Lead organizational change to improve the experience of care, population health, and professional work life while decreasing cost of care.
• Competency 2: Evaluate the best available evidence for use in clinical and organizational decision making.
• Competency 3: Apply quality improvement methods to impact patient, population, and systems outcomes.
• Competency 4: Design patient- and population-centered care to improve health outcomes.
• Competency 5: Integrate interprofessional care to improve safety and quality and to decrease cost of care.
• Competency 6: Evaluate the ability of existing and emerging information, communication, and health care technologies to improve safety and quality and to decrease cost of care.
• Competency 7: Defend health policy that improves the experience of care, population health, and professional work life while decreasing cost of care.

Note: You will also be assessed on two additional criteria unaligned to a course competency:

• Integrate writing feedback to improve the clarity and quality of the final product.
• Demonstrate completion of hours toward the practicum experience.

See the scoring guide for specific grading criteria related to these additional requirements.

Details on reflection