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Evidence-Based Approach


Instructions:

After reviewing the materials you created to research a specific diagnosis in the first two assessments, apply the PICO(T) process to develop a 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 chosen diagnosis, and 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” (BELOW) 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.


Create PICO(T) Questions:

PICOT QUESTION PROCESS

Creating a question using the PICOT elements will provide a framework for the research you need to conduct an evidence-based study or to make an evidence-based decision. 

 

PICOT Elements:

(P) – 
Population, Patients or Problem: The sample of subjects used in a study, or the problem being addressed. 

(I) – 
Intervention:  The treatment that will be provided to subjects enrolled in your study.

(C) – 
Comparison or Control:  Identifies an alternative intervention or treatment to compare. Many study designs refer to this as the control group. If an existing treatment is considered the ‘gold standard’, then it should be the comparison group. A control group is not required for every type of study.

(O) – 
Outcome: The clinical outcome that measures the effectiveness of the intervention. 

(T) – 
Time: Duration of the data collection.  Some versions don’t include this element, and time may not be specified in cases where the question is focused on prediction or diagnoses. 

 

PICOT Question Format Examples:

Please be sure to check your assignment, as it may direct you to use a different format.

·
Intervention: In _______ (P), how does _______ (I) compared to  _______  (C) affect _______  (O) within _______ (T)?

·
Prognosis/Prediction:  In _______ (P), how does _______ (I) compared to _______ (C) influence/predict _______ (O) over _______ (T)?

·
Diagnosis or Diagnostic test:  In _______   (P) are/is _______   (I) compared to _______ (C) more accurate in diagnosing _______ (O)?

·
Etiology:  Are _______ (P), who have _______ (I) compared to those without _______ (C) at _______ risk for/of _______ (O) over _______ (T)?

·
Meaning:  How do_______ (P) with _______ (I) perceive _______ (O) during _______ (T)?

 

Example PICOT Questions:

· For residents of long-term care facilities (P), how does implementation of a hydration assessment tool (I) compared to current practice (C) affect the number of hospital admissions with the diagnosis of dehydration (O) during a three-month period (T)?

· In acute care hospitals (P), how does having a rapid response team (I) compared with not having a response team (C) affect the number of cardiac arrests (O) during a three-month period (T)?

· In women with gestational diabetes (P), how does a monitored diet and exercise program over the course of pregnancy (I &T), compare to the use of metformin only (C) reduce the incidence of high birth weight babies(O)?  

· In patients admitted for acute myocardial infarction (P), how well does the hospital’s new data model created from EMR data (I) compared to current practices (C) predict readmission rates (O) within 30 days after initial discharge (T)?

· For patients of a rural health clinic (P), does the use of text message reminders (I), compared with telephone calls (C) reduce the number of missed appointments (O) over a six month period (T)?

 

References:

·

Melnyk, B.M., Fineout-Overholt, E., Stillwell, S. & Williamson, K. M. (2010). Evidence-Based Practice: Step by Step: The Seven Steps of Evidence-Based Practice. AJN, American Journal of Nursing, 110, 51-53.

· Melnyk, B. M., & Fineout-Overholt, E. (2015). Evidence-based practice in nursing & healthcare: A guide to best practice. (Not in library)


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.

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