PICO(T) Questions and an Evidence-Based Approach

Gestational diabetes maternal risk
Create a 3 page Gestational diabetes maternal risk  submission in which you develop a PICO(T) question for a specific care issue and evaluate the evidence you locate, which could help to answer the question. PICO(T) is an acronym that helps researchers and practitioners define aspects of a potential study or investigation. It stands for: P Patient/population/problem. I Intervention. C Comparison (of potential interventions, typically). O – Outcome(s). T – Time frame (if time frame is relevant). The end goal of applying PICO(T) is to develop a question that can help guide the search for evidence (Boswell Cannon, 2015). From this perspective, a PICO(T) question can be a valuable starting point for nurses who are starting to apply an evidence-based model or EBPs. By taking the time to precisely define the areas in which the nurse will be looking for evidence, searches become more efficient and effective. Essentially, by precisely defining the types of evidence within specific areas, the nurse will be more likely to discover relevant and useful evidence during their search. Competency 1: Interpret findings from scholarly quantitative, qualitative, and outcomes research articles and studies. Competency 2: Analyze the relevance and potential effectiveness of evidence when making a decision. Explain criteria that should be considered when determining credibility of resources such as journal articles and websites. Analyze the credibility and relevance of evidence and resources within the context of a quality or safety issue, or a chosen diagnosis. Competency 3: Apply an evidence-based practice model to address a practice issue. Explain the importance of incorporating credible evidence into an EBP model used to address a quality or safety issue, or a chosen diagnosis. Competency 4: Plan care based on the best available evidence. Describe a quality or safety issue, or a chosen diagnosis, that could benefit from an evidence-based approach. Competency 5: Apply professional, scholarly communication strategies to lead practice changes based on evidence.

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Sample paper
When furthering care for patients the PICO(T) format is a helpful approach to exploring the effect of therapy and expanding patient care to ensure that needs are met. The pneumonic PICO(T) stands for Population/Patient, Intervention, Comparison, Outcome, and Time. Utilizing this research method, this writer will examine the issue behind nurse burnout rates in connection to safe staffing ratio rules. (2020). This writer will be applying the PICO(T) approach to research, go in depth of the findings, and explore the relevance of key research. The practice issue acknowledged for exploration is the need to initiate safe staffing ratios in healthcare settings to lower the rate of nurse burnout which in turn is safer for the patients. The question being investigated is: Does having safe staffing ratios in place decrease nurse burnout? The proposed intervention of this study is reduction in the nurse-to-patient ratio in hospital settings. Research has proved that when the number of patients a nurse is responsible for is lessened, fatigue, stress, and the overall burnout of healthcare professionals decreases. (Cimiotti, Aiken, Sloane & Wu, 2012). The population that is being examined are nurses in hospital settings that do not currently have staffing ratios in place. Since the objective is to explore the care practices that address this issue, only factors related to the care provided in a hospital are considered. The study disregards cultural, political, and social factors. Nurses make up the largest group of the clinical staff population, approximately 55% in hospitals. Due to their large volume this is where most reformers have chosen to reduce hospital costs. What this means is these hospitals consider nurses and the cost to staff them as an expense that can easily by cut. Hospitals do this by increases nurses hours and decreasing the number of staff. In 2013 2,976 hospitals were penalized due to high nurse-to-patio ratios. High nurse-to-patient ratios are linked to risky consequences including increased stress and mental PICO(T) QUESTIONS AND AN EVIDENCE-BASED APPROACH exhaustion for the nurses, a high number of mistakes and accidents which has resulted in a surge of malpractice suits. The average turnover rate for a Registered Nurse in the United States is 56%. Burnout syndrome in nurses has been shown to increase by 23% for every additional patient assignment the nurse takes on. (Cimiotti, Aiken, Sloane & Wu, 2012). Only 14 states as of 2015 chose to address nurse staffing issues by law or by some other limiting efforts regulations. California has continued to be the only state in the country to pass legislative laws the truly regulate nurse-to-patient ratios. The California law has led to better demeanor of the nurses in the state, lower levels of illness in the staff, and a lower turnover rate. Californias laws have mandated hospitals to have specific ratios based on the acuity of patients in specific departments. (2020). Safe staffing is considered a cost effective way to save hospitals money. When California laws were put in place, the hospitals income increased from $12.5 billion to more than $20 billion. The average cost to replace an RN (registered nurse) is $88,000, when nurse ratios are implemented nurse turnover rates are lower, again saving the organization money. (Carlson, 2017). It is proposed that ratios should be specific to unit needs, the more critical patients are, the less a nurse should be responsible for. In intensive care units a nurse should have two patients. In emergency departments it is three, unless the patients are deemed critical, or it is a trauma unit then they should only have one. Medical surgical units currently are at a 1:6 ratio, but ideally need to be at 1:4. (Cimiotti, Aiken, Sloane & Wu, 2012). The number of patients one nurse is responsible for has a direct impact on the ability to adequately assess, monitor and safely care for them. Outcomes are better for the nurse, the patients and the hospital as an organization when safe nurse-to-patient ratios are set in place. PICO(T) QUESTIONS AND AN EVIDENCE-BASED APPROACH exhaustion for the nurses, a high number of mistakes and accidents which has resulted in a surge of malpractice suits. The average turnover rate for a Registered Nurse in the United States is 56%. Burnout syndrome in nurses has been shown to increase by 23% for every additional patient assignment the nurse takes on. (Cimiotti, Aiken, Sloane & Wu, 2012). Only 14 states as of 2015 chose to address nurse staffing issues by law or by some other limiting efforts regulations. California has continued to be the only state in the country to pass legislative laws the truly regulate nurse-to-patient ratios. The California law has led to better demeanor of the nurses in the state, lower levels of illness in the staff, and a lower turnover rate. Californias laws have mandated hospitals to have specific ratios based on the acuity of patients in specific departments. (2020). Safe staffing is considered a cost effective way to save hospitals money. When California laws were put in place, the hospitals income increased from $12.5 billion to more than $20 billion. The average cost to replace an RN (registered nurse) is $88,000, when nurse ratios are implemented nurse turnover rates are lower, again saving the organization money. (Carlson, 2017). It is proposed that ratios should be specific to unit needs, the more critical patients are, the less a nurse should be responsible for. In intensive care units a nurse should have two patients. In emergency departments it is three, unless the patients are deemed critical, or it is a trauma unit then they should only have one. Medical surgical units currently are at a 1:6 ratio, but ideally need to be at 1:4. (Cimiotti, Aiken, Sloane & Wu, 2012). The number of patients one nurse is responsible for has a direct impact on the ability to adequately assess, monitor and safely care for them. Outcomes are better for the nurse, the patients and the hospital as an organization when safe nurse-to-patient ratios are set in place. concern in hospitals across the country and has been considered the norm for too long by too many healthcare organizations. The relevance of the article written by Keith Carlson was acknowledged as he voiced the cry for help from nurses in the United States. He reports that while discussed by legislation around the world, there is much disagreement behind safe staffing ratios. The organization that published his article as well as the American Nurses Association are focused on the fact that inadequate nurse staffing levels are not only dangerous to the patients, but is a part of the bigger problem the country is struggling with, the growing nursing shortage. He explores the ways that the current situation with hospitals in the U.S. is a part of the cycle of nurse turnover and driving the countries experienced RNs away from bedside nursing. Conclusion While the nationwide nursing shortage and large rate of nurse burnout is among a large problem, there is a great need to develop care practices that make it safer for nurses to do their jobs each day. Their drive to help others is what leads them to the medical field, poor staffing is not what should drive them away from it. The PICO(T) framework was applied here to determine whether or not laws supporting safe staffing ratios is more effective at preventing nurse burnout than hospitals that do not comply with this. The previously mentioned articles provide reliable, current and extensive research that magnifies the dangers of what happens when safe staffing is not considered.

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