- NURS FPX 4030 Assessment 3 PICO (T) Questions and an Evidence-Based Approach.
PICO(T) Questions and an Evidence-Based Approach
Evidence-based practice is a fundamental part of a medical caretaker’s position, and researching for clinical evidence is essential to the interaction. This is based on collecting, interpreting, and appraising whether sources are relevant and clinically significant. It is then followed by translating the research into daily patient care practice. The initial stage of any research examination is framing an appropriate clinical question, which can be finished using the PICO(T) process (Zuzelo et al., 2018).
PICO(T) is a memory partner that utilizes language to formulate a valuable clinical question on which research will be based. According to Zuzelo et al. (2018), the PICO(T) model incorporates characterizing a patient, issue, intervention, comparison and outcome. When and if the “T” is utilized, this would represent a time frame to be examined. In this cycle, there are seven steps to completing the strategy effectively. The first is to create the PICO(T) question, and the second is to identify specific watchwords that would be utilized for the search.
The next part is planning and applying strategies, followed by executing the search through the identified databases. Sometimes, the search is too broad, and the results should be refined. The next step is to investigate all the literature to identify the most valid sources and finally assess the evidence that will be utilized for research.
Description of a Practice Issue
The practice issue picked for NURS FPX 4030 Assessment 3 PICO(T) Questions and an Evidence-Based Approach recollects safety for medication, specifically in the reconciliation cycle. According to Schepel et al. (2019), medical goofs that happen through the administration of drugs affect countless individuals each year and cost billions of dollars. Many times, these adverse events are preventable. There has been a significant amount of research based on the root causes of medication administration mistakes. One area that has been.
Identified as problematic, causing many mistakes during patient handovers, medication reconciliation ought to be a standardized cycle. The PICO(T) question that was formulated is according to the accompanying:
Is using a daily medication timeout effective in lessening mistakes during the discharge pattern of medication reconciliation?
- P = The population is the patients being discharged from a facility.
- I = The intervention utilizes a medication timeout strategy.
- C = A comparison of this would reject a timeout process.
- O= The outcome is expected to decrease medication mishandling before the patient is discharged.
Source research should now be framed to answer this question as effectively and thoroughly as conceivable, based on scientific research tracked down in the various medical databases (Zuzelo et al., 2018).
Effective Sources of Evidence
A search through databases, for example, Ebsco host, Bar Medication, and Clinical Key, tracked down several relevant journals in light of the PICO(T) question. The Journal of Pharmaceutical Arrangement and Practice is one such organization, as safety in medication administration can be a pharmacy-driven initiative in facilities.
The Quality Management in Healthcare journal contained several articles on the topic, and one pertinent article was found in the Research and Social and Administrative Pharmacy journal. The American Journal of Health Systems Pharmacy was also utilized as a source, and the Journal of Critical Care distributed a research study relevant to medication reconciliation timeouts. The search revealed four articles.
Findings from the Articles Relating to the Health Care Issue
The first article by Gao et al. (2018) outlined a strategy for quality improvement through research utilizing a multidisciplinary timeout checklist during discharge. This study assessed whether this directly impacted the hospital’s reduction of medical medication errors. The study incorporated the Model For Improvement Framework and created a discharge checklist to educate patients on discharge medications. The checklist was utilized to standardize the cycle and ensure that each patient was discharged with the same degree of understanding.
NURS FPX 4030 Assessment 3 PICO (T) Questions and an Evidence-Based Approach
The following article (Schepel et al.,2019) was selected as it outlines strategies for further creating medication safety by utilizing a standardized cycle. This interaction included implementing a timeout strategy and utilizing pharmacists to assist with the medication reconciliation. The third article selected (Stolldorf et al., 2020) gave research data through a MARQUIS study, a multi-centre medication reconciliation quality improvement study. The study gave participating hospitals a toolkit to create and standardize a medication reconciliation program incorporating a timeout method.
The final selected article (Tainter et al., 2018) was a study on utilizing a medication timeout system in an intensive care unit. The study used a quality improvement intervention by including a time out for each patient that the noticed medical caretakers encountered during their shift in a 180-bed hospital facility.
Relevance of Findings and Making Decisions Related to the PICO(T) Question
The findings were relevant to the PICO(T), and each has its distinct applicability to answering the question. The study by Gao et al. (2018) presented the study’s results, which was conducted over six months. They noticed 190 discharge timeouts that were Completed during various shifts. Out of this, they had the option to catch mistakes in medication during discharge by 11.1%, leading them to conclude that a discharge timeout strategy can potentially decrease preventable medication botches.
Medication Reconciliation and Timeouts
The article by Schepel et al. (2019) found that by implementing the strategy of medication reconciliation and timeouts, they could reduce mistakes and improve patient outcomes. The relevance of the Stolldoff et al. (2020) study showed that utilizing the MARQUIS hospital tool kit for medication reconciliation strategies and the timeout strategy as one of the tools will support safety in the medication reconciliation processes.
Furthermore, the article by Tainter et al. (2018) found that during 347 patient encounters when the timeout method was utilized, 179, which equated to 51.6%, resulted in catching a mistake before the patient was discharged. They also assumed a daily medication timeout should be suggested for patient safety.
Conclusion
Utilizing a PICO(T) question as a starting point for research is essential to evidence-based research. In this scenario, the NURS FPX 4030 Assessment 3 PICO(T) Questions and an Evidence-Based Approach were formulated to determine whether a medication timeout cycle should be used in discharging patients to limit patient harm and mistakes. The research was conducted through various databases, and four articles were determined valid based on the CRAAP test. Each article was significant and contributed to answering the PICO(T) question. Based on the research, it was determined that utilizing a timeout strategy can effectively contribute to patient safety.
References
Gao, M. C., Martin, P. B., Motal, J., Gingras, L. F., Chai, C., Maikoff, M. E.,. & Eiss, B. M. (2018). A multidisciplinary discharge timeout checklist improves patient education and captures discharge process errors. Quality Management in Healthcare, 27(2), 63-68.
Schepel, L., Aronpuro, K., Kvarnström, K., Holmström, A. R., Lehtonen, L., Lapatto-Reiniluoto, O.,. & Airaksinen, M. (2019). Strategies for improving medication safety in hospitals: development of clinical pharmacy services. Research in Social and Administrative Pharmacy, 15(7), 873-882.
Stolldorf, D. P., Mixon, A. S., Auerbach, A. D., Aylor, A. R., Shabbir, H., Schnipper, J., & Kripalani, S. (2020). Implementation and sustainability of a medication reconciliation toolkit: A mixed methods evaluation. American Journal of Health-System Pharmacy, 77(14), 1135-1143.
Tainter, C. R., Nguyen, A. P., Pollock, K. A., O’Brien, E. O., Lee, J., Schmidt, U.,. & Meier, A. (2018). The impact of a daily “medication time out” in the Intensive Care Unit. Journal of Critical Care, 43, 366–369.
Zuzelo, P. R. (2018). Evidence-based practice methodology: Use the correct approach. Holistic Nursing Practice, 32(6), 340-342.