Identification of the PICOT components

PICOT Formulation

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According to Abbade et al (2016), PICOT format is used in the comparative research studies on the relationship between the exposure and the outcome. The exposure in this case can be considered to be the newly developed intervention that is targeted at addressing health issues. This discussion is therefore focused on looking at the two-practice question based on the PICOT format to help in driving the practice change (Abbade et al., 2016).

Practice Question 1

Identification of the PICOT components

Population: children of ages between 5 to 19 years with a body mass index (BMI) of more than

Intervention: the use of the motivational interviewing during a regularly well-child scheduled visitation and its influence on the BMI, BP, quality of life, and the daily physical exercise

Compared: Usual practice is compared to the intervention of motivational interviewing in the regular well-child visitation.

Outcome: the implementation intervention i.e. motivational interviewing influences improvement in the BMI, daily physical exercise, and quality of life.

Time: 8-10 weeks

The keywords used in the identification of the practice question

The keywords or terms that guide the search process to facilitate the process of responding to the practice questions include the motivational interviewing, regular well-child visitation, the BMI, the quality of life, the physical exercise, blood pressure (BP), and the 8-10 weeks timeframe.

To respond to the practice question further, a researched-based intervention focused is on the use of motivational interviewing. One of the articles generated from the research work is by Luque et al (2019) that involved the use of the Obemat2.0 trial. The Obemat2.0 trial was used to assess the effectiveness of multi-component motivational program to treat childhood obesity that is linked between the primary care and hospitals specialized services when compared to the usual intervention that is carried out in the primary care (Luque, et al., 2019).

The authors performed a cluster randomized clinical trial through the use of the two intervention arms i.e. the motivational intervention group and usual care group as the control using 167 study subjects. In the motivational intervention, there were motivational interviewing, learning materials, the utilization of the electronic health physical activity monitor and three group-based gatherings. Based on the results from the study, the primary results show an increase in the score of the body mass index before and after 12 or 12 plus 3 months implementation. The secondary results i.e. the pre and post intervention included the compliance to the medication, the waist circumference, fat mass index, the fat-free mass index, the total body weight, and the mineral density of the borne (Luque, et al., 2019).

The research-evidence based intervention being addressed

The research-evidence based intervention was the motivational interventions such as motivational interviewing, learning materials, the utilization of the electronic health physical activity monitor, and the three group-based sessions (Luque, et al., 2019).

The quantifiable outcomes and how they will be measures

The quantifiable outcomes from the article include body mass index, compliance to the treatment, waist circumference, fat mass index, fat-free mass index, the mineral density of the bone, lipid profile of the blood, the glucose metabolism, the psychological issues, and the total body weight. These are the key components that are associated with obesity. The assessment of the outcome is based on looking at whether there is an increase or reduction in the BMI based on the z score after the implementation period; whether there is an improvement in the adherence process to the medication; and looking at the changes in the score of other parameters mentioned above, for example, the waist circumference, glucose metabolism and the mineral density of the bone marrow (Luque, et al., 2019).

The valid measurements or tools

The measurement tool used for the measurement of the quantifiable data was Obemat2.0. This tool was used to assess the effectiveness of the multicomponent motivational program to help in treating childhood obesity. The multicomponent motivation program included the motivational interviewing, the learning materials, and utilization of the electronic health physical activity monitor (Luque, et al., 2019).

Whether the practice question can be answered within the specified period

The 8 to 10 weeks period is inadequate to measure as well as give accurate and reliable data that would reveal the true picture on the impacts of the intervention. The generated data would not be enough to implement the proposed intervention since the reduction in the BMI, the improvement in the physical activities, and the quality of life requires adequate time for the assessment. The time is also limited concerning factors such as resources required, making contact with the patients, and the measurements of the outcomes (Luque, et al., 2019).

Practice Question 2

Identification of the PICOT elements

Population: the adult care patients

Intervention: the implementation of the research-based skincare integrity bundle

Comparison: the implementation of the intervention that involves the use of the researched-based skincare integrity bundle is being compared to the standard care practice that does not involve any intervention to impact the hospital-associated pressure injuries.

Outcome: the implementation of the intervention will influence the rates of the hospital-associated pressures injuries

Time: the 8 to 10 weeks of the implementation process of the proposed intervention

The keywords used identified in practice question

Some of the key terms focused on in this research question include the skincare integrity bundle, standard care, critical care patients or population, hospital-acquired pressure injuries, the incidence of the skincare integrity bundles, and the 8 to 10 weeks timeframe.

Based on the use of the above terms, the generated research-based evidence is by Cruz (2020) that focused on the impacts of using pressure preventive bundle within 2 months. The author aimed at implementing the intervention involving the use of the intervention for the reduction of the rates of the pressure injuries amongst adult in the ICU. The author reports that patient in the ICU units is at high risk of pressure injuries as a result of the acuity diagnosis. Therefore, they need a longer type of healthcare services, medical procedures, and the application of various types of medical equipment (Cruz, 2020 ).

The research-based evidence intervention

In this study, the evidence presented to help in addressing the issue of pressure injuries among patients in the ICU is the preventive bundles. According to the author, this evidence-based intervention helps reduce the reported incidences of the pressure injuries amongst adult patients within the ICU. The author further reveals that the intervention can be used to assess, examine, and to offer continuous bedside support and positive feedback to the healthcare providers (Cruz, 2020).

The quantifiable outcomes, how to measure them, and the potential tool to help in their measurements

According to the author, the successful implementation of the intervention must be able to lead to the attainment of 10 percent or more in the reduction of the rate of pressure injury cases. The author also indicates that the intervention must be able to give about or more than 90 percent of the provider compliance to the implementation of the preventive bundles. The achievement of these expectation confirms the effectiveness of the intervention program (Cruz, 2020 ).

The outcomes from the implementation of the preventive bundles in the prevention of the pressure injuries are analyzed or measured by assessing the changes. There is an expectation that the implementation of the intervention will be improved amongst healthcare providers. There is a need to be a consistency in the process of implementing the bundle towards the prevention of the pressure bundles (Cruz, 2020).

The valid measurement tool that can be used for the quantification of the data to confirm the effectiveness of the intervention is the compliance checklist tool. This tool is used for the monitoring, auditing, and to offer continuous effective feedback to the providers within the ICU units. The tool is useful in providing information concerning adherence to the implementation of the intervention (Cruz, 2020).

Whether the practice question would be answerable within 8 to 10 weeks

The effective implementation can’t generate data that can be relied on concerning the importance of the preventive bundles within 8 to 10 weeks. This is a procedure that deals with health, therefore, requires adequate time for preparation and plan on the types of resources that will be required. It also requires the training of the nurses and other healthcare providers while at the same time allowing the team to ensure that such proposed practices are implemented within the ICU units (Cruz, 2020).

References

Abbade, L. P., Wang, M., Sriganesh, K., Mbuagbaw, L., & Thabane, L. (2016). Framing of research question using the PICOT format in randomised controlled trials of venous ulcer disease: A protocol for a systematic survey of the literature. BMJ Open, 6(11), e013175. doi:https://doi.org/10.1136/bmjopen-2016-013175 Cruz, C. (2020 ). Reducing the Incidence of Pressure Injuries in Adult ICU Patients at McAllen Medical Center with the Implementation of a Pressure Injury Preventive Bundle: A Quality Improvement Project. Luque, V., Feliu, A., Escribano, J., Ferre, N., Flores, G., Monne, R., . . . Closa-Monasterolo, R. (2019). The Obemat2.0 Study: A Clinical Trial of a Motivational Intervention for Childhood Obesity Treatment. Nutrients, 11(2), 419. doi:https://doi.org/10.3390/nu11020419

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