Describe The Difference Between A Nursing Practice Problem And A Medical Practice Problem. Provide One Example Of Each. Discuss Why Is It Important To Ensure Your PICOT Is Based On A Nursing Practice Problem.
Although nursing practice problems and medical practice problems are related in that they are used for medicine, there are differences between the two. A nursing practice problem is an issue encountered during nursing practice, such as during a patient assessment, related to the patient’s response to a health problem they are experiencing. There are numerous considerations to the nursing practice problems (Fuller, 1982). This ranges from the patient’s signs and symptoms to an illness to their difficulties in completing the activities of daily living due to a fractured extremity. This is due to nursing care involves the entire individual, family or community. Fuller, (1982) states that nursing practice problems, “…deal with modalities of patient care such as support, comfort, prevention of trauma, promotion of recovery, health screening, appraisal and/or assessment, health education, and coordination of health care.”
A medical practice problem is concerned with a medical condition or disease. It identifies a condition, searches for causes, establishes a prognosis, and prescribes a treatment for the condition (Chiffi & Zanotti, 2015).
Chiffi and Zanotti (2015) state, “In conclusion, medical and nursing diagnoses have different goals: a medical diagnosis identifies a variation from a norm, while a nursing diagnosis should judge the existence of a potential for enhancing self-care.”
Consider a patient with a fractured wrist. The physician will set the fracture and prescribe pain medication. These are examples of medical practice problems. The nurse will review the aftercare and medication instructions with the patient. The nurse will also review care of the splint and possibly arrange a visiting RN to help with activities of daily living.
The PICOT question is the first step in establishing or improving evidence-based practice with the goal of solving problems with patients. “Nurses use EBP to provide patients with safe, quality care and to improve outcomes” (Helbig, 2018). The PICOT is based on a nursing practice problem because it is designed to improve patient care. An example of using PICOT for evidence-based practice would be studying the frequency of oral care with the goal of reducing the incidence of ventilator associated pneumonias. It is not designed for disease research.
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Here is a 275 word paper on the difference between nursing practice problems and medical practice problems based on the discussion:
Nursing practice problems focus on issues that impact patient health and well-being during the course of nursing care. In contrast, medical practice problems center on diagnosing and treating diseases or medical conditions. An example of a nursing practice problem is a patient experiencing pain and difficulty with activities of daily living due to a fractured wrist. The nurse would assess the injury, provide pain management, review self-care instructions, and arrange follow-up support as needed. Comparatively, setting and treating the fractured bone itself would constitute a medical practice problem handled by the physician who would reduce the fracture, apply a cast or splint, and prescribe medications to aid healing (Chiffi & Zanotti, 2015).
The goals of nursing versus medical diagnoses also differ. A medical diagnosis identifies a deviation from normal health, while a nursing diagnosis should evaluate a patient’s capacity for self-care (Chiffi & Zanotti, 2015). This demonstrates how nursing practice problems examine broader issues impacting patient wellness, functionality, and independence rather than focusing solely on pathology.
The PICOT framework is a valuable tool for evidence-based nursing practice that formulates answerable clinical questions. However, it is important PICOT questions stem from true nursing practice problems rather than medical issues (Helbig, 2018). Limiting PICOT’s scope to nursing concerns allows research findings to specifically enhance the care only nurses can provide. For example, investigating oral care frequency to reduce ventilator-associated pneumonia addresses a nursing priority of patient safety rather than disease treatment (Helbig, 2018). In summary, distinguishing nursing from medical problems ensures PICOT facilitates optimal evidence-based changes to nursing practice.
