B. Discuss the impact of a clinical practice problem on the patient or patients and the organization it affects.
PICO is a framework commonly used in the healthcare field to identify key components of a clinical practice problem. It stands for:
P: Population or Patient: Who is the population or patient group that is being addressed in the practice problem?
I: Intervention: What is the proposed intervention or treatment being considered?
C: Comparison: What is the comparison group or alternative treatment being considered?
O: Outcome: What is the desired outcome or measure of success for the intervention?
For example, if the clinical practice problem is “How can we reduce the incidence of pneumonia in elderly patients in long-term care facilities?”, the PICO components would be:
P: Elderly patients in long-term care facilities
I: Implementing a pneumonia vaccination program
C: No intervention or standard care
O: Reduction in the incidence of pneumonia in the population
If the clinical practice problem is “What is the most effective treatment for managing pain in patients with osteoarthritis?”, the PICO components would be:
P: Patients with osteoarthritis
I: Various pain management interventions (e.g. medication, physical therapy, acupuncture)
C: Placebo or no treatment
O: Effectiveness in managing pain in the population.
Discuss the impact of a clinical practice problem on the patient or patients and the organization it affects
A clinical practice problem can have a significant impact on both the patient or patients affected and the organization it affects.
For the patient or patients, a clinical practice problem may result in suboptimal or inadequate care, leading to negative outcomes such as pain, suffering, or even death. For example, if a clinical practice problem involves a lack of access to necessary medications, patients may not receive the treatment they need and may experience worsening symptoms or complications. A clinical practice problem may also lead to decreased patient satisfaction and trust in the healthcare system, as patients may feel that their needs are not being adequately met.
For the organization, a clinical practice problem can lead to increased costs and decreased efficiency. For instance, if a clinical practice problem results in a high rate of preventable hospital readmissions, the organization may incur additional costs due to repeated hospitalizations and may struggle to effectively allocate resources. A clinical practice problem may also negatively impact the organization’s reputation and public image, potentially leading to a decline in patient volume and revenue.
The impact of a clinical practice problem can be significant and far-reaching, highlighting the importance of identifying and addressing these issues in order to improve patient care and the efficiency and effectiveness of the healthcare system.
1. Identify each of the following PICO components of the clinical practice problem:
• P: patient, population, or problem
• I: intervention
• C: comparison
• O: outcome
2. Develop an evidence-based practice (EBP) question based on the clinical practice problem discussed in part B and the PICO components identified in part B1.
Note: Refer to the “Appendix B: Question Development Tool” web link for information on the creation of an EBP question.
C. Select a research-based article that answers your EBP question from part B2 to conduct an evidence appraisal.
Note: The article you select should not be more than five years old.
1. Discuss the background or introduction (i.e., the purpose) of the research-based article.
2. Describe the research methodology used in the research-based article.
3. Identify the level of evidence for the research-based article using the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model.
Note: Refer to the “Appendix E: Research Evidence Appraisal Tool” web link for information on how to level a research-based article.
4. Summarize how the researcher analyzed the data in the research-based article.
5. Summarize the ethical considerations of the research-based article. If none are present, explain why.
6. Identify the quality rating of the research-based article according to the JHNEBP model.
Note: Refer to the “Appendix E: Research Evidence Appraisal Tool” web link for information on how to establish the quality rating.
7. Analyze the results or conclusions of the research-based article.
a. Explain how the article helps answer your EBP question.
D. Select a non-research-based article from a peer-reviewed journal that helps to answer your EBP question from part B2 to conduct an evidence appraisal.
Note: The article you select should not be more than five years old.
1. Discuss the background or introduction (i.e., the purpose) of the non-research-based article.
2. Describe the type of evidence (e.g., case study, quality improvement project, clinical practice guideline) used in the non-research-based article.
3. Identify the level of evidence in the non-research-based article using the JHNEBP model.
Note: Refer to the “Appendix F: Non-Research Evidence Appraisal Tool” web link for information on how to level the non-research-based article.
4. Identify the quality rating of the non-research-based article according to the JHNEBP model.
5. Discuss how the author’s recommendations in the non-research-based article help answer your EBP question.
E. Recommend a practice change that addresses your EBP question using both the research-based and non-research-based articles you selected for part C and part D.
1. Explain how you would involve three key stakeholders in supporting the practice change recommendation.
2. Discuss one specific barrier you may encounter when implementing the practice change recommendation.
3. Identify one strategy that could be used to overcome the barrier discussed in part E2.
4. Identify one outcome (the O component in PICO) from your EBP question that can be used to measure the recommended practice change.
F. Acknowledge sources, using APA-formatted in-text citations and references, for content that is quoted, paraphrased, or summarized.
G. Demonstrate professional communication in the content and presentation of your submission.
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