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PICOT Statement Paper

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PICOT Statement Paper

Running head: REDUCING STILLBIRTHS Reducing stillbirths NRS 490 April 8, 2018 1 REDUCING STILLBIRTHS 2 The

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problem Even though infant mortality in the US is not as high as it is in developing countries, stillbirths still remain high, accounting for a high percentage of maternal deaths. In every 160 pregnancies in the US, at least one of the babies is usually still born, adding up to 26,000 deaths each year. This is a high rate compared to the rates of other developed countries (Robert M. Silver, 2007). Still birth is an emotional experience for both the mother and the health care provider. High stillbirth rates can be attributed to multiple factors including negligence of patient needs by healthcare providers, as well as a patient’s physical, mental, and emotional state due to factors such as being overweight, giving birth after a certain age, drug addiction and smoking, or having been diagnosed with diabetes (CACCIATORE, 2010). Description and setting in which the problem can be observed Compared to other highly industrialized countries such as Japan, Germany, and Australia, US has a high stillbirth rate, whose main cause could be the increasing gap between the rich and the poor. Most of these stillbirth statistics indicate racial and economic trends. As has been identified by research findings, multiple parties including health care providers, patients, and the community have a role to play in minimizing the rate of stillbirths (Gary L Darmstadt, 2009). According to research, factors such as a woman’s age contribute to the likelihood of a still birth, with women under the age of 15 being more likely to have still births compared to women within the age of 25 to 29. Women who are over 35 also have a higher risk of experiencing stillbirths (Fernando C Barros, 2010). Impact of the problem Stillbirth causes a high emotional and psychological pain to the family experiencing the loss. However, stillbirth is not simply an individual’s problem but is also a national issue which ought to be addressed at a community and at a national level (BMJ, 2015). Many REDUCING STILLBIRTHS 3 causes of stillbirth including economic and social factors, health complications, or drug abuse are known to recur in subsequent pregnancies, hence leading to an increase of the chances of experiencing stillbirth in the next pregnancy (ulfiqar A. Bhutta, 2003). Due to these difficulties in addressing the root causes, most professionals and the community have a difficult in identifying the level of care which one needs for subsequent pregnancies. Significance of the problem and its implications to nursing Nursing care has a significant impact on maternal care and impacts the possibility of a mother experiencing stillborn birth. This care also affects a patient’s reaction post the stillbirth, and especially how they deal with the loss. Patients with medical conditions such as High blood pressure have a high possibility of experiencing stillbirth, hence the need to pay keen attention to patients with specific needs to ensure that they are healthy and well cared for during the pregnancy. Factors such as religious beliefs, previous history of loss, and family structures also affect how a patient is likely to care for themselves during a pregnancy, and nurses would be expected to understand these social cultural factors in order to ensure that a patient is well cared for (RANZCOG, 2014). Proposed solution In order to minimize the cases of stillborn births, there are various behavioral and social mediated approaches which healthcare professionals and the community can take. These include ensuring that quality and universal healthcare is accessible to all, educating the community on the effects of maternal exposure to harmful practices and substances, and ensuring that maternal nutrition before and after pregnancy is ensured (Esme V Menezes, 2009). REDUCING STILLBIRTHS 4 References BMJ. (2015). Risk of recurrent stillbirth: systematic review and meta-analysis. BMJ , 350. Retrieved from https://www.bmj.com/content/350/bmj.h3080 CACCIATORE, J. (2010). Stillbirth:Patient-centered Psychosocial Care. CLINICAL OBSTETRICS AND GYNECOLOGY, 9. Retrieved from https://repository.asu.edu/attachments/145706/content/Stillbirth%20Patient%20center ed%20psychosocial%20care%20final%20Cacciatore%202010.pdf Esme V Menezes, M. Y. (2009). Reducing stillbirths: prevention and management of medical disorders and infections during pregnancy. BMC Pregnancy Childbirth, 9. Fernando C Barros, Z. q. (2010). Global report on preterm birth and stillbirth. Barros, 36. Retrieved from https://link.springer.com/content/pdf/10.1186%2F1471-2393-10-S1S3.pdf Gary L Darmstadt, M. Y. (2009). Reducing stillbirths: interventions during labour. Retrieved from NCBI: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2679412/ RANZCOG. ( 2014). Caring for families. Retrieved from Evidence-based guidance for healthcare professionals: https://www.ranzcog.edu.au/RANZCOG_SITE/media/RANZCOGMEDIA/Women’s%20Health/Caring-for-families-experiencing-stillbirth-Part1.pdf?ext=.pdf Robert M. Silver, M. W. (2007). WORK-UP OF STILLBIRTH: A REVIEW OF THE EVIDENCE. Am J Obstet Gynecol, 433-444. ulfiqar A. Bhutta, G. L. (2003). Using Evidence to Save Newborn Lives. Policy Perspectives on Newborn Health, 6.
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PICOT Statement Paper

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PICOT Statement Paper

Running head: MENTAL HEALTH FOR HEALTHY PEOPLE 2020 Mental Health for Healthy People 2020 1 MENTAL

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HEALTH FOR HEALTHY PEOPLE 2020 2 The issue that is the focus of this project is improving the coordination of care for the purpose of improving patient outcomes. Care coordination can be defined as the practice of organizing patient care activities between several participants engaged in caring for the patient for the purpose of facilitating the delivery of care. The issue of care coordination can be observed in a variety of healthcare settings involved in the delivery of care to the patients. Care coordination requires effective collaboration between the healthcare staff involved in caring for the patient and it is an important practice that conserves the resources of the health care provider and also the patient’s time. Care coordination also facilitates accurate diagnosis and treatment since all the participants in the provision of patient care receive the relevant information about diagnosis and treatment from all the providers involved in caring for the patient (Cohen and Adler-Milstein, 2015). The main objective of care coordination in any health care setting is meeting the needs and preferences of the patients in the delivery of high-value and high-quality health care. This implies that the health care providers know the needs and preferences of the patient and thus communicated to the right providers at the right time so that this information can be utilized in guiding the delivery of appropriate, safe, and effective care. Care coordination has a significant impact on the quality of care provided by healthcare staff, work environment, and also on the patient outcomes. Effective care coordination improves the work environment in the provision of care by facilitating efficient and appropriate delivery of health care services both across and within systems. Care coordination also has a significant impact on improving the quality of care provided by healthcare staff because the absence of coordinated care can result in unsafe practices and also increases the risk of poor patient outcomes.an improvement in patient outcome is a major impact of care coordination whereby various studies have indicated that the clinical outcomes and satisfaction of patients are reported MENTAL HEALTH FOR HEALTHY PEOPLE 2020 3 to increase when there is an effective coordination between all the providers involved caring for the patient (McAllister, et al 2018). Care coordination also facilitates addressing the potential gaps in realizing the patients’ interrelated developmental, medical, behavioral, social, and financial needs for the purpose of achieving the best health care outcomes according to the preferences of the patient. The significance of the issue of care coordination includes helping to address some challenges that health care facilities are facing today. This is because care coordination helps to reduce the high rates of readmission which are caused by the lack of education in patients regarding their treatment plan or medication. Care coordination also has significance in addressing the problems faced by referral staffs since the disjointed nature of today’s health care systems pose a challenge to the referral staff in terms of dealing with lost information which may result to a less efficient care (Daveson, et al., 2014). The healthcare problem whereby specialists are not provided with adequate information on the patient’s test performed before can also be addressed by effective care coordination. The practical implication of care coordination to nursing include that the role of nurses in the process of care coordination is not clear. Therefore, their role and goals of each clinician should be clarified in order to avoid role conflict and confusion in care coordination. The solution to effective care coordination that can improve the patients’ outcome is implementing electronic health record (EHR) systems. EHRs can reduce fragmentation in the provision of care by integrating and organizing the health information of the patient and facilitating its quick distribution to all the care providers participating in patient’s care (Wu, et al. 2017). Accurate EHRs can facilitate all the providers involved in patient’s care to have up-to- MENTAL HEALTH FOR HEALTHY PEOPLE 2020 4 date and accurate medical information about a patient and thus improving quality care and patient outcomes. MENTAL HEALTH FOR HEALTHY PEOPLE 2020 5 References Brown, N. M., Green, J. C., Desai, M. M., Weitzman, C. C., & Rosenthal, M. S. (2014). Need and unmet need for care coordination among children with mental health conditions. Pediatrics, 133(3), e530-e537. Cohen, G. R., & Adler-Milstein, J. (2015). Meaningful use care coordination criteria: Perceived barriers and benefits among primary care providers. Journal of the American Medical Informatics Association, 23(e1), e146-e151. Daveson, B. A., Harding, R., Shipman, C., Mason, B. L., Epiphaniou, E., Higginson, I. J., … Murray, S. (2014). The Real-World Problem of Care Coordination: A Longitudinal Qualitative Study with Patients Living with Advanced Progressive Illness and Their Unpaid Caregivers. PLoS ONE, 9(5), e95523. http://doi.org/10.1371/journal.pone.0095523 Foster, S. D., Hart, K., Lindsell, C. J., Miller, C. N., & Lyons, M. S. (2018). Impact of a low intensity and broadly inclusive ED care-coordination intervention on linkage to primary care and ED utilization. The American Journal of Emergency Medicine. Lemke, M., Kappel, R., McCarter, R., D’Angelo, L., & Tuchman, L. K. (2018). Perceptions of Health Care Transition Care Coordination in Patients with Chronic Illness. Pediatrics, e20173168. McAllister, J. W., McNally, R. K., Rodgers, R., Mpofu, P. B., Monahan, P. O., & Lock, T. M. (2018). Effects of a Care Coordination Intervention with Children with Neurodevelopmental Disabilities and Their Families. Journal of developmental and behavioral pediatrics: JDBP. MENTAL HEALTH FOR HEALTHY PEOPLE 2020 6 Morton, S., Shih, S. C., Winther, C. H., Tinoco, A., Kessler, R. S., & Scholle, S. H. (2015). Health IT-enabled care coordination: a national survey of patient-centered medical home clinicians. The Annals of Family Medicine, 13(3), 250-256. Wu, F. M., Shortell, S. M., Rundall, T. G., & Bloom, J. R. (2017). The role of health information technology in advancing care management and coordination in accountable care organizations. Health care management review, 42(4), 282-291. While your paper as to content is thorough, you have justified the right margin (made it even) throughout your paper which throws all the spacing in your paper off. As I deduct 0.1 points for each APA infraction, you would wind up with 0 points for this assignment, so I am only deducting 3 points for all of the errors with the spacing and please make sure in the future you do not use an even right margin as it is not APA. Additionally, the other errors in your paper are graded per the Clarification of the Week Two Assignment Post in main forum.
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PICOT Statement Paper

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PICOT Statement Paper

Topic: Reducing infection rates of central lines with more handwashing (nurses and patients)

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Review the Topic Materials and the work completed in NRS-433V to formulate a PICOT statement for your capstone project.

A PICOT starts with a designated patient population in a particular clinical area and identifies clinical problems or issues that arise from clinical care. The intervention should be an independent, specified nursing change intervention. The intervention cannot require a provider prescription. Include a comparison to a patient population not currently receiving the intervention, and specify the timeframe needed to implement the change process.

Formulate a PICOT statement using the PICOT format provided in the assigned readings. The PICOT statement will provide a framework for your capstone project.

In a paper of 500-750 words, clearly identify the clinical problem and how it can result in a positive patient outcome.

Make sure to address the following on the PICOT statement:

Evidence-Based Solution
Nursing Intervention
Patient Care
Health Care Agency
Nursing Practice
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.

 

 

 

 

FYI from the class that will help with assignment:

Research Purpose

The research purpose is the statement of why the study is being undertaken. The purpose statement may be explicit or implicit but should be stated objectively. The research purpose is more specific than the research problem and is generated by way of deductive reasoning. The research purpose communicates the aim or goal of the study. In addition, the major variables to be studied, along with the population and setting, are identified in the research purpose (Cooper & Schindler, 2003).

As the research purpose becomes clearer, the researcher must determine the feasibility of the study by examining the commitment required in time and money, as well as expertise required, subject availability, and any ethical considerations. An example of a clinical research purpose that might be deemed feasible is to determine if a relationship exists between the extent of participation in selected behaviors that may be detrimental to health and the propensity to take risks.

Review of Literature

The purpose for the review of literature is to gain a broad understanding of the available information related to the research problem. Relevant literature is examined, and provides credibility to the study being pursued. There are three steps to the review of literature process: locating relevant sources, critiquing the sources, and generating the written report of the resulting knowledge. Literature can be located through electronic literature searches of electronic databases, such as CINAHL, MEDLINE, Science Direct, and HealthSTAR, and print resources such as those found in libraries.

The literature review section should be written in an organized manner, beginning with the introduction, leading to the presentation of empirical and theoretical sources, and ending with the summary of relevant ideas. The information gained through the review of literature is logically organized and presented in the review-of-literature section of the report (Cooper & Schindler, 2003).

Research Question

Once the problem has been identified, the literature review completed, and the conceptual framework chosen, the research question needs to be formulated. The question may either be in the form of a statement, a question, or a hypothesis. The research question must be succinct, clear, and it must answer the question being studied.

Formulating the research question may be one of the most difficult steps of the research process. Usually, the initial dilemma is very broad, and must be narrowed to be reasonably studied. A research question should be based on facts, which will lead to the formulation of investigative questions. The question should be theoretical, practical, and feasible (Cooper & Schindler, 2003).

Hypothesis

The hypothesis is a prediction of the researcher’s expected findings of the research study. The hypothesis includes the variables to be studied and their relationships, the population to be studied, and the type of research to be conducted. The hypothesis also directs the measurement of variables, the selection of the design, and the interpretation of the findings. The findings of the study either indicate acceptance or non-acceptance of the hypothesis (Cooper & Schindler, 2003).

Research Purpose

The research purpose is the statement of why the study is being undertaken. The purpose statement may be explicit or implicit but should be stated objectively. The research purpose is more specific than the research problem and is generated by way of deductive reasoning. The research purpose communicates the aim or goal of the study. In addition, the major variables to be studied, along with the population and setting, are identified in the research purpose (Cooper & Schindler, 2003).

As the research purpose becomes clearer, the researcher must determine the feasibility of the study by examining the commitment required in time and money, as well as expertise required, subject availability, and any ethical considerations. An example of a clinical research purpose that might be deemed feasible is to determine if a relationship exists between the extent of participation in selected behaviors that may be detrimental to health and the propensity to take risks.

Review of Literature

The purpose for the review of literature is to gain a broad understanding of the available information related to the research problem. Relevant literature is examined, and provides credibility to the study being pursued. There are three steps to the review of literature process: locating relevant sources, critiquing the sources, and generating the written report of the resulting knowledge. Literature can be located through electronic literature searches of electronic databases, such as CINAHL, MEDLINE, Science Direct, and HealthSTAR, and print resources such as those found in libraries.

The literature review section should be written in an organized manner, beginning with the introduction, leading to the presentation of empirical and theoretical sources, and ending with the summary of relevant ideas. The information gained through the review of literature is logically organized and presented in the review-of-literature section of the report (Cooper & Schindler, 2003).

Research Question

Once the problem has been identified, the literature review completed, and the conceptual framework chosen, the research question needs to be formulated. The question may either be in the form of a statement, a question, or a hypothesis. The research question must be succinct, clear, and it must answer the question being studied.

Formulating the research question may be one of the most difficult steps of the research process. Usually, the initial dilemma is very broad, and must be narrowed to be reasonably studied. A research question should be based on facts, which will lead to the formulation of investigative questions. The question should be theoretical, practical, and feasible (Cooper & Schindler, 2003).

Hypothesis

The hypothesis is a prediction of the researcher’s expected findings of the research study. The hypothesis includes the variables to be studied and their relationships, the population to be studied, and the type of research to be conducted. The hypothesis also directs the measurement of variables, the selection of the design, and the interpretation of the findings. The findings of the study either indicate acceptance or non-acceptance of the hypothesis (Cooper & Schindler, 2003).

PICOT Statement Paper

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PICOT Statement Paper

) PICOT Statement Paper

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View Rubric

Max Points: 75

Details: Facility for practicum is a Dialysis unit.

Review the Topic Materials and the work completed in NRS-433V to formulate a PICOT statement for your capstone project.

A PICOT starts with a designated patient population in a particular clinical area and identifies clinical problems or issues that arise from clinical care. The intervention should be an independent, specified nursing change intervention. The intervention cannot require a provider prescription. Include a comparison to a patient population not currently receiving the intervention, and specify the timeframe needed to implement the change process.

Formulate a PICOT statement using the PICOT format provided in the assigned readings. The PICOT statement will provide a framework for your capstone project.

In a paper of 500-750 words, clearly identify the clinical problem and how it can result in a positive patient outcome.

Make sure to address the following on the PICOT statement:

Evidence-Based Solution
Nursing Intervention
Patient Care
Health Care Agency
Nursing Practice
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to Turnitin.

Apply Rubrics

PICOT Statement Paper RUBRIC

1
Unsatisfactory
0.00%

2
Less than Satisfactory
75.00%

3
Satisfactory
79.00%

4
Good
89.00%

5
Excellent
100.00%

80.0 %Content

30.0 %Identification of Clinical Problem/Issue

Clinical problem/issue is not identified, and resolution is not addressed.

Clinical problem/issue is identified with little discussion of resolution or patient outcome.

Clinical problem/issue is identified but not supported with clinical observations or evidence. The identified problem/issue can be resolved, or a patient outcome shows minimal improvement.

Clinical problem/issue is identified based on clinical observation experience or evidence in literature. Articles are cited to support the need for change in nursing practice. The identified problem/issue can be resolved, or a patient outcome can be improved using nursing interventions.

Clinical problem/issue is identified based on key concepts that define evidence-based practice or clinical experience. Articles are cited to support the need for change in nursing practice. The identified problem/issue can be resolved, or a patient outcome can show a marked improvement through a nursing intervention.

30.0 %Clinical Problem/Issue, Including Description, Evidence-Based Solution, Nursing Intervention, Patient Care, Health Care Agency, and Nursing Practice

Clinical problem/issue is not described with clarity and the corresponding elements are not included.

Clinical problem/issue description includes a basic understanding of the problem/issue and setting, with few of the following elements explained: evidence-based solution, nursing intervention, patient care, health care agency, and nursing practice.

Clinical problem/issue description includes a basic understanding of the problem/issue, the setting, and the patient population. The following elements are explained: evidence-based solution, nursing intervention, patient care, health care agency, and nursing practice. Minimal rationale is provided to support the resolution of the clinical problem/issue.

Clinical problem/issue description includes a thorough understanding of the problem/issue, the setting, the patient population, and why it is a problem/issue. The following elements are explained in detail: evidence-based solution, nursing intervention, and patient care consistent with specific health care agency and nursing practice. Sound rationale is provided supporting the clinical problem/issue resolution.

Clinical problem/issue description includes a developed and thorough explanation of the problem/issue, the setting, the patient population, and the rationale for why it is a problem/issue. The identified clinical problem/issue explains the following elements with detail and clarity: evidence-based solution, nursing intervention, and improved patient care consistent with specific health care agency resulting in nursing practice change. Sound rationale is provided in the discussion of the clinical problem/issue resolution.

10.0 %PICOT Statement Focused on Resolution, Improvement, Application, and Intervention

PICOT statement does not focus on resolution of a problem/issue, improvement of patient care or application of a nursing intervention.

PICOT statement discusses a clinical problem/issue without a focus on improvement or intervention.

PICOT statement focuses on the resolution of a clinical problem/issue that improves patient care through the application of a nursing intervention.

PICOT statement focuses on the resolution of a clinical problem/issue, with discussion of improving patient care through the application of an evidenced-based nursing intervention.

PICOT statement clearly focuses on the resolution of a clinical problem/issue and aims at improving patient care through the application of an evidenced-based nursing intervention.

10.0 %PICOT Statement Including Population, Intervention, Comparison, Outcomes, and Time

Population, Intervention, Comparison, Outcomes, and Time are not included.

Population, Intervention, Comparison, Outcomes, and Time are present, but lack detail or are incomplete.

Population, Intervention, Comparison, Outcomes, and Time are present.

Population, Intervention, Comparison, Outcomes, and Time are clearly provided and well developed.

Population, Intervention, Comparison, Outcomes, and Time are comprehensive and thoroughly developed with supporting details.

15.0 %Organization and Effectiveness

5.0 %Presentation

Paper lacks any discernible overall purpose or organizing claim.

Thesis is insufficiently developed or vague. Purpose is not clear.

Thesis is apparent and appropriate to purpose.

Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose.

Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.

5.0 %Argument Logic and Construction

Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.

Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.

Argument is orderly, but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis.

Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.

Clear and convincing argument that presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.

5.0 %Mechanics of Writing (includes spelling, punctuation, grammar, language use)

Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.

Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register), sentence structure, or word choice are present.

Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct sentence structure and audience-appropriate language are used.

Prose is largely free of mechanical errors, although a few may be present. A variety of sentence structures and effective figures of speech are used.

Writer is clearly in command of standard, written, academic English.

5.0 %Format

2.0 %Paper Format (use of appropriate style for the major and assignment)

Template is not used appropriately or documentation format is rarely followed correctly.

Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent.

Template is used, and formatting is correct, although some minor errors may be present.

Template is fully used; There are virtually no errors in formatting style.

All format elements are correct.

5.0 %Format

3.0 %Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)

Sources are not documented.

Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.

Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.

Sources are documented, as appropriate to assignment and style, and format is mostly correct.

Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.

100 %