NURS FPX 4030 Assessment 3 Picot Questions and an Evidence Based Approach

NURS FPX 4030 Assessment 3 Picot Questions and an Evidence Based Approach

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Capella University

NURS-FPX 4030 Making Evidence-Based Decisions

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PICO (T) Questions and an Evidence-Based Approach

The PICO(T) approach, a mnemonic for patient/population, intervention, comparison, outcome, and time, is a structured method for formulating clinical research questions. This approach is beneficial for researchers and healthcare professionals to integrate credible and valuable information into evidence-based practice and clinical decision-making. This paper analyzes a PICO(T) question related to Chronic Kidney Disease (CKD), enhancing the precision and accuracy of research inquiries and contributing to more effective evidence synthesis and application in healthcare settings.

Practice Issue to be Explored and PICO(T) Question

Chronic kidney disease is a healthcare issue that poses significant challenges for the patients suffering from the disease. It is an ongoing loss of renal function, evidenced by decreased glomerular filtration rate (GFR), increased proteinuria, reduced urinary frequency, and several mechanical abnormalities within the human kidneys (Chen et al., 2019). Several poor consequences of the disease include complete loss of kidney function, requiring renal replacement therapy and hemodialysis, and, in severe cases, kidney transplantations.

Complicated stages of CKD may result in end-stage renal disease (ESRD), eventually leading to death (Tonelli & Dickinson, 2020). Besides, CKD impacts an individual’s quality of life by influencing physical, emotional, and psychological well-being, alongside affecting daily living. Therefore, there is a substantial need to integrate evidence-based research to manage the disease and prevent complications effectively. Hence, we developed a PICO(T) question to research the role of a tailored educational program in improving patient outcomes and enhancing the quality of care. The research question is as follows: 

In patients diagnosed with CKD (P), how does a tailored educational program (I), as compared to routine clinical education (C), result in patients’ adherence to treatment and lifestyle modifications (O) in six months (T)?

The exploration of the practice issue and the importance of personalized education stands to benefit significantly from a PICO(T) approach. This structured approach facilitates a comprehensive understanding of CKD-related complications, ensuring that the research inquiry is specific and aligns with evidence-based principles to advocate for the worth of tailored education in minimizing these complications. It aids in reorganizing information and critically evaluating the evidence, contributing to informed decision-making and improved patient health outcomes in CKD management.

Identification of Sources of Evidence

Several sources of evidence are readily available online to provide information regarding our PICO(T) question. However, finding credible and valuable resources based on the CRAAP criteria is essential. These criteria are essential for researchers to extract relevant and authentic information from a widespread pool of knowledge and information. The CRAAP test is a mnemonic for currency (up-to-date information), relevance (aligns with the topic of research), authority (authors are field-specific and the journal is credible), accuracy (other reliable resources adequately support research information), and purpose (the purpose of the study is consistent to the purpose of the research inquiry and is clearly described) (Esparrago-Kalidas, 2021).

Various databases, such as Google Scholar, PubMed Central, and ScienceDirect, provide credible and useful resources. However, for researching our PICO(T) question, Google Scholar is the most useful and relevant resource. This database entails features to narrow down the information using filters. Using the “sort by date,” filter enabled us to find current and updated resources relevant to our PICO(T) question using “sort by relevance feature.” Moreover, this database contains information from authorized journals and articles, well-recognized worldwide. During our research for the PICO(T) question, we found several relevant articles from the “Journal of Renal Care,” the “Journal of Multidisciplinary Healthcare,” and the journal “Kidney Medicine,” which is another valuable and relevant resource for our PICO(T) inquiry.

These resources provide accurately supported claims, and the purpose of the resource is consistent with the purpose of the PICO(T) question. Similarly, the journal “Kidney Medicine” is the most valuable and relevant resource. Being an official journal of the National Kidney Foundation, it complies with the national organization’s standards, indicating the journal’s authority. It fulfills the CRAAP criteria likewise to the database Google Scholar. The journal provides an option to find up-to-date articles, ensuring the currency. The journal’s relevance is demonstrated through information on renal disorders and their clinical management.

NURS FPX 4030 Assessment 3 Picot Questions and an Evidence Based Approach

This journal aims to spread adequately scholarly-supported knowledge about kidney diseases, enabling researchers and healthcare providers to incorporate field-specific best practices in clinical settings. The journal Kidney Medicine eagerly hunts for information focused on cultivating nephrology education and improving patient-reported outcomes, which is consistent with the purpose of our PICO(T) inquiry (Kidney Medicine Journal, n.d.). 

These resources specifically assisted in finding relevant information about tailored education and its role in improving clinical outcomes for CKD patients. The keywords used are patient-centered education, tailored educational intervention for CKD patients, and educational interventions for improving treatment adherence. Using keywords and filters like sort by date helped us find relevant information and refine and identify credible, applicable information related to our PICO(T) inquiry. The article by Andersen et al. (2019) advocates the need for tailored education (intervention) for renal patients (population) to improve their lifestyle behaviors and clinical outcomes (outcome).

Another resource by Zhianfar et al., 2020 focuses on the effectiveness of patient-centered education (intervention) for CKD patients (population) to improve patient satisfaction and adherence to the treatment (outcome). Lastly, the resource by Ladin and Rossi (2020) presents the importance of patient-centered, tailored education (intervention) in kidney disorders patients (population). This resource mentions that such an educational approach is essential to improve patient outcomes, augment patient satisfaction scores, and improve patients’ adherence to post-treatment medication and other lifestyle modifications.

Findings from the Relevant Sources of Evidence

Based on our research question about the significance of tailoring patient education and health promotion, three distinct research studies present various perspectives on effective strategies to improve patient outcomes in CKD patients. 

• In a study, Andersen et al. (2019) emphasize the effectiveness of tailored patient education for renal transplant patients. The study findings revealed that patients had positive experiences with the education, sharing their views that healthcare professionals could provide holistic knowledge covering all aspects of life. Patients showed progressive changes in their lifestyle and behaviors towards their healthcare, ultimately enhancing self-management of the disease. The authors further state that this knowledge is essential for patients to improve clinical outcomes and quality of life for renal patients. Thus, this resource is the most relevant to our PICO(T) question. Moreover, the resource is credible as it comprehensively fulfills the CRAAP criteria. 
• Another scholarly resource advocates the effectiveness of a patient-centered, multidimensional education approach to improve CKD patients’ quality of life and treatment adherence. This intervention improved patient satisfaction scores, quality of life scores, and adherence to treatment regimens (Zhianfar et al., 2020). 
• In their article, Ladin and Rossi (2020) mention the importance of patient-centered education in kidney disorders. They claim the effectiveness of such tailored education for bettering patient outcomes, increasing satisfaction scores, and improving adherence to post-treatment medication and other lifestyle modifications. Such an intervention leads to behavioral changes, improving diet and exercise, and reducing harmful behaviors. Moreover, these educational programs help to address challenges related to health literacy and healthcare disparities, motivating patients to participate actively in their healthcare journey. 

Decision-Making on PICO Question Using the Findings

The findings presented earlier are relevant to the PICO(T) question as all of these resources advocate the importance of patient-centered, individually tailored education for CKD patients to improve the quality of care, enhance treatment adherence, and promote lifestyle modifications through self-management. Based on these findings, we conclude our PICO(T) inquiry in favor of our interventional component (tailored education) compared to routine clinical education in achieving the desired outcomes.

Patient-centered and individualized education in healthcare brings substantial results in encouraging patients’ active participation in their healthcare journey, eventually motivating self-management behaviors to monitor and prevent poor complications. The most relevant findings are from Andersen et al. (2019), as the study primarily focuses on renal transplant patients suffering from later stages of CKD.

The conclusions from the study related to improved patient experiences, enhanced lifestyle changes, and treatment adherence are consistent with our research inquiry outcomes. Thus making the article a most helpful resource.

References

Andersen, M. H., Wahl, A. K., Engebretsen, E., & Urstad, K. H. (2019). Implementing a tailored education programme: Renal transplant recipients’ experiences. Journal of Renal Care, 45(2), 111–119. https://doi.org/10.1111/jorc.12273 

Chen, T. K., Knicely, D. H., & Grams, M. E. (2019). Chronic kidney disease diagnosis and management. JAMA, 322(13), 1294–1304. https://doi.org/10.1001/jama.2019.14745

Esparrago-Kalidas, A. J. (2021). The effectiveness of CRAAP test in evaluating credibility of sources. International Journal of TESOL & Education, 1(2), 1–14. https://i-jte.org/index.php/journal/article/view/25 

Kidney Medicine Journal. (n.d.). Aims and scope: Kidney Medicine. https://www.kidneymedicinejournal.org/content/aims 

NURS FPX 4030 Assessment 3 Picot Questions and an Evidence Based Approach

Ladin, K., & Rossi, A. (2020). Person-centered kidney education: The path forward. Kidney Medicine, 2(5), 511–513. https://doi.org/10.1016/j.xkme.2020.08.001 

Tonelli, M., & Dickinson, J. A. (2020). Early detection of CKD: Implications for low-income, middle-income, and high-income countries. Journal of the American Society of Nephrology, 31(9), 1931. https://doi.org/10.1681/ASN.2020030277

Zhianfar, L., Nadrian, H., Asghari Jafarabadi, M., Espahbodi, F., & Shaghaghi, A. (2020). Effectiveness of a multifaceted educational intervention to enhance therapeutic regimen adherence and quality of life amongst Iranian hemodialysis patients: A randomized controlled trial (MEITRA Study). Journal of Multidisciplinary Healthcare, 13, 361–372. https://doi.org/10.2147/jmdh.s247128