The first step of the evidence-based practice process is to evaluate a nursing practice environment to identify a nursing problem in the clinical area
The first step of the evidence-based practice process is to evaluate a nursing practice environment to identify a nursing problem in the clinical area. When a nursing problem is discovered, the nurse researcher develops a clinical guiding question to address that nursing practice problem.
For this discussion question, you will create a clinical guiding question known as a PICOT question. The PICOT question must be relevant to a nursing practice problem (coordination of health care, assessment, education, patient support, trauma prevention, recovery, health screenings, etc.).
After reviewing the relevant topic materials:
- Select a nursing practice problem of interest.
- Develop a PICOT question using the template and example provided below.
- Identify two articles, one qualitative and one quantitative, related to the problem of interest. Provide an APA-formatted reference for each article, and explain how each relates to your PICOT question. Be sure to identify which article is qualitative and which article is quantitative. These articles may be used in this week’s assignment.
PICOT question intervention format:
In_______________(Population), how does _______________ (Intervention) compared to _______________ (Comparison) affect _______________ (Outcome) within______________(Time, optional)?
Example: In critically ill patients in an Intensive Care Unit (ICU) (P), how do daily 2% chlorhexidine cloth baths (I) compared to daily disposable non-antimicrobial cloth baths (C) affect the incidence of health care-associated infections (HAIs) (O)?
In responses to peers, provide feedback related to peers’ PICOT questions and their associated articles.
Initial discussion question posts should be a minimum of 200 words and include at least two references cited using APA format. Responses to peers or faculty should be 100-150 words and include one reference. Refer to “RN-BSN Discussion Question Rubric” and “RN-BSN Participation Rubric,” located in Class Resources, to understand the expectations for initial discussion question posts and participation posts, respectively.
Sample Expert Answer
PICOT question: In children with asthma (P), how does a nurse-led self-management education program (I), compared to usual discharge instructions (C), affect 30-day hospital readmission rates (O) within one month post-discharge (T)?
The first article that fits this PICOT was done by Ng et al. (2021). The randomized controlled trial directly aligns with the PICOT question, as it investigates how structured, nurse-led education compares to usual discharge instructions in improving outcomes for children with asthma. The study found that children who received the nurse-led program had significantly fewer unscheduled visits and hospital readmissions after discharge compared to those who received routine discharge teaching.
This mirrors the intervention and comparison elements of the PICOT, demonstrating that nurse-led education empowers families with skills and confidence to manage asthma effectively. By emphasizing parent knowledge, adherence, and confidence, the article provides quantitative evidence that supports nurse-driven interventions as a strategy to lower 30-day readmission rates in pediatric asthma care.
The second article was done by Jones et al. (2022). The qualitative study complements the PICOT by exploring why usual discharge instructions may not adequately prevent hospital readmissions. Caregivers highlighted barriers such as unclear follow-up, inconsistent advice, and difficulties accessing preventive medications after discharge. These insights explain why standard discharge instructions (the comparison in PICOT) may fail to reduce readmissions.
Moreover, the solutions suggested by caregivers, including personalized asthma action plans, proactive education, and coordinated follow-up closely resemble nurse-led interventions, reinforcing their relevance. By revealing the lived experiences of families, this article provides a contextual foundation for implementing and refining nurse-led self-management education programs to address real-world gaps, thereby reducing the likelihood of early readmissions within one month.
References
Jones, R., Turner, B., Perera, P., Hiscock, H., & Chen, K. (2022). Understanding caregiver perspectives on challenges and solutions to pediatric asthma care for children with a previous hospital admission: A multi-site qualitative study. The Journal of Asthma: official journal of the Association for the Care of Asthma, 59(10), 1973–1980. https://doi.org/10.1080/02770903.2021.1984528
Ng, J. S. K., Chau, J. P. C., Chan, A. W. K., Lui, J. K. C., & Cheng, J. W. C. H. (2021). A nurse-led web-based home asthma education program for children and their families: A randomized controlled trial. Journal of Pediatric Nursing, 59(1), 158–163. https://doi.org/10.1016/j.pedn.2021.04.014
