Cardiac Arrest and Rapid Response Team

This question format model, helps in optimization of applied research specifics, medical style questions, updated peer review of research, and even allows assessing students to support evidence based practice in defining appropriate questions (Holloway et al. 2004).

The key steps involved in evidence based practice come from a thirst for knowledge that once ignited makes the next step to asking a well worded clinical question easier. A well formulated question improves patient outcomes and supports the implementation of change. One such method looks at foreground and background questions. A background question is usually a basic knowledge question and is usually answered by a textbook. Foreground questions are usually specific and once answered can help in clinical changes. An acronym useful for formulating a well worded question is PICOT. ( Stillwell, Fineout-Overholt, Melnyk, Williamson, 2010).

However, this is not the recommended protocol shown in the literature. The current unit practice and evidenced based practice will be compared. The barriers to performing evidenced based practice will also be assessed.

A PICOT question is formulated in order to assist the researcher in obtaining answers to a specific question, decreases the uncertainty surrounding the issue, and provides a systematic approach to achieve an answer (Melnyk, & Fineout-Overhold, 2013). The authors find that each component of the PICOT question drives the next step of the evidence based practice process. First, a specific population must be determined by controlling the group to a certain age range or special sub-group. By compiling a specific group the clinician is more likely to formulate better evidence to support the issue. Next, an intervention is introduced and can be a therapy, test, disease process, etc. The authors conclude that, “the more specifically the intervention or issue of interest is defined, the more focused the search will be” (p.29). Then, a comparison group is added, but only necessary if completing a quantitative study. Lastly, an outcome is determined of which the study will reveal by a given time period.

Today, we are continually striving to improve the quality of care that we deliver and the best method in applying relevant research into clinical practice is through evidence based practice (EBP). We have now come to a time in our careers to shift our direction on how to employ evidence based practice techniques when managing our patient's health care needs. Facilitation is a method that has been investigated as a way to help clinicians accomplish the implementation of evidence into practice. As clinicians, we are encouraged to think outside the box and utilize critical thinking skills as well as express our role as nurse practitioners as part of the health care team.

Based on this finding triangulation was not used in this study. The study used a written interview guide completed by one interviewer. As a reference for interviewers, four selected guideline bundles were given. According to the meetings and observations made in the SICU’s the guidelines were developed. To ensure understanding and usefulness of the questions pilot interviews were utilized, which included five participants to help prompt for well thought out responses and ideas. For the researcher to ask correct questions the interview guide included two general open ended questions and prompts to find out more about a topic. For instance, one of the questions asked for task ambiguity stated, “What tasks need to be completed for this patient per guidelines?” (Gurses et al., 2013). Since several interviewees had different views and perceptions to understand their viewpoint, there were follow up questions and clarifications that were conducted. Each interview was recorded in an appropriate fashion and transcribed verbatim. Enough data were gathered with depth and richness within the study (Gurses et al., 2013).

First, I thought it was significant how Dr. Loring meticulously described the meaning of evidence-based practice through dividing this concept into four smaller branches. Though we have discussed the meaning of evidence-based practices in class, I was struck by the specific way that it was presented today. She stated that in addition to support from research, professional agreement, values and preferences, and capacity must be considered before implementing an evidence-based practice. By professional agreement, Dr. Loring emphasized the importance of locating the established research within

According to Melnyk & Fineout-Overholt (2015), it is very important that the clinician communicates a well formed clinical question effectively, thereby, achieving the maximum amount of relevant information in a short amount of time. In order to accomplish this, one must utilize the components recommended in our test to formulate a clear and concise clinical question. First, is to determine what the clinical issue is that is creating the conundrum in your practice. Second, is the ability to describe the questions in an style that is credible. Third, in order to answer the clinical inquiry, one must determine if the query is searchable in a PICOT format. The fourth component and most important is the clinician's skill level in which it takes

Fred S. Apple, PhD; MaryAnn M. Murakami, BA; Lesly A. Pearce, MS; Charles A. Herzog, MD

In a quantitative PICOT format (P) stands for Population, patient, problem (I) Intervention (C) Comparison and (O) Outcome (University Campus Suffolk, 2012). One of the safety issues I have noticed in Summerville is children driving the bicycle without a helmet. This is a serious safety issue as it can result in serious head injury and death. A quantitative research question was made by using the PICOT format based on this safety concern.

Johnny Obrien aged 79 years, presented to the Emergency Department after a fall at the RSL, resulting in a laceration on his left elbow which required 3 stitches. He lives by himself with no family close by, and has a history of hypertension and alcohol addiction. Clinical reasoning is a cyclic process, where cues are collected and their data processed to come to a conclusion of the patient situation so that appropriate interventions can be implemented and evaluated through reflective practices which allows for further learning (Levett-Jones 2013). Applying these clinical reasoning skills in practice is important as it has a positive impact on patient outcomes, resulting in less adverse effects due to the detection of patient deterioration throughout this process to ensure safe and effective care (Levett-Jones 2010).Subjective data is information from the patient’s point of view, including their feelings, perceptions and concerns, whereas objective data is information that is observable or measurable (Delmar Cengage Learning 2015).

The PICO (T) format is a way to develop a clinical question that lends itself to searching for evidence. Select a common nursing practice (e.g., wound care management) in your clinical setting and formulate a PICO question. Once you have formulated your question, conduct a library search and locate one scholarly article that addresses the topic you have selected. Post your clinical question in the TD, explain the PICO(T) elements, and provide a full reference of the article you selected.

Being able to narrow down specific areas that need work is important for when the article discusses assessment and treatment.

Jonathan S. Einbinder, MD, MPH; Kenneth W. Scully, MS; Robert D. Pates, PhD; Jane R. Schubart, MBA, MS; Robert E. Reynolds, MD, DrPH

(2011). Nursing research and evidence-based practice: Ten steps to success. Sudbury, MA: Jones and Bartlett Learning.