Nursing Case Studies Picot Questions

Osteoporosis is a bone disease that occurs when the body loses too much bone, makes too little bone, or both. As a result, bones become weak and may break from a fall or, in serious cases, from sneezing or minor bumps (nof.org). This skeletal disease is characterized by the increase in the fragility of bones as a result of reduced bone mass density and the deformation of the structure of bone tissue (Angin,Erden,Can, 849). Many patients with osteoporosis are instructed by their doctor to exercise; as this will improve their rehabilitation of this disease and lessen the pain associated with it.

Nurses, especially nurses working on an Addiction Medicine unit, are well-positioned to provide patient and family education on opioid addiction (Manworren, 2015; Painter, 2017). Effective patient and family education can theoretically improve the capacity for patients at risk for opioid dependence and/or patients experience opioid dependence to cope with the problem, reduce risks, and prevent relapse (Costello et al., 2016; McNeil et al., 2015). Nurses working on an inpatient unit provide patient education as part of regular daily care and during the course of discharge planning and management (Costello et al., 2016). Patient and family education related to the patient’s diagnosis and/or reason for admission is standard practice on most units. However, nurses, including nurses working on an addiction treatment unit, may lack sufficient knowledge in opioid addiction prevention and management to provide suitable patient-centered education to patients and their families (Costello et al., 2016). Moreover, there is currently no established model or protocol for nursing-directed patient and family opioid addiction education (Costello et al., 2016; Manworren,

I believe to design a study in which my pico question can be addressed is very easy to perform. I performed a data based search using the terms central line, dressing change and risk of infection. The data based showed more than hundred results of study focusing on the topic of infection control in patient with central line.

The management of osteoporosis patients start with the diagnosis by rolling out secondary causes and then confirm it by measuring bone mineral density (BMD). After that, begin the treatment with lifestyle changes, pharmacological medications, and surgery for some fractures if needed. In this essay I will cover generally the diagnosis, treatment, and prevention of osteoporosis in five steps.

Osteoporosis is a treatable disease, but not a curable one. There are different types of treatment for osteoporosis. Some of the medications that can be taken for treatment of osteoporosis are estrogen, bisphosphonates, calcitionin, raloxifene, parathyroid hormone, and testosterone replacement (UCSF Medical Center, 2010). Some of the more common names for bisphosphonates are Fosamax, Actonel, Boniva, and Reclast (Mayo Clinic, 2009). These treatments are taken orally once a week or once a month. In addition to the medications, there is also the treatment of exercise and diet. With a diet high in calcium, stopping unhealthy habits, like smoking and drinking, and regular exercise can reduce the likelihood of bone fractures in people with osteoporosis (The New York Times, 2010). In Ms. Duckworth’s incident, it would be recommended that she increase the amount of calcium in her diet and exercise, and depending on the severity of the osteoporosis, medication.

Osteoporosis is a detrimental bone condition, the tissue in the bones deteriorate and thus the bones become progressively brittle which presents a risk for rupture. Osteoporosis impacts more than 44 million Americans and is linked to a suggested 2 million bone fractures each year. According to the National Osteoporosis Foundation, the amount of fissures due to osteoporosis may escalate above 3 million by the year 2025. Osteoporosis is typically undetected and advances with slight warning signs until a fissure ensues. Effects of osteoporosis encompass height reduction and a curved upper back, anyone can have osteoporosis, however it is prevalent in elderly women and many may break a bone due to this condition. Recovery and prevention are vital in combating osteoporosis, though it may never be eradicated one can take measures to stabilize bone density and gain strength.

Osteoporosis is a disorder of bones that affects bones making them low in bone mass fragile and will lead to bone fracture. Bone fracture will easily occur as this disease cause the matrix inside the bone become weak and brittle.Bones can become so brittle due to activities such as coughing can cause fractures.According to Macgill (2015) the origin of the word osteoporosis explain the condition of ‘osteo’ is for bone and ‘porosis’ means porous that resulting in weakness. At this condition, the bone tissue is mineralized normally, but the production is not enough to preserve the normal skeletal architecture. 80% of women and 20% men of 28 million American are affected with the osteoporosis. Approximately, women with the age of 50 will develop osteoporosis. Thin bones are the cause of 1.5 million fractures a year. As in Malaysia, the statistic shows that osteoporosis related to fractured is the common health problem especially in elderly..

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.

As generally stated in the introduction, osteoporosis is a skeletal disorder that involves the strength and integrity of one’s bones. The WHO defines osteoporosis as, “a systemic skeletal disorder characterized by low-bone mass, deterioration of bone tissue, increased bone fragility, and its susceptibly to recurrent fractures.” 2 The most important factor to take into account when addressing osteoporosis is the mass of bone, also referred to as, bone mineral density (BMD). As bone mass begins to decline, typically in the older population, specifically postmenopausal women, individuals are at an increased risk for fractures.3 As a result of this serious condition, many people are affected by morbidity, mortality, and economic difficulty.1

Melinda, you have an excellent PICOT question. It is precise and clear-cut. I agree with you, in that the nurses stay for 1-2years and may leave many hospitals. This happens if they are not satisfied with their job (Johnson, 2009). Even the leaders could change within that period.

Osteoporosis is a degenerative disease of the bones generally brought on by the process of aging, unfortunately there can also be a number of underlying or secondary causes; however, preventative care and drug treatments can minimize the severity of this prevalent disease. Osteoporosis has been estimated to affect more than 200 million people worldwide (Bethel, 2015). According to the National Osteoporosis Foundation, 9.9 million Americans have osteoporosis and an additional 43.1 million have low bone density.

Osteoporosis is an age related disorder, more common in females compared to males. Osteoporosis is defined as a “skeletal disorder characterized by compromised bone strength predisposing to increased risk of fractures (Manolagaas, 2014). Osteoporosis is defined as “a disease characterized by low bone mass and deterioration of bone tissue (What is osteoporosis?2014). Osteoporosis is sometimes also referred as “silent thief” as the bone loss occurs very slowly and silently without any symptoms (Osteoporosis facts & statistics.2014). The most common site for fracture due to osteoporosis is hip followed by humerus (Woltman & den Hoed, 2010) . Osteoporosis can occur at any age, although it is a disorder common in females (especially post-menopausal females). Everyone is prone to osteoporosis (Osteoporosis facts & statistics.2014). According to Osteoporosis Canada, 1 in 3 Canadian females and 1 in 5 Canadian males may suffer fractures due to osteoporosis during their lifetime (Osteoporosis facts & statistics.2014). Canadian health care system spends 1.2 billion dollars for the acute hospitalization caused by osteoporosis and in 2010 the health care system spent 3.9 billion dollars for the total treatment of osteoporosis (Osteoporosis facts & statistics.2014). Osteoporosis can be screened and diagnosed by various methods; however the dual energy x ray absorptiometry (DXA) is commonly used. If the T-score values are less than -1 and greater than -2.5SD it is termed as osteopenia,

We utilized data from the Study of Osteoporotic Fractures (SOF)(36), a prospective cohort study of community-dwelling women aged 65 years and older in 1986-1988 (SOF visit 1). In brief, 9,704 predominantly Caucasian older women were recruited from population-based listings in 4 locations in the United States as follows: Baltimore, Maryland; Minneapolis, Minnesota; Monongahela Valley (near Pittsburgh), Pennsylvania; and Portland, Oregon. Starting with the initial visit (visit 1), participants attended clinic visits approximately every 2 years. An additional 662 African-American older women were recruited during SOF visit 6 (1997-1998). Women were not enrolled in SOF only if they were unable to walk without assistance and had not previously undergone a bilateral hip replacement. The institutional review board at each site approved the study and participants provided written informed consent.

Osteoporosis is described by the NHS as “a condition that weakens bones” and is fairly common, affecting roughly 3 million, with more than 300,000 people receiving treatment each year. Fractures are extremely common as the weakened bones are more susceptible to damage, even coughing may cause vertebral damage. Osteoporosis can be classified as type I or II, “both type I and type II osteoporosis occur through an imbalance between total skeletal bone formation and bone resorption which is sustained over many years” (Theobald, 2005), and are related to a lack of vitamin

This article was a study of how many women in primary care offices were prescribed medications that could be used in the prevention and treatment of osteoporosis; along with what type of physician would most likely prescribe a medication related to osteoporosis. These studies were to determine if in specific medications were often prescribed in order to help prevent or treat osteoporosis. The prescribed medications that were being looked for in the medical records were: estrogen, bisphosphonate, calcitonin, and calcium. The primary care offices that were studied were two family practice offices and three obstetrics/ gynecology offices. There were two groups of women examined: seven hundred and eighty-two were in the prevention group and thirty-one in the treatment group. The prevention group was composed of women who were not diagnosed with osteoporosis in their recent medical records; while in contrast the treatment group was composed of women who were specifically diagnosed with the disease.