Caring for Patients with Pressure Ulcers - PICO(T) Approach - Essay Example

The PICO (T) Approach

Introduction

The PICO (T), is a mnemonic that practitioners of evidence-based practice, particularly evidence-based medicine. It is used to frame a question or an answer for a healthcare-related question. This framework, however, it can still be used to also develop literature search strategies to achieve a systemic review of various data. More often than not, clinicians experience good results in their practice and wish to research to explore their anecdotal experiences. It is compelling for any professional to further their knowledge and experiences. Understanding your research question is very critical for clinicians' research. The PICOT format helps with the summarizing of research questions that expound on the effects of therapy (Guyatt, 2008).

P- stands for the population. This refers to the subject of the study. The size of a sample that one would like to use or recruit for particular research.

I – stands for interventions. This refers to the treatment or the measures that are provided to the population of the study.

C- stands for comparison. That is, the sample you intend to use to compare with the treatment interventions. This is mostly referred to by most studies as the control group. Should there be a type of treatment considered to have the golden status, then this would be the comparison group.

O- this is the outcome of a study. It represents the results the research aims at measuring to examine how effective the intervention was.

T- this is the time/ duration taken to collect the data for your research.

Define a practice issue to be explored via a PICO(T) approach.

Use of the PICO(T) Approach when Caring for Patients with pressure ulcers

The health issue identified for resolution is to identify EBP pressure ulcer prevention strategies and to also be able to orally describe the significance of the presence of a pressure ulcer prevention program. The PICOT question asked in chronic/acute patients (P), is how does repositioning of a client with low movements at more frequent intervals (I) compared to use of more expensive intervention means such as the use of specialty mattresses (C), reduce the formation and development of pressure ulcers (O) under a T, period of 90days? The implementation of the client's repositioning will help prevent further pressure ulcers with conditions like incontinent care and nutrition held constant (hypothesis of the study).

This evidence-based is meant to examine pressure ulcers, a common finding in the healthcare setting. They occur when pressure is applied to an area over a period commonly referred to as a pressure injury; it is measure in centimeters. The population being studied is a sample of patients admitted having chronic/acute care units with low mobility or no self-powered mobility. Given the study's objectives, the research aims to use its findings to verbally address the usefulness of pressure ulcer prevention programs in healthcare.

Identify sources of evidence that could be potentially effective in answering a PICO(T) question.

To obtain relevant resources for such research work, searches were done from sources such as the Summon Capella University library’s search online. Utilizing this search engine gave the researchers access to PubMed Central and CINAHL. Among those searches, google scholar and Ovid online were also used to obtain scholarly sources for evidence. To obtain results, the following words and phrases were used for the search: prevention of pressure ulcer for chronic or acute patients, how to prevent pressure ulcers from forming on patients, does turning patients who have zero mobility help prevent the formation of pressure ulcers, pressure injury prevention programs, are pressure injury prevention programs worth it? Does turning immobile patients help with the prevention of pressure ulcers? What are some of the prevention measures for pressure injury for chronic/acute patients? To acquire only up to date data, only the latest findings get reviewed, articles published more than five years ago should not be used as part of the research findings.

Findings from Articles

Offloading patients, which is also otherwise referred to as turning or repositioning them, especially patients with zero self mobility, helps t relieve too much pressure, which may be preventing sufficient blood flow, increasing the incidences of the formation of pressure ulcers or injuries due to pressure. Combining the repositioning and turning of the patients with proper skincare should help heal pressure injuries and also prevent future formation of pressure ulcers. Use of mattresses that provide alternating pressure systems while ensuring low air loss help in pressure redistribution, which serves to also prevent such injuries from occurring (Werthman, 2019). To establish whether these mattresses help prevent pressure injury occurrences, a comparative analysis was carried out in which a low-cost preventive approach was compared to a high-cost approach that entailed using the specialty mattress. All the subjects of the study were patients in an acute setting. In this case, the low-cost method entails repositioning patients every two hours to offload the patients' weight from the pressure points. The use of specialty mattresses is more justified, especially on patients with severe/extreme conditions. However, turning and repositioning patients has been found useful in a good number of studies. The repositioning is more of a preventive measure. Whereas patients have already formed pressure injuries, the more costly way, that is, the specialty mattress can be used to heal and prevent further injuries (Loi, 2017). Research by (Woodhouse 2019) showed that patients who are most likely to form pressure injuries are not repositioned often. According to Loi's research, which helped with prevention was staffing to create low-pressure points, which he referred to as low-cost intervention. Research also shows that having a program that deals with the prevention of such injuries would make the process more hands-on.

The relevance of Findings from Articles

The study that was done by Nixon et al. provided insight from both the repositioning and the use of the specialty mattresses. It was considered relevant because it was done over three years of study and provided comparative work on expensive and low-cost pressure injury prevention measures. The study done by Woodhouse in 2019 was selected because it presented a systematic review of the efficacy of the evidence-based intervention procedure. He did so by using inter-practitioner variability of turning and repositioning to other factors that were used practically and in theory. His findings were that repositioning had more effects than other expensive means, especially on patients under acute care. Once practitioners got trained on how to best do the turning and repositioning, better results were found.

Conclusion

Care practices approved by the use of numerous studies are justified and can be applied universally. The results of the study are not a surprise at all. The fact that low-cost pressure injury preventive measures are just as effective as high-cost preventive measure makes sense based on all the studies and the comparative analysis made with regards to the two methods. Applying the use of the PICO (T) framework compares the low-cost preventive measure, that is, the use of repositioning and turning and the high-cost intervention; that is, the use of specialty mattresses proved that the low-cost measure is also as effective if not more. Articles used in this research prove the accuracy of the findings and the timeliness of the information by adequately exploring the effectiveness of both intervention strategies.