Discussion: PICOT Statement Analysis
Discussion: PICOT Statement Analysis
Discussion: PICOT Statement Analysis
Chronic obstructive pulmonary disease (COPD) is a condition that affects most of the American population. Inhalation of smoke from tobacco is its main cause. Statistics shows that COPD is ranked as the third leading disease contributing to mortality in the US. Often, patients present to the emergency department with symptoms that include cough, chronic dyspnea, and comorbidity that can lead to early mortality. The high prevalence rate of the disease is attributed to the fact that it remains largely undiagnosed. For instance, it is estimated that 13 million people in the US with the disease remain undiagnosed (Mamary et al., 2018). One’s vulnerability to the disease has been shown to be highly dependent on factors such as lung function, level of education, depression, and exercise capacity (Martinez et al., 2017). The comorbidities that cause functional impairment and death among patients with COPD include congestive heart failure, diabetes, obstructive sleep apnea, and chronic kidney disease (Putcha et al., 2014). There are significant racial disparities in the populations affected by COPD. According to Putcha et al., (2014), individuals from Africa-American origin with COPD have an enhanced risk of dying from the disease when compared to other ethnicities. They also experience the worst quality of life when compared to non-Hispanic Whites. Individuals from African-American backgrounds have increased COPD prevalence and mortality due to other chronic conditions such as cardiovascular disease, stroke, and diabetes (Putcha et al., 2014). Therefore, this paper seeks to examine the issue of chronic obstructive pulmonary disease among African-American patients. The analysis will guide in the formulation of a PICOT statement that will guide the whole process of research. The need for this analysis is necessitated by the increased focus on the provision of evidence-based care to populations in need of healthcare.
Population Description
African-Americans are considered part of the ethnic minorities in the US. According to data by The African American Population, the population of African-Americans was 47.8 million in the year 2018. This number represented 14.6% of all of the population of America (Black Demographics, 2018). The Hispanic-Latinos are considered the leading population of ethnic minorities in the state. The disproportionate distribution of the African-Americans v. white Americans make African-Americans the leading ethnic minority while the White Americans comprises the ethnic majority in the state. The prevalence rate of COPD among the African-American population is significantly high when compared to other ethnicities. According to (Ejike et al., 2019), the mortality rate in the US among African-American populations has been rising significantly over the years. The high rate of mortality is attributed to the fact that their susceptibility to the health effects of tobacco is more than in other ethnicities (Ejike et al., 2019).
Nurses play an important role in providing care to patients suffering from COPD. They embrace the use of evidence-based practice in ensuring that their health care needs are met. Nurses engage in the critical analysis of the best available evidence to ensure that the patients with COPD receive optimal care that meets their needs. Nurses also explore the different determinants of health affecting the patients affected by COPD. Accordingly, patients from ethnic minorities have been shown to experience challenges in healthcare due to socio-economic factors. These factors include the access to low quality care that does not meet their needs and low insurance coverage among them. There is also the fact that individuals from ethnic minorities have challenges in access to high quality and affordable care that addresses their needs (Korpershoek et al., 2016). Therefore, it is the responsibility of the nurses to ensure that the different determinants of health among the patients suffering from COPD are explored and addressed for equity and equality in healthcare.
The management of COPD also relies mainly on the use of health promotion activities. Nurses utilize their knowledge in science of nursing in ensuring that that the patients are empowered to engage in activities that will promote their health. For instance, nurses provide health education on the need for the patients to avoid the factors that increase their risk of COPD. The most critical factor is educating them on the need for smoking cessation since it increases their risk of further respiratory health problems. Nurses also work with other healthcare providers to ensure that the healthcare needs of these patients are met (Khan et al., 2017). An example is referring such patients to smoking cessation clinic where they will be assisted with ways of ceasing from smoking. Therefore, the nurses’ science knowledge is important in facilitating effective management of these patients.
Potential Solution
The management of COPD is largely dependent on the use of pharmacological interventions. As shown by Voorham et al., (2019) in their research, long-acting inhaled bronchodilators are administered to reduce the symptoms as well as exarbetions of the disease to improve the wellbeing of the patient. The long-acting bronchodilators can be either long-acting inhaled beta agonists or long-acting muscarinic antagonists. However, there is an increased use of combined long-acting muscarinic antagonists and long-acting inhaled beta agonists in cases where the control of COPD is unsatisfactorily. There is also the evidence that inhaled corticosteroids can be included in the therapy, as a way of improving the health outcomes of these patients. The addition of the corticosteroids is referred to as the use of triple therapy in the management of COPD. The available clinical evidence has shown that the use of triple therapy (corticosteroids, long-acting beta agonists, and long-acting muscarinic antagonists) is more effective than dual therapy (long-acting muscarinic antagonists and long-acting beta agonists) (Voorham et al., 2019). However, there is an acute shortage of evidence relating to its efficacy or response rate among patients of different ethnicities (Zheng et al., 2018). The need for examining the response rate across ethnicities arises from the fact that the use of corticosteroids in the management of COPD increases the risk of other problems such as immune system suppression, bone loss, easy bruising, and pneumonia. Therefore, it raises the need for further analysis that will be guided by the following PICOT statement:
In African-American patients with COPD, will the use of triple therapy result in faster recovery and reduced complications when compared with dual therapy within a period of six months?
How the Solution Supports Healthcare Equity
As shown earlier, patients from ethnic minorities such as African-Americans have been shown to be highly vulnerable to various health conditions and have a high risk of experiencing challenges in seeking healthcare they need. As a result, it is important to engage in clinical research that aims at exploring the clinical response among them to the current methods of disease management. The study findings will inform the need for the provision of patient-centered interventions that not only addresses their physiological needs but also promote their empowerment and satisfaction with care. Through this, the concept of equity in healthcare will be promoted. The national focus of healthcare policies is to enhance increased access to high quality and affordable care for all the populations. Therefore, through this proposed intervention, the researcher aims at ensuring that healthcare equity is promoted by ensuring that the management of COPD is appropriate to the needs of patients from ethnic minorities.
Conclusion
Chronic obstructive pulmonary disease is a serious health problem that affects a majority of the population in the US. However, individuals from ethnic minorities are largely affected by the disease. The mortality rate among them is also high due to various determinants of health among them. The management of COPD mainly relies on either the use of triple therapy or dual therapy. However, there is a shortage in the evidence-based data on the efficacy of these interventions in patients from ethnic minorities, hence, the proposed interventions.
References
Black Demographics. (2018).2018 Black Population: 47.8 million, 14.6% of USA. Retrieved on 10th October 2019 from https://blackdemographics.com/
Ejike, C. O., Dransfield, M. T., Hansel, N. N., Putcha, N., Raju, S., Martinez, C. H., & Han, M. K. (2019). Chronic Obstructive Pulmonary Disease in America’s Black Population. American journal of respiratory and critical care medicine, (ja).
Khan, A., Dickens, A. P., Adab, P., & Jordan, R. E. (2017). Self-management behaviour and support among primary care COPD patients: cross-sectional analysis of data from the Birmingham Chronic Obstructive Pulmonary Disease Cohort. NPJ primary care respiratory medicine, 27(1), 46.
Korpershoek, Y. J., Bos-Touwen, I. D., De Man-Van Ginkel, J. M., Lammers, J. W., Schuurmans, M. J., & Trappenburg, J. C. A. (2016). Determinants of activation for self-management in patients with COPD. International journal of chronic obstructive pulmonary disease, 11, 1757.
Mamary, A. J., Stewart, J. I., Kinney, G. L., Hokanson, J. E., Shenoy, K., Dransfield, M. T., … & COPDGene® Investigators. (2018). Race and gender disparities are evident in COPD underdiagnoses across all severities of measured airflow obstruction. Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation, 5(3), 177.
Martinez, C. H., Murray, S., Barr, R. G., Bleecker, E., Bowler, R. P., Christenson, S. A., … & Curtis, J. L. (2017). Respiratory symptoms items from the COPD assessment test identify ever-smokers with preserved lung function at higher risk for poor respiratory outcomes. An analysis of the subpopulations and intermediate outcome measures in COPD study cohort. Annals of the American Thoracic Society, 14(5), 636-642.
Putcha, N., Han, M. K., Martinez, C. H., Foreman, M. G., Anzueto, A. R., Casaburi, R., … & Make, B. J. (2014). Comorbidities of COPD have a major impact on clinical outcomes, particularly in African Americans. Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation, 1(1), 105.
Voorham, J., Corradi, M., Papi, A., Vogelmeier, C. F., Singh, D., Fabbri, L. M., … & Price, D. (2019). Comparative effectiveness of triple therapy versus dual bronchodilation in COPD. ERJ open research, 5(3), 00106-2019.
Zheng, Y., Zhu, J., Liu, Y., Lai, W., Lin, C., Qiu, K., … & Yao, W. (2018). Triple therapy in the management of chronic obstructive pulmonary disease: systematic review and meta-analysis. bmj, 363, k4388.
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FOLLOW EVERY INSTRUCTION.. YOU HAVE TO USE THE DOCUMENTS ATTACHED BELLOW TO ANSWER THE SSIGMENT.. USE RUBRICS TO ANSWER THE ASSIGMENT..HAS TO BE FREE OF PLAGIARISM.
Details:
Prepare this assignment as a 1,500-1,750 word paper using the instructor feedback from the Topic 1, 2, and 3 assignments and the guidelines below.
Discussion: PICOT Statement Analysis
PICOT Statement
Revise the PICOT statement you wrote in the Topic 1 assignment.
The final PICOT statement will provide a framework for your capstone project (the project students must complete during their final course in the RN-BSN program of study).
Research Critiques
In the Topic 2 and Topic 3 assignments you completed a qualitative and quantitative research critique. Use the feedback you received from your instructor on these assignments to finalize the critical analysis of the study by making appropriate revisions.
The completed analysis should connect to your identified practice problem of interest that is the basis for your PICOT statement.
Refer to “Research Critique Guidelines.” Questions under each heading should be addressed as a narrative in the structure of a formal paper.
Proposed Evidence-Based Practice Change
Discuss the link between the PICOT statement, the research articles, and the nursing practice problem you identified. Include relevant details and supporting explanation and use that information to propose evidence-based practice changes.
Discussion: PICOT Statement Analysis
Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.
Discussion: PICOT Statement Analysis
RUBRICS
Benchmark – Research Critiques and PICOT Statement Final Draft
1
Unsatisfactory 0.00% |
2
Less than Satisfactory 75.00% |
3
Satisfactory 83.00% |
4
Good 94.00% |
5
Excellent 100.00% |
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60.0 %Content
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5.0 % Nursing Practice Problem and PICOT Statement
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A nursing practice problem is not clearly described and/or a PICOT statement is not included.
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PICOT statement describes a nursing practice problem but lacks reliable sources.
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PICOT statement describes a nursing practice problem and includes a few reliable sources.
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PICOT statement articulates a nursing practice problem using supporting information from reliable sources.
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PICOT statement clearly articulates a nursing practice problem using substantial supporting information from numerous reliable sources.
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5.0 % Background of Study
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Background of study including problem, significance to nursing, purpose, objective, and research questions is incomplete.
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Background of study including problem, significance to nursing, purpose, objective, and research questions is included but lacks relevant details and explanation.
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Background of study including problem, significance to nursing, purpose, objective, and research questions is partially complete and includes some relevant details and explanation.
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Background of study including problem, significance to nursing, purpose, objective, and research questions is complete and includes relevant details and explanation.
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Background of study including problem, significance to nursing, purpose, objective, and research questions is thorough with substantial relevant details and extensive explanation.
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5.0 % Method of Study
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Discussion of method of study including discussion of conceptual/theoretical framework is incomplete.
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Discussion of method of study including discussion of conceptual/theoretical framework is included but lacks relevant details and explanation.
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Discussion of method of study including discussion of conceptual/theoretical framework is partially complete and includes some relevant details and explanation.
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Discussion of method of study including discussion of conceptual/theoretical framework is complete and includes relevant details and explanation.
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Discussion of method of study including discussion of conceptual/theoretical framework is thorough with substantial relevant details and extensive explanation.
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5.0 % Results of Study
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Discussion of study results including findings and implications for nursing practice is incomplete.
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Discussion of study results including findings and implications for nursing practice is included but lacks relevant details and explanation.
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Discussion of study results including findings and implications for nursing practice is partially complete and includes some relevant details and explanation.
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Discussion of study results including findings and implications for nursing practice is complete and includes relevant details and explanation.
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Discussion of study results including findings and implications for nursing practice is thorough with substantial relevant details and extensive explanation.
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5.0 % Ethical Considerations
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Discussion of ethical considerations associated with the conduct of nursing research is incomplete.
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Discussion of ethical considerations associated with the conduct of nursing research is included but lacks relevant details and explanation.
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Discussion of ethical considerations associated with the conduct of nursing research is partially complete and includes some relevant details and explanation.
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Discussion of ethical considerations associated with the conduct of nursing research is complete and includes relevant details and explanation.
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Discussion of ethical considerations associated with the conduct of nursing research is thorough with substantial relevant details and extensive explanation.
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5.0 % Conclusion
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Conclusion does not summarize a critical appraisal and applicability of findings.
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Conclusion is vague and does not discuss importance to nursing.
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Conclusion summarizes utility of the research and importance to nursing practice.
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Conclusion summarizes utility of the research from the critical appraisal and the findings importance to nursing practice.
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Conclusion summarizes utility of the research from the critical appraisal, knowledge learned, and the importance of the findings to nursing practice.
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10.0 % Evidence of Revision
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Final paper does not demonstrate incorporation of feedback or evidence of revision on research critiques.
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Incorporation of research critique feedback or evidence of revision is incomplete.
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Incorporation of research critique feedback and evidence of revision are present.
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Evidence of incorporation of research critique feedback and revision is clearly provided.
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Evidence of incorporation of research critique feedback and revision is comprehensive and thoroughly developed.
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10.0 % PICOT Statement, Research Article, and Nursing Practice Problem Link (C. 2.2)
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Discussion of the link between the PICOT statement, research articles, and nursing practice problem is not included.
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Discussion of the link between the PICOT statement, research articles, and nursing practice problem is incomplete or incorrect.
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Discussion of the link between the PICOT statement, research articles, and nursing practice problem is included but lacks relevant details and supporting explanation.
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Discussion of the link between the PICOT statement, research articles, and nursing practice problem is complete and includes relevant details and supporting explanation.
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Discussion of the link between the PICOT statement, research articles, and nursing practice problem is extremely thorough with substantial relevant details and extensive supporting explanation.
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10.0 % Proposed Evidence-Based Practice Change (C. 3.2)
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The proposed evidence-based practice change is not included.
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The proposed evidence-based practice change is incomplete or incorrect.
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Discussion of the link between the PICOT statement, research articles, and nursing practice problem is included but lacks relevant details and supporting explanation. The proposed evidence-based practice change is included but lacks supporting explanation and relevant details.
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The proposed evidence-based practice change is complete and includes supporting explanation and relevant details.
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The proposed evidence-based practice change is extremely thorough and includes substantial supporting explanation and numerous relevant details.
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30.0 %Organization and Effectiveness
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10.0 % Thesis Development and Purpose
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Paper lacks any discernible overall purpose or organizing claim.
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Thesis is insufficiently developed or vague. Purpose is not clear.
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Thesis is apparent and appropriate to purpose.
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Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose.
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Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.
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10.0 % Argument Logic and Construction
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Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.
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Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.
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Argument is orderly, but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis.
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Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.
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Argument is clear and convincing and presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.
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10.0 % Mechanics of Writing (includes spelling, punctuation, grammar, language use)
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Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.
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Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register), sentence structure, or word choice are present.
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Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct sentence structure and audience-appropriate language are used.
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Prose is largely free of mechanical errors, although a few may be present. A variety of sentence structures and effective figures of speech are used.
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Writer is clearly in command of standard, written, academic English.
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10.0 %Format
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5.0 % Paper Format (use of appropriate style for the major and assignment)
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Template is not used appropriately or documentation format is rarely followed correctly.
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Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent.
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Template is used, and formatting is correct, although some minor errors may be present.
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Template is fully used; There are virtually no errors in formatting style.
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All format elements are correct.
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5.0 % Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)
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Sources are not documented.
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Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.
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Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.
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Sources are documented, as appropriate to assignment and style, and format is mostly correct.
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Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.
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100 % Total Weightage
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