PICOT Question and Literature Search

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 assignment, you will create a clinical guiding question know as a PICOT question. The PICOT question must be relevant to a nursing practice problem. To support your PICOT question, identify six supporting peer-revised research articles, as indicated below. The PICOT question and six peer-reviewed research articles you choose will be utilized for subsequent assignments.

Use the “Literature Evaluation Table” to complete this assignment.

1. Select a nursing practice problem of interest to use as the focus of your research. Start with the patient population and identify a clinical problem or issue that arises from the patient population. In 200–250 words, provide a summary of the clinical issue.
2. Following the PICOT format, write a PICOT question in your selected nursing practice problem area of interest. The PICOT question should be applicable to your proposed capstone project (the project students must complete during their final course in the RN-BSN program of study).
3. The PICOT question will provide a framework for your capstone project.
4. Conduct a literature search to locate six research articles focused on your selected nursing practice problem of interest. This literature search should include three quantitative and three qualitative peer-reviewed research articles to support your nursing practice problem.

Note: To assist in your search, remove the words qualitative and quantitative and include words that narrow or broaden your main topic. For example: Search for diabetes and pediatric and dialysis. To determine what research design was used in the articles the search produced, review the abstract and the methods section of the article. The author will provide a description of data collection using qualitative or quantitative methods. Systematic Reviews, Literature Reviews, and Metanalysis articles are good resources and provide a strong level of evidence but are not considered primary research articles.  Therefore, they should not be included in this assignment.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center. 

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 not required to submit this assignment to LopesWrite.

Healthy People 2020 is a framework to assist communities in preventing disease and promoting health. Search the scientific literature and find a research study related to one of the focus areas identified by Healthy People 2020.

In a 750-1000-word essay, critically appraise the study by answering each of the following questions:

1. What is the study question and is it relevant?

2. Does the study add anything new?

3. What type of research question is being asked?

4. Was the study design appropriate for the research question?

5. Did the study methods address the most important potential sources of bias?

6. Was the study performed according to the original protocol?

7. Does the study test a stated hypothesis? If so, what is it?

8. Does the data justify the conclusions?

9. Are there any conflicts of interest?

10. There are methodological points to consider in appraising literature that are specific to cross-sectional, cohort, case-control, clinical trials, and case studies. 

Based on the design of this study, what are the key methodical points to consider?

You are required to use a minimum of three scholarly resources.

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

Use the empty outline and fill in each section with the information for your author’s claim. You will need at least 3 support points. In the Intro you need to write a solid author’s claim (thesis). You do not need to write complete sentences except for the author’s claim. This is an outline of sorts. You should find at least two articles to use as reference that could be used to substantiate your support. In the end you should have an empty outline filled and the citation for two articles that will add support to your author’s claim.

Urinary Obstruction

Case Studies

The 57-year-old patient noted urinary hesitancy and a decrease in the force of his urinary stream for several months. Both had progressively become worse. His physical examination was essentially negative except for an enlarged prostate, which was bulky and soft.

Studies

Results

Routine laboratory studies

Within normal limits (WNL)

Intravenous pyelogram (IVP)

Mild indentation of the interior aspect of the bladder, indicating an enlarged prostate

Uroflowmetry with total voided flow of 225 mL

8 mL/sec (normal: >12 mL/sec)

Cystometry

Resting bladder pressure: 35 cm H2O (normal: <40 cm H2O)

Peak bladder pressure: 50 cm H2O (normal: 40-90 cm H2O)

Electromyography of the pelvic sphincter muscle

Normal resting bladder with a positive tonus limb

Cystoscopy

Benign prostatic hypertrophy (BPH)

Prostatic acid phosphatase (PAP)

0.5 units/L (normal: 0.11-0.60 units/L)

Prostate specific antigen (PSA)

1.0 ng/mL (normal: <4 ng/mL)

Prostate ultrasound

Diffusely enlarged prostate; no localized tumor

Diagnostic Analysis

Because of the patient’s symptoms, bladder outlet obstruction was highly suspected. Physical examination indicated an enlarged prostate. IVP studies corroborated that finding. The reduced urine flow rate indicated an obstruction distal to the urinary bladder. Because the patient was found to have a normal total voided volume, one could not say that the reduced flow rate was the result of an inadequately distended bladder. Rather, the bladder was appropriately distended, yet the flow rate was decreased. This indicated outlet obstruction. The cystogram indicated that the bladder was capable of mounting an effective pressure and was not an atonic bladder compatible with neurologic disease. The tonus limb again indicated the bladder was able to contract. The peak bladder pressure of 50 cm H2O was normal, again indicating appropriate muscular function of the bladder. Based on these studies, the patient was diagnosed with a urinary outlet obstruction. The PAP and PSA indicated benign prostatic hypertrophy (BPH). The ultrasound supported that diagnosis. Cystoscopy documented that finding, and the patient was appropriately treated by transurethral resection of the prostate (TURP). This patient did well postoperatively and had no major problems.

Critical Thinking Questions

1. Does BPH predispose this patient to cancer?

2. Why are patients with BPH at increased risk for urinary tract infections?

3. What would you expect the patient’s PSA level to be after surgery?

4. What is the recommended screening guidelines and treatment for BPH?

5. What are some alternative treatments / natural homeopathic options for treatment?

Assessment Instructions 

You are the parent of two teenagers and an active PTA member at their school. The principal approached you about an upcoming professional gathering for middle- and high-school nurses in your district. She asked you to make a short presentation on school health privacy and how it can affect nurse-student care within the teen population, where personal health issues and privacy concerns often collide.

Preparation

Research and gather information about the issues facing school nurses in your state of licensure, as well as state and federal privacy laws that govern your school health privacy information. You will also need to learn about the legal limitations and responsibilities of the school nurse.

Directions

Create a 6–8-slide PowerPoint presentation that examines the privacy issues unique to nurses serving the high-school age population. Address the following:

• Describe the types of health and wellness issues that can affect adolescents in their high-school years. Be sure you think beyond the usual things and really research the types of issues that are affecting young people today.
• Explain how privacy laws can impact the school nurse in regard to patient safety and health outcomes for adolescents.
• Explain how privacy laws benefit the student, the school, and the school nurse.
• Recommend two specific evidence-based ethical strategies regarding health and wellness privacy communications in a school environment.

Use the notes section of each slide to expand your points and cite your supporting evidence. Also, include a title slide and a reference slide that lists the resources you used in this assessment.

Be creative. Consider your intended audience.

Additional Requirements

Your presentation should meet the following requirements:

• Written communication: Written communication should be free of errors that detract from the overall message.
• References: Include a reference slide with a minimum of three references; a majority of these should be peer-reviewed sources. All resources should have been published within the last 5 years.
• APA format: Resources and citations should be formatted according to current APA style and formatting.
• Length: 6–8 slides.