course materials

1. Picot Questions and Evidence Based Practices in Care Essay
Picot Questions and Evidence Based Practices in Care Essay ON Picot Questions and
Evidence Based Practices in Care EssayCreate a 3-5-page submission in which you develop a
PICO(T) question for a specific care issue and evaluate the evidence you locate, which could
help to answer the question.Assessment 3 Instructions: PICO(T) Questions and an Evidence-
Based Approach Create a 3-5-page submission in which you develop a PICO(T) question for
a specific care issue and evaluate the evidence you locate, which could help to answer the
question. PICO(T) is an acronym that helps researchers and practitioners define aspects of a
potential study or investigation. It stands for: • • • • • P – Patient/population/problem. I –
Intervention. C – Comparison (of potential interventions, typically).O – Outcome(s). T –
Time frame (if time frame is relevant). The end goal of applying PICO(T) is to develop a
question that can help guide the search for evidence (Boswell Cannon, 2015). From this
perspective, a PICO(T) question can be a valuable starting point for nurses who are starting
to apply an evidence-based model or EBPs. By taking the time to precisely define the areas
in which the nurse will be looking for evidence, searches become more efficient and
effective. Essentially, by precisely defining the types of evidence within specific areas, the
nurse will be more likely to discover relevant and useful evidence during their search. You
are encouraged to complete the Vila Health PCI(T) Process activity before you develop the
plan proposal. This activity offers an opportunity to practice working through creating a
PICO(T) question within the context of an issue at a Vila Health facility. These skills will be
necessary to complete Assessment 3 successfully. Picot Questions and Evidence Based
Practices in Care EssayThis is for your own practice and self-assessment and demonstrates
your engagement in the course. Demonstration of Proficiency By successfully completing
this assessment, you will demonstrate your proficiency in the course competencies through
the following assessment scoring guide criteria: • • • • • • • • • Competency 1: Interpret
findings from scholarly quantitative, qualitative, and outcomes research articles and
studies. Explain the findings from articles or other sources of evidence. Competency 2:
Analyze the relevance and potential effectiveness of evidence when making a decision.
Identify sources of evidence that could be potentially effective in answering a PICO(T)
question. Explain the relevance of the findings from chosen sources of evidence to making
decision related to a PICO(T) question. Competency 3: Apply an evidence-based practice
model to address a practice issue. Define a practice issue to be explored via a PICO(T)
approach. Competency 5: Apply professional, scholarly communication strategies to lead
practice changes based on evidence.Picot Questions and Evidence Based Practices in Care

2. EssayCommunicate using writing that is clear, logical, and professional with correct
grammar and spelling using current APA style. Reference Boswell, C., Cannon, S. (2015).
Introduction to nursing research. Burlington, MA: Jones Bartlett Learning. Professional
Context As a baccalaureate-prepared nurse, you will be responsible for locating and
identifying credible and scholarly resources to incorporate the best available evidence for
the purposes of enhancing clinical reasoning and judgement skills. When reliable and
relevant evidence-based findings are utilized, patients, health care systems, and nursing
practice outcomes are positively impacted. PICO(T) is a framework that can help you
structure your definition of the issue, potential approach that you are going to use, and your
predictions related to the issue. Word choice is important in the PICO(T) process because
different word choices for similar concepts will lead you toward different existing evidence
and research studies that would help inform the development of your initial question.
Scenario For this assessment, please use an issue of interest from your current or past
nursing practice. If you do not have an issue of interest from your personal nursing practice,
then review the optional Case Studies presented in the resources and select one of those as
the basis for your assessment. Picot Questions and Evidence Based Practices in Care
EssayInstructions For this assessment, select an issue of interest an apply the PICO(T)
process to define the question and research it. Your initial goal is to define the population,
intervention, comparison, and outcome. In some cases, a time frame is relevant and you
should include that as well, when writing a question you can research related to your issue
of interest. After you define your question, research it, and organize your initial findings,
select the two sources of evidence that seem the most relevant to your question and analyze
them in more depth. Specifically, interpret each source’s specific findings and best practices
related to your issues, as well explain how the evidence would help you plan and make
decisions related to your question. If you need some structure to organize your initial
thoughts and research, the PICOT Question and Research Template document (accessible
from the “Create PICO(T) Questions” page in the Capella library’s Evidence Based Practice
guide) might be helpful. In your submission, make sure you address the following grading
criteria: • • • • • • Define a practice issue to be explored via a PICO(T) approach. Identify
sources of evidence that could be potentially effective in answering a PICO(T) question.
Picot Questions and Evidence Based Practices in Care EssayExplain the findings from
articles or other sources of evidence. Explain the relevance of the findings from chosen
sources of evidence to making decision related to a PICO(T) question. Communicate using
writing that is clear, logical, and professional with correct grammar and spelling using the
current APA style. Example Assessment: You may use the following to give you an idea of
what a Proficient or higher rating on the scoring guide would look like: Assessment 3
Example [PDF]. Additional Requirements Your assessment should meet the following
requirements: • • • Length of submission: Create a 3–5-page submission focused on defining
a research question and interpreting evidence relevant to answering it. Number of
references: Cite a minimum of four sources of scholarly or professional evidence that your
findings and considerations. Resources should be no more than 5 years old. APA formatting:
Format references and citations according to the current APA style. Portfolio Prompt:
Remember to save the final assessment to your ePortfolio so that you may refer to it as you

3. complete the final capstone course. 1 Using a PICO(T) Framework and Evidence to Develop
Care Practices Learner’s Name Capella University NURS-FPX4030: Making Evidence-Based
Decisions Instructor Name August, 2020 Copyright ©2019 Capella University. Copy and
distribution of this document are prohibited. 2 Using a PICO(T) Framework and Evidence to
Develop Care Practices When developing care practices for patients, the PICO(T) research
framework, which expands to Population/Patient, Intervention, Comparison, Outcome, and
Time, can be used to create an effective care plan and ensure that patients’ needs are met.
Picot Questions and Evidence Based Practices in Care EssayRelying on secondary research,
the author of this paper will define a practice issue surrounding patients with dementia,
apply the PICO(T) process, identify sources of evidence that may provide answers to the
research question, explain key findings from articles, and explain the relevance of those key
findings. Use of the PICO(T) Approach when Caring for Patients with Dementia The practice
issue identified for resolution is the need to develop care practices that effectively manage
agitation in patients with dementia in nursing homes that are outside of pharmacological
approaches. The question being explored is: Is the non-pharmacological approach,
specifically an intervention approach, more effective than the pharmacological approach in
managing behavioral symptoms (such as agitation) in patients with dementia? The
intervention approach identified is person-centered care or patient-centered care (PCC), an
approach that emphasizes more on an individual’s experiences and the communication of
his or her needs than on the pure implementation of a health care provider’s expertise
(Desai, et al., 2017).The population being studied are patients with dementia with agitative
behavioral symptoms in nursing homes. As the objective is to explore care practices that
address this issue, only factors related to care in nursing homes are considered. The study
does not take into consideration cultural, political, and social factors (Kim & Park, 2017).
Identification of Sources of Evidence DICE Model Copyright ©2019 Capella University. Copy
and distribution of this document are prohibited. 3 The DICE (Describe, Investigate, Create,
and Evaluate) model is a notable PCC intervention model that identifies optimal treatment
options for patients with dementia with neuropsychiatric symptoms. Developed by a panel
of interdisciplinary experts at the University of Michigan Program for Positive Aging, the
model is constitutive of a four-step approach. The first step of the approach is the accurate
description of the patient’s behavior, the second is the identification of possible underlying
causes, the third is the creation and implementation of treatment plans, and the fourth is
the assessment of the strategies developed (Desai et al., 2017; Kales et al., 2014).The
model’s essential recommendations for facilitating improvement in neuropsychiatric
symptoms among patients with dementia are educating the caregiver; forging better
communication between the patient and the caregiver; assisting the caregiver in organizing
meaningful activities such as cooking, painting, or reading depending on the patient’s
interests; and training the caregiver on simplifying his or her work routines (Desai et al.,
2017; Kales et al., 2014). Individualized Intervention Model The individualized intervention
model is a model in which intervention activities are carried out based on the history,
needs, abilities, and preferences of patients with dementia. In this model, PCC-based
activities are directly carried out by trained health care staff with expertise in social work,
recreational therapy, geriatric psychiatry, and psychology (Kim & Park, 2017). Care Staff-

4. Directed Model In the care staff–directed model, PCC activities are based on the staff’s
education and training on empathy and person-centeredness. The model also makes a
provision for offering Copyright ©2019 Capella University. Copy and distribution of this
document are prohibited. 4 staff regular feedback for their work. The intervention period in
such a model ranges from 3 months to 2 years (Kim & Park, 2017). Findings from Articles
As PCC is a major nonpharmacological approach to treating agitation in patients with
dementia, its effectiveness is studied by making a comparative analysis to the
pharmacological approach to manage behavioral symptoms in patients with dementia.
Pharmacological treatment in general refers to the use of psychotropic medication to
manage agitation or neuropsychotic symptoms (NPS) in patients with dementia
(Madhusoodanan & Ting, 2014; Kales et al., 2014).Some of the common pharmacological
interventions include the use of antipsychotropics, antidepressants such as sertraline and
citalopram, and sedative-hypnotics through the use of benzodiazepines to control acute
agitation (Madhusoodanan & Ting, 2014). The use of psychotropic medication poses high
risks of mortality and harmful side effects (Kales et al., 2014). Psychotropic medication is
also expensive and is restricted by regulatory bodies. However, the use of pharmacological
intervention is justified when the benefits outweigh the risks or in situations wherein
nonpharmacological interventions have proven unsuccessful (Madhusoodanan & Ting,
2014). The PCC approach has proven effective in addressing the etiology of aggressive
outbursts. Unlike the pharmacological approach, which is based on treating symptoms, the
PCC approach contributes to the resolution of underlying causes (Desai et al., 2017). The
study by Kales et al. (2014) finds reasonable evidence of the DICE program’s contribution
toward better clinical practices and improvement in aggressive behavior, and it observes
that the approach results in fewer hospitalizations and readmissions. In their systematic
review and meta-analysis of 19 primary studies, Kim and Park (2017) found 15 studies that
measure the impact of PCC on Copyright ©2019 Capella University.Copy and distribution of
this document are prohibited. 5 agitation using the Cohen-Mansfield Agitation Inventory (an
agitation mapping instrument) and the Brief Agitation Rating Scale. They found that 8 of the
15 studies show positive effects on agitation with individualized interventions (with a
significant mean difference of -0.513), showing better effects than with care staff–directed
interventions (with a significant mean difference of -0.160). As this paper relies on
secondary research on the PCC intervention to manage agitative behavior in patients with
dementia in nursing homes, there are multiple time frames for the various intervention
studies reviewed. While some studies had a long intervention period ranging from 9 months
to 2 years, others had shorter intervention periods of just a few weeks. From the above
exploration of the research problem based on the PICO(T) framework, it is clear that this
framework has contributed to the delineation of precise intervention practices and has
brought conceptual clarity on the issue of agitative behavior in patients with
dementia.Relevance of Findings from Articles The study by Kales et al. (2014) was chosen
as it provides a comprehensive explanation of the PCC-based DICE intervention program
and its potential outcomes and draws an objective comparison of the program with
pharmacological intervention. The study observed that the DICE model was developed by a
panel of experts with years of clinical and research expertise in managing NPS in patients

5. with dementia. The strategies formulated in the DICE approach were found to carry a strong
evidence base. As it is evidence-informed, the DICE approach could be helpful for clinicians
across diverse settings. Kales et al. (2014) conclude their study with a discussion on the
potential of the DICE approach in enhancing clinical practices and ensuring the treatment of
agitative behavior in patients with dementia. Copyright ©2019 Capella University. Copy and
distribution of this document are prohibited. 6 The rationale for selecting the study by Kim
and Park (2017) was that it presents a systematic review and meta-analysis of 19 primary
intervention studies, of which 17 studies are from long-term care facilities. In their
systematic review and meta-analysis of these studies, Kim and Park (2017) found that PCC
has a significant impact on reducing NPS in patients with dementia. Kim and Park’s (2017)
review found the increased engagement between care providers and patients and the
magnitude of the program’s intensity to be the reasons for shortterm PCC intervention
having greater benefits in comparison to long-term intervention. The findings are relevant
because they are based on 17 long-term, clinical PCC intervention studies comprising both
controlled and non-controlled cluster-randomized trials conducted over the past 10 years
(Kim & Park, 2017).Kim & Park’s findings prove to be the most credible. In their systematic
review and meta-analysis of primary studies, Kim and Park’s findings (2017) adhere to the
guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.
They also utilize analysis tools such as the Cochrane Collaboration’s risk of bias and the risk
of bias assessment tool to ensure quality screening of the studies. Conclusion There is a
need to develop care practices that are outside of pharmacological approaches for managing
agitation in patients with dementia. The PICO(T) framework was applied to determine if the
intervention approach of person-centered care or patient-centered care (PCC) was more
effective than the pharmacological approach by identifying sources of evidence, explaining
the findings and proving the relevance of those findings. The articles by Kales et al. (2014)
and Kim and Park (2017), provide precise, reliable, and relevant information to adequately
explore the effectiveness of the PCC approach. Copyright ©2019 Capella University. Copy
and distribution of this document are prohibited. 7 References Desai, A., Wharton, T.,
Struble, L., & Blazek, M. (2017). Person-centered primary care strategies for assessment of
and intervention for aggressive behaviors in dementia. Journal of Gerontological Nursing,
43(2), 9–17. https://search-proquestcom.library.capella.edu/docview/1862119355?pq-
origsite=summon Kales, H. C., Gitlin, L. N., & Lyketsos, C. G. (2014). Management of
neuropsychiatric symptoms of dementia in clinical settings: Recommendations from a
multidisciplinary expert panel. Journal of the American Geriatrics Society, 62(4), 762–769.
https://ncbi.nlm.nih.gov/pmc/articles/PMC4146407/# Kim, S. K. & Park, M. (2017).
Effectiveness of person-centered care on people with dementia: A systematic review and
meta-analysis. Clinical Interventions in Aging, 12, 381–397.
https://doaj.org/article/400107a4cbaa44e6b7c0e3531bb4abac Madhusoodanan, S., &
Ting, M. B. (2014). Pharmacological management of behavioral symptoms associated with
dementia. World Journal of Psychiatry, 4(4), 72–79.
https://ncbi.nlm.nih.gov/pmc/articles/PMC4274589/ Copyright ©2019 Capella University.
Copy and distribution of this document are prohibited. PICOT Question and Search Strategy
Template Use with the library guide: Evidence Based Practice in Nursing & Health Sciences

6. 1. Define your question using PICOT (review the “Create PICOT Questions” page as needed):
Population: __________________________________________________________________ Intervention:
__________________________________________________________________ Comparison:
__________________________________________________________________ Outcome:
__________________________________________________________________ Time (optional):
__________________________________________________________________ 2. Write out your question:
______________________________________________________
________________________________________________________________________________ 3. Write down the
most important words from your question in the gray boxes. For each top term, add
synonyms or related terms in the boxes below it. All these are your search terms. 4. Review
the “Best Bets” in the Nursing Databases list. Check the databases you will search: __
CINAHL Complete (*Recommended) __ Health & Medical Collection __ Nursing & Allied
Health __ OVID Nursing Full Text Plus __ Public Health Database __ PubMed Central 5. Write
in your first search below.Follow the instructions on the “Find EBP Articles…” page. AND OR
AND OR ? Scholarly/peer reviewed ? Limit publication date: 6. Type of studies you want to
include in your search: __ Systematic Review or Meta-Analysis __ Individual Research
Studies __ Clinical Practice Guidelines __ Critically Appraised Research Studies 7. What
information did you find to help answer your question?
__________________________________________________________________________________
__________________________________________________________________________________
______________________________________________________________________ This form is adapted from:
Syrene A. Miller, PICO Worksheet and Search Strategy, National Center for Dental Hygiene
Research …Purchase answer to see full attachment