Week 2: PICOT/PICo and Practice Questions

Week 2: PICOT/PICo and Practice Questions

Week 2: PICOT/PICo and Practice Questions

For my evidenced based practice proposal project, I chose to go with a qualitative approach for research on veterans’ risk for suicide post deployment. For this project, I wanted to better understand the motivation and thought process of the veteran post deployment and if there were extenuating circumstances that accelerated their decision towards self-harm and thus qualitative research was the best approach. Ramchand (2016), discusses the need for qualitative approach as a way to better understand where veterans are coming from when they experience suicidal ideation and what is driving them to a place of crisis. There are so many different research trajectories on the subject of post war veterans and their risk for suicide such as the integration of females in combat zones and pre-existing mental illness in the combat veteran that I was not sure how to narrow down the issue to formulate a question. I chose to keep the subject matter broad and my research question is: Are post war veterans at a greater risk for suicide as they reintegrate into society?

Population (P): Post war veterans

Interest (I): Risk for suicide

Context (Co): Reintegration into society

            The qualitative research design I chose to use is the phenomenology because it looks at the lived experiences of the individual. This research design seeks to understand the individual and the experiences they have lived by asking in-depth questions about their life and circumstances surrounding their existence. Polit &Beck (2017), discuss how individuals create truth about their own reality through their lived experiences. In depth questioning from the researcher helps to draw out these truths and better understand the circumstances that molded their beliefs. Interpretive phenomenology allows the researcher to enter the world of the participant without pre-conceived notions or ideas to better understand the individual (Polit, 2017). I have chosen to research the post war veterans risk for suicide through the interpretive aspect of the phenomenological design because I want to understand their thought process on the subject and not come with my own agenda or pre-conceived ideas.

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Polit, D. & Beck, C. (2017). Essentials of nursing research: Appraising evidence for nursing practice (9th ed.). Philadelphia, PA: Wolters Kluwer.

Ramchand, R., Ayer, L., Kotzias, V., Engel, C., Predmore, Z., Ebener, P., & Haas, G. (2016). Suicide risk among women veterans in distress: Perspectives of responders on the veterans’ crisis line. Women’s Health Issues: Official Publication of The Jacobs Institute of Women’s Health26(6), 667-673. doi:10.1016/j.whi.2016.07.005

Quantitative Approach

Initially, I thought that the qualitative approach would be a better approach for my evidence-based project proposal.  After further review, I now am convinced that the quantitative approach is a better approach for my evidence-based Practice (EBP) project proposal. Evidence-based practice is aimed at hardwiring current knowledge into common care decisions to improve care processes and patient outcomes (Stevens, 2013).   Evidence-based practice also unifies research evidence with clinical expertise and encourages through individualization of care through inclusion of patient preferences (Stevens, 2013).

Why the Quantitative Approach is best for rural populations’ unplanned healthcare (Area of Interest)

Because of my clinical experience with my area of interest in the rural population, this approach will allow a collection of opinions, facts, attitudes, and behaviors to be analyzed.  The quantitative approach will also allow results to be generalized from a larger population such as the rural population.  With the use of the quantitative approach, this population will have the opportunity to reveal their needs and causes of lack of healthcare.  This research approach will be beneficial in order to decrease the incidence of unplanned healthcare, which is one of the biggest healthcare challenges that this population continues to face.  With the use of the quantitative research method, data can be collected from various forms such as: online surveys, paper surveys, telephone interviews, and face to face interviews.  The collection of this data will allow comparison of opinions and further investigation toward a resolution.   As exploration of the chosen population occurs with the combination of clinical experiences, an advancement of the proposed EBP will promote the intended outcome of better healthcare strategies. 

PICO Quantitative Question

In the rural population (P) does health education, early diagnosis, and healthcare programs (I) compared to deploying health resources geographically (C) reduce the incidence of unplanned healthcare (O).

Quantitative Practice Question

Is there a link between the lack of healthcare education, early diagnosis, healthcare programs and unplanned healthcare?

Reference Stevens, K.R. (2013).  The Impact of Evidence-based Practice in Nursing and the Next big Ideas.  Online Journal Issues in Nursing, 18(2), 1.  doi: 10.3912/OJIN18No02MAN04

I believe both quantitative and qualitative approaches could be beneficial for this specific topic, but I plan to focus on the qualitative approach. In qualitative research the focus is on the collection and analysis of data. The researcher has to remain fluid and flexible during the research process. Their direction may need to change slightly in order to get closer to their goal. Qualitative research main purpose is to explore and describe a participant’s experience. The approach starts out with a broad question, but process oriented and context bound (Malagon-Maldonado, 2014). The focus for quantitative research is usually narrow and product related.   

My PICo question is: in a hospital setting where nurses conduct bedside shift report opposed to station-based report, is patient satisfaction higher?  I picked this question to help guide the nurses to understand the value bedside shift report has for the patients and their families as well as the nurses. We have set this practice as a standard in our hospital and many units do very well. We see staff struggling on the units that have larger number of patients. While using the qualitative approach I will start broad in my question but hope to identify some research specific to the patient satisfaction in the emergency department. As the nursing operations manager of the emergency department, we strive to improve our communication with our patients concerning their plan of care. This research will hopefully identify some of the barriers and how successful organizations supported their staff to overcome those barriers (Taylor, 2015).

Malagon-Maldonado, G. (2014). Qualitative Research in Health Design. Health Environments Research & Design Journal (HERD) (Vendome Group LLC)7(4), 120-134. Retrieved from http://www.herdjournal.com.chamberlainuniversity.idm.oclc.org/ME2/Default.asp

Taylor, J. S. (2015). Improving patient safety and satisfaction with standardized bedside handoff and walking rounds. Clinical Journal of Oncology Nursing, 19(4), 414-416. Retrieved from https://cjon.ons.org