NRS-433V PICOT Statement Paper

PICOT Statement Paper
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Review the Topic Materials and the work completed in NRS-433V to formulate a PICOT statement for your capstone project.

A PICOT starts with a designated patient population in a particular clinical area and identifies clinical problems or issues that arise from clinical care. The intervention should be an independent, specified nursing change intervention. The intervention cannot require a provider prescription.NRS-433V PICOT Statement Paper. Include a comparison to a patient population not currently receiving the intervention, and specify the timeframe needed to implement the change process.

Formulate a PICOT statement using the PICOT format provided in the assigned readings. The PICOT statement will provide a framework for your capstone project.NRS-433V PICOT Statement Paper

In a paper of 500-750 words, clearly identify the clinical problem and how it can result in a positive patient outcome.

Make sure to address the following on the PICOT statement:

Evidence-Based Solution
Nursing Intervention
Patient Care
Health Care Agency
Nursing Practice
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.NRS-433V PICOT Statement Paper

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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.NRS-433V PICOT Statement Paper

PICOT Statement Paper

	1 Unsatisfactory 0.00%	2 Less than Satisfactory 75.00%	3 Satisfactory 79.00%	4 Good 89.00%	5 Excellent 100.00%
80.0 %Content
30.0 %Identification of Clinical Problem/Issue	Clinical problem/issue is not identified, and resolution is not addressed.NRS-433V PICOT Statement Paper	Clinical problem/issue is identified with little discussion of resolution or patient outcome.	Clinical problem/issue is identified but not supported with clinical observations or evidence. The identified problem/issue can be resolved, or a patient outcome shows minimal improvement.	Clinical problem/issue is identified based on clinical observation experience or evidence in literature. Articles are cited to support the need for change in nursing practice. The identified problem/issue can be resolved, or a patient outcome can be improved using nursing interventions.NRS-433V PICOT Statement Paper	Clinical problem/issue is identified based on key concepts that define evidence-based practice or clinical experience. Articles are cited to support the need for change in nursing practice. The identified problem/issue can be resolved, or a patient outcome can show a marked improvement through a nursing intervention.
30.0 %Clinical Problem/Issue, Including Description, Evidence-Based Solution, Nursing Intervention, Patient Care, Health Care Agency, and Nursing Practice	Clinical problem/issue is not described with clarity and the corresponding elements are not included.NRS-433V PICOT Statement Paper	Clinical problem/issue description includes a basic understanding of the problem/issue and setting, with few of the following elements explained: evidence-based solution, nursing intervention, patient care, health care agency, and nursing practice.	Clinical problem/issue description includes a basic understanding of the problem/issue, the setting, and the patient population. The following elements are explained: evidence-based solution, nursing intervention, patient care, health care agency, and nursing practice. Minimal rationale is provided to support the resolution of the clinical problem/issue.	Clinical problem/issue description includes a thorough understanding of the problem/issue, the setting, the patient population, and why it is a problem/issue. The following elements are explained in detail: evidence-based solution, nursing intervention, and patient care consistent with specific health care agency and nursing practice. Sound rationale is provided supporting the clinical problem/issue resolution.NRS-433V PICOT Statement Paper	Clinical problem/issue description includes a developed and thorough explanation of the problem/issue, the setting, the patient population, and the rationale for why it is a problem/issue. The identified clinical problem/issue explains the following elements with detail and clarity: evidence-based solution, nursing intervention, and improved patient care consistent with specific health care agency resulting in nursing practice change. Sound rationale is provided in the discussion of the clinical problem/issue resolution.
10.0 %PICOT Statement Focused on Resolution, Improvement, Application, and Intervention	PICOT statement does not focus on resolution of a problem/issue, improvement of patient care or application of a nursing intervention.	PICOT statement discusses a clinical problem/issue without a focus on improvement or intervention.NRS-433V PICOT Statement Paper	PICOT statement focuses on the resolution of a clinical problem/issue that improves patient care through the application of a nursing intervention.	PICOT statement focuses on the resolution of a clinical problem/issue, with discussion of improving patient care through the application of an evidenced-based nursing intervention.NRS-433V PICOT Statement Paper	PICOT statement clearly focuses on the resolution of a clinical problem/issue and aims at improving patient care through the application of an evidenced-based nursing intervention.
10.0 %PICOT Statement Including Population, Intervention, Comparison, Outcomes, and Time	Population, Intervention, Comparison, Outcomes, and Time are not included.NRS-433V PICOT Statement Paper	Population, Intervention, Comparison, Outcomes, and Time are present, but lack detail or are incomplete.	Population, Intervention, Comparison, Outcomes, and Time are present.	Population, Intervention, Comparison, Outcomes, and Time are clearly provided and well developed.NRS-433V PICOT Statement Paper	Population, Intervention, Comparison, Outcomes, and Time are comprehensive and thoroughly developed with supporting details.
15.0 %Organization and Effectiveness
5.0 %Presentation	Paper lacks any discernible overall purpose or organizing claim.	Thesis is insufficiently developed or vague. Purpose is not clear.	Thesis is apparent and appropriate to purpose.	Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose.	Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.
5.0 %Argument Logic and Construction	Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.	Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.NRS-433V PICOT Statement Paper	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.	Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.NRS-433V PICOT Statement Paper	Clear and convincing argument that presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.
5.0 %Mechanics of Writing (includes spelling, punctuation, grammar, language use)	Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.	Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register), sentence structure, or word choice are present.NRS-433V PICOT Statement Paper	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.	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.NRS-433V PICOT Statement Paper	Writer is clearly in command of standard, written, academic English.
5.0 %Format
2.0 %Paper Format (use of appropriate style for the major and assignment)	Template is not used appropriately or documentation format is rarely followed correctly.NRS-433V PICOT Statement Paper	Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent.	Template is used, and formatting is correct, although some minor errors may be present.	Template is fully used; There are virtually no errors in formatting style.NRS-433V PICOT Statement Paper	All format elements are correct.
5.0 %Format
3.0 %Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)	Sources are not documented.	Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.	Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.	Sources are documented, as appropriate to assignment and style, and format is mostly correct.NRS-433V PICOT Statement Paper	Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.
100 %Total Weightage	NRS-433V PICOT Statement Paper

Applying the four elements of a statement according to PICOT format helps nursing researchers to formulate a question that would be easier to investigate using Evidence based Process (LoBiondo & Haber, 2017). Regarding elderly persons, is implementing a program to prevent fall with normal care reduce the rate of falls in comparison to normal care? This problem statement follows the PICOT format with the exclusion of time as it is not applicable in this case. NRS-433V PICOT Statement Paper

P – In regard to elderly persons who falls

I – Program to prevent fall together with normal care

C – Normal care

O – Reduced rate of falls

Literature Review

1. Risk factors for falls among older adults: A review of the literature

Abstract

Falls are one of the major causes of mortality and morbidity in older adults. Every year, an estimated 30–40% of patients over the age of 65 will fall at least once. Falls lead to moderate to severe injuries, fear of falling, loss of independence and death in a third of those patients. The direct costs alone from fall related injuries are a staggering 0.1% of all healthcare expenditures in the United States and up to 1.5% of healthcare costs in European countries. NRS-433V PICOT Statement Paper. This figure does not include the indirect costs of loss of income both to the patient and caregiver, the intangible losses of mobility, confidence, and functional independence. Numerous studies have attempted to define the risk factors for falls in older adults. The present review provides a summary and update of the relevant literature, summarizing demographic and modifiable risk factors. The major risk factors identified are impaired balance and gait, polypharmacy, and history of previous falls. NRS-433V PICOT Statement Paper. Other risk factors include advancing age, female gender, visual impairments, cognitive decline especially attention and executive dysfunction, and environmental factors. Recommendations for the clinician to manage falls in older patients are also summarized. NRS-433V PICOT Statement Paper

2. The direct costs of fatal and non-fatal falls among older adults — United States

Abstract

This study sought to estimate the incidence, average cost, and total direct medical costs for fatal and non-fatal fall injuries in hospital, ED, and out-patient settings among U.S. adults aged 65 or older in 2012, by sex and age group and to report total direct medical costs for falls inflated to 2015 dollars. NRS-433V PICOT Statement Paper

Incidence data came from the 2012 National Vital Statistics System, 2012 Healthcare Cost and Utilization Project-Nationwide Inpatient Sample, 2012 Health Care Utilization Program National Emergency Department Sample, and 2007 Medical Expenditure Panel Survey. Costs for fatal falls were derived from the Centers for Disease Control and Prevention's Web-based Injury Statistics Query and Reporting System; costs for non-fatal falls were based on claims from the 1998/1999 Medicare fee-for-service 5% Standard Analytical Files. Costs were inflated to 2015 estimates using the health care component of the Personal Consumption Expenditure index. NRS-433V PICOT Statement Paper

3. Older adults’ perceptions of technologies aimed at falls prevention, detection or monitoring

Abstract

This review provides an overview of older adults’ perceptions of falls technologies. We undertook systematic searches of MEDLINE, EMBASE, CINAHL and Psych INFO, COMPENDEX and the Cochrane database. Key search terms included ‘older adults’, ‘seniors’, ‘preference’, ‘attitudes’ and a wide range of technologies, they also included the key word ‘fall*’. We considered all studies that included older adults aged 50 and above. Studies had to include technologies related specifically to falls prevention, detection or monitoring. The Joanna Briggs Institute (JBI) tool and the Quality Assessment Tool for Quantitative Studies by the Effective Public Health Practice Project (EPHPP) were used. NRS-433V PICOT Statement Paper

4. Perspectives and Experiences Related to Physical Activity of Elders in Long-Term-Care Settings

Abstract

This qualitative study investigated individual and situational factors influencing physical activity (PA) practices of elders in residential-care/assisted-living (RC/ AL) communities. This article describes the results of focus-group interviews involving 47 residents across 6 RC/AL settings. Thematic analysis revealed 6 themes: staying active, past PA experiences, value of PA, barriers to PA, strategies to facilitate PA, and support needs to promote PA. Staying active meant walking indoors and out, attending chair-exercise programs, performing professionally prescribed home exercises, and using available exercise equipment. NRS-433V PICOT Statement Paper. Past PA experiences shaped current preferences and practices. Participants agreed that exercise helped maintain physical functioning but recounted cognitive and situational barriers to PA. Lack of dedicated exercise space and short corridors hampered efforts to stay active. Participants wished for individualized home exercise programs and supervised exercise sessions. Future research should examine the extent to which the physical environment and PA programming in RC/AL communities affect elders’ PA. NRS-433V PICOT Statement Paper

5. An Analysis of Patient Falls and Fall Prevention Programs Across Academic Medical Centers

Abstract

UHC conducted an analysis of more than 25 000 patient fall reports entered the UHC Patient Safety Net incident reporting tool. Gaps were found in the completion of fall risk assessments, the ability of tools to accurately assess risk, and prevention strategies inpatient units and emergency department. Common factors in falls resulting in major harm or death included age more than 80 years, altered mental status, ambulation (often without assistance), toileting, and diuretics and anticoagulants. NRS-433V PICOT Statement Paper

6. A qualitative study on the perceptions of preventing falls as a health priority among older people in Northern India

Abstract

Background in India, fall-related injury morbidity and mortality is an emerging public health problem in older people. Despite awareness of a growing burden, there is a scarcity of literature on effective and acceptable interventions. This study was undertaken to explore the perceptions of older people regarding the risk of falls and understanding of fall prevention programmes. NRS-433V PICOT Statement Paper. We conducted six focus group discussions (FGDs), comprising single gender for three socio-demographic groups in a north Indian city, Chandigarh, in 2011. FGDs were conducted in local language (Punjabi), recorded, transcribed and translated in English. Two researchers independently conducted thematic analysis. Careful consideration of health priorities is required for development of falls prevention, particularly among the urban poor. Further, initiatives that foster community engagement, such as participatory action may increase acceptability of initiatives to prevent fall-related injury among older people in India. NRS-433V PICOT Statement Paper

References

Ambrose, A. F., Paul, G., & Hausdorff, J. M. (2013). Risk factors for falls among older adults: a review of the literature. Maturitas, 75(1), 51-61.

Burns, E. R., Stevens, J. A., & Lee, R. (2016). The direct costs of fatal and non-fatal falls among older adults—United States. Journal of safety research, 58, 99-103. NRS-433V PICOT Statement Paper

Hawley-Hague, H., Boulton, E., Hall, A., Pfeiffer, K., & Todd, C. (2014). Older adults’ perceptions of technologies aimed at falls prevention, detection or monitoring: a systematic review. International journal of medical informatics, 83(6), 416-426.

Jagnoor, J., Keay, L., Jaswal, N., Kaur, M., & Ivers, R. (2013). A qualitative study on the perceptions of preventing falls as a health priority among older people in Northern India. Injury prevention, injuryprev-2012.

LoBiondo-Wood, G., & Haber, J. (2017). Nursing Research-E-Book: Methods and Critical Appraisal for Evidence-Based Practice. Elsevier Health Sciences.

Phillips, L. J., & Flesner, M. (2013). Perspectives and experiences related to physical activity of elders in long-term-care settings. Journal of Aging and Physical Activity, 21(1), 33-50.

Williams, T., Szekendi, M., & Thomas, S. (2014). An analysis of patient falls and fall prevention programs across academic medical centers. Journal of nursing care quality, 29(1), 19-29.