PICOT Research Question

Introduction

Type 2 diabetes mellitus has been rapidly increasing and because of that, there has been an increase in the incidence of diabetic foot ulceration. It is one of the most debilitating complications of diabetes. According to Lipsky (2016), most people who have diabetes have a 25% chance of developing a foot complication. A foot ulcer is defined as an ulcer that is associated with peripheral artery disease and/or peripheral neuropathy in a diabetic patient. Among diabetic patients, foot ulceration prevalence is approximately 4-10% with older patients being at higher risk (Alexiadou & Doupis, 2012). Diabetic foot care is an integral part of the care given to a diabetic patient by his/her nurse. Through an increased awareness by nursing professionals, the ability to identify a patient who is at risk for developing foot ulceration, and therefore, instituting proper foot care, is crucial in reducing the risk for amputation.

Feasible Questions

1. What is the risk of infection in patients with diabetes and what organisms are responsible?

2. Which broad spectrum antibiotic is more effective in treating polymicrobial foot infections in diabetics?

3. What prevention strategies should be incorporated through foot care in preventing diabetic foot ulcers and infections?

4. What is the most effective approach to stimulating wound healing in patients with diabetic ulceration of the foot?

5. What comorbid disease processes affect the formation of diabetic foot ulceration?

According to Aslam and Emmanuel (2010), a “researchable question is an uncertainty about a problem that can be challenged, examined, and analyzed to provide useful information.” For the above five questions, I determined the feasibility based on the clinical practicality of the questions, their relevance and significance in nursing, and whether they were researchable as far as current literature or not. Through research of scholarly and peer-reviewed articles, I found that question four (What is the most effective approach to stimulating wound healing in patients with diabetic ulceration of the foot?) was the most feasible considering the above criteria.

PICOT Criteria

The concept of PICOT was developed by Richardson et al. in 1995 in order to break clinical questions into keywords that can be searched (Davies, 2011). The PICOT question chosen for this paper is: What is the most effective approach to stimulating wound healing in patients with diabetic ulceration of the foot?

P (Patient or Population)-Adults over the age of 18 with diabetic ulceration of the foot.

I (Intervention)-Focus on novel approaches to manage foot ulcers including bioengineered skin and tissue substitutes, new dressings, and hyperbaric oxygen (Wu, Driver, Wrobel, & Armstrong, 2007).

C (Comparison)-Compare the fundamental basics of diabetic foot ulcer care such as infection control, debridement, perfusion, and pressure mitigation.

O (T) (Outcome)-The basic measures of diabetic foot ulcer care may be enough in the care of a mild ulcer, but these new techniques provide a more intensive treatment to care for and prevent complications with a moderate to severe ulcer.

Keywords

The purpose of keywords when conducting a literature review for a research paper is to define the field, the topic, and the research issue for which it will be written. Since they also make a paper searchable for other researchers, it is important to use relevant and up-to-date keywords. Ten keywords that can be used in a literature search for wound healing in diabetic patients with foot ulcers include: diabetes, ulceration, diabetic foot ulcers, peripheral neuropathy, peripheral artery disease, foot care, diabetic ulcer complications, type 2 diabetes, diabetic nursing care, and ulcer prevention. I chose these keywords to help in the literature research based on the topic of diagnosis, treatment, and prevention in diabetic foot ulcers.

Conclusion

A well-thought out research question is the beginning of a quality research paper. The framework (PICOT) discussed here is helpful in formulating a feasible question and subsequent keyword search for an answer when developing a new research project. If the question is well-defined, it will lead to a successful study. It is beneficial to allow for only one research question based on its relevance to a patient’s health or nursing practices. Once the research question has been formulated, the progress of finding an answer and administering the results to a specific patient population needs to be well-documented. An appropriate question, ultimately, is what generates facts rather than opinions, which is clearly the overall goal of any research project.

In Part 3 of the Course Project, you consider how the evidence you gathered during Part 2 can be translated into nursing practice.Now that you have located available research on your PICOT question, you will examine what the research indicates about nursing practices. Connecting research evidence and findings to actual decisions and tasks that nurses complete in their daily practice is essentially what evidence-based practice is all about. This final component of the Course Project asks you to translate the evidence and data from your literature review into authentic practices that can be adopted to improve health care outcomes. In addition, you will also consider possible methods and strategies for disseminating evidence-based practices to your colleagues and to the broader health care field.To prepare:

Consider Parts 1 and 2 of your Course Project. How does the research address your PICOT question?
With your PICOT question in mind, identify at least one nursing practice that is supported by the evidence in two or more of the articles from your literature review. Consider what the evidence indicates about how this practice contributes to better outcomes.
Explore possible consequences of failing to adopt the evidence-based practice that you identified.
Consider how you would disseminate information about this evidence-based practice throughout your organization or practice setting. How would you communicate the importance of the practice?

To complete:In a 3- to 4-page paper:

Restate your PICOT question and its significance to nursing practice.
Summarize the findings from the articles you selected for your literature review. Describe at least one nursing practice that is supported by the evidence in the articles. Justify your response with specific references to at least 2 of the articles.
Explain how the evidence-based practice that you identified contributes to better outcomes. In addition, identify potential negative outcomes that could result from failing to use the evidence-based practice.
Outline the strategy for disseminating the evidence-based practice that you identified throughout your practice setting. Explain how you would communicate the importance of the practice to your colleagues. Describe how you would move from disseminating the information to implementing the evidence-based practice within your organization. How would you address concerns and opposition to the change in practice?

PART 1 AND 2 ARE ATTACHED