PICO(T) Questions to Preventing Hospital-Acquired Pneumonia

 

Hospital-acquired pneumonia (HAP) is a major healthcare concern, especially among the elderly, since it raises morbidity, mortality, and healthcare expenditures (Baker & Quinn, 2018). The prevention of HAP in elderly patients is a critical nursing practice issue that warrants exploration using a PICO(T) approach. Nurses can systematically identify the necessary components of a research question, which aids in evidence-based decision-making and practice improvement by employing the PICO(T) framework (McClinton, 2022). In this case, the PICO(T) research question is formulated as follows: In elderly patients (P), how does the implementation of evidence-based infection control measures (I) compared to standard care (C) affect the incidence of hospital-acquired pneumonia (O) during their hospital stay (T)? This question identifies the population, intervention, comparison, outcome, and time components, enabling a targeted and effective search for evidence that can be applied to nursing practice.

Exploring the prevention of HAP in elderly patients using a PICO(T) approach offers several benefits. Firstly, McClinton (2022) notes that the structured format helps to identify the most relevant evidence to answer the research question, increasing the likelihood of finding high-quality, applicable research. This facilitates the integration of evidence into nursing practice, which can ultimately lead to improved patient outcomes and a reduction in the incidence of HAP. Secondly, the PICO(T) approach promotes critical thinking and allows for a thorough assessment of the available evidence, ensuring that the chosen interventions are supported by rigorous research (Ten, 2022). This is especially significant in the context of HAP prevention because it allows for the identification of the most effective infection control methods that can be adopted in clinical practice to reduce the risk of HAP in older patients. Lastly, utilizing a PICO(T) approach to explore the issue of HAP prevention supports the principles of evidence-based practice, which emphasizes the integration of clinical expertise, patient values, and the best available evidence. According to Ten (2022), the adoption of structured frameworks such as the PICO(T) approach enables nurses to ensure that their practice is informed by the latest research and tailored to the specific needs of the elderly patient population, ultimately enhancing the quality of care provided and contributing to a safer healthcare environment.

Effective Sources of Evidence for the PICO(T) Question

To answer the PICO(T) question, the sources of evidence identified as potentially effective include studies by Baker and Quinn (2018), Jitmuang et al. (2022), Kim et al. (2022), and Patty et al. (2021). These articles were chosen because they provide a thorough overview of several aspects of HAP such as its prevalence, diagnosis, risk factors, preventative efforts, and the role of evidence-based nursing practice in its management. The peer-reviewed article by Baker and Quinn (2018) presents data on the incidence of non-ventilator HAP in the United States and reveals the need for improved prevention strategies. The rationale for selecting this article is its focus on the magnitude of the HAP problem, which highlights the urgency of addressing this issue in clinical practice. The study findings can help nurses prioritize the implementation of evidence-based infection control measures to reduce the incidence of HAP in elderly patients.

The study by Jitmuang et al. (2022) discusses the development of a multiplex pneumonia panel for diagnosing HAP and ventilator-associated pneumonia, emphasizing the importance of accurate and timely diagnosis. The criteria for choosing this article lies in the innovative diagnostic tool it presents, which can aid nurses in identifying HAP cases quickly and initiating appropriate treatment. Incorporating such diagnostic methods can enhance the overall effectiveness of HAP prevention strategies. Kim et al. (2022) present a comprehensive risk assessment for HAP, identifying sociodemographic, clinical, and hospital environmental factors associated with its incidence. The rationale for selecting this article is its focus on the multifactorial nature of HAP risk factors. Understanding these factors can help nurses develop targeted infection control measures tailored to individual patient risk profiles, thus enhancing the effectiveness of HAP prevention efforts. The study by Patty et al. (2021) investigates the incidence and predictors of non-ventilator HAP in a community hospital, providing insights into potential prevention strategies. The reason for selecting this article is its demonstration of the effectiveness of evidence-based interventions in reducing HAP incidence. The findings can inform nurses about the value of incorporating evidence-based infection control measures in clinical practice to prevent HAP in elderly patients. Nurses can gain a comprehensive understanding of the various factors contributing to HAP in elderly patients and the best evidence-based approaches to address them by identifying these effective sources of evidence. This knowledge will enable healthcare professionals to implement targeted infection control measures, ultimately reducing the incidence of HAP and improving patient outcomes.

Findings from the Articles and Their Relevance to the Nursing Incident

Baker and Quinn (2018) found that the incidence of non-ventilator HAP in the United States was significantly high, highlighting the urgent need for effective prevention strategies. These findings emphasize the magnitude of the problem and the importance of implementing evidence-based infection control practices to reduce the prevalence of HAP. Jitmuang et al. (2022) reported on the development of a multiplex pneumonia panel for diagnosing HAP and ventilator-associated pneumonia, emphasizing the importance of rapid and accurate diagnosis in the management of these conditions. The findings of this study provide an innovative diagnostic tool that can aid nurses in identifying HAP cases quickly and initiating appropriate treatment. Early detection and intervention can significantly impact patient outcomes, making this study particularly relevant to the nursing incident. Kim et al. (2022) conducted a comprehensive risk assessment for HAP, identifying sociodemographic, clinical, and hospital environmental factors associated with its incidence. These findings shed light on the multifactorial nature of HAP risk factors allowing for a better understanding of the complex interactions that contribute to the development of HAP. Nurses in the hospital can identify vulnerable patients, tailor preventive measures accordingly, and target high-risk areas within the hospital environment to reduce HAP incidence by recognizing these factors. Patty et al. (2021) investigated the incidence and predictors of non-ventilator HAP in a community hospital, providing valuable insights into potential prevention strategies. The findings of this study demonstrate the effectiveness of evidence-based interventions in reducing HAP incidence. Understanding the factors that contribute to HAP and applying evidence-based practices will enable nurses to actively pursue the elimination of the risk of HAP in elderly patients. The most credible sources for helping nurses at the hospital adopt an evidence-based practice in the prevention of HAP include Baker and Quinn (2018) and Patty et al. (2021), as they focus specifically on the incidence, predictors, and prevention strategies of non-ventilator HAP, which is directly applicable to alleviating the nursing incident that occurred at the hospital.

Relevance of the Findings to Decision-Making Related to the PICO(T) Question

The findings from the chosen sources of evidence contribute significantly to decision-making related to the PICO(T) question, as they address various aspects of HAP prevention and management. These findings offer valuable insights that can guide the development and implementation of effective preventive measures, ultimately improving patient outcomes and the quality of care provided in the hospital where the incident occurred. First, the swift and accurate diagnosis of HAP is essential for timely intervention and improved patient outcomes. The development of a multiplex pneumonia panel reported by Jitmuang et al. (2022) emphasizes the importance of early detection and accurate diagnosis. This diagnostic tool can assist nurses and other healthcare professionals in identifying HAP cases quickly, allowing for the initiation of appropriate treatment and reducing the risk of complications.

Second, understanding the risk factors associated with HAP is crucial in the development of targeted prevention strategies. The comprehensive risk assessment conducted by Kim et al. (2022) highlights the multifactorial nature of HAP risk factors, including sociodemographic, clinical, and hospital environmental factors. By recognizing these factors, nurses can identify vulnerable patients, tailor preventive measures accordingly, and target high-risk areas within the hospital environment to reduce HAP incidence. Third, the implementation of evidence-based interventions is effective in reducing HAP incidence. Patty et al. (2021) demonstrated the impact of evidence-based interventions on HAP prevention in a community hospital setting. These findings can guide nurses in adopting and implementing evidence-based practices in their daily care routines, ultimately minimizing the risk of HAP in elderly patients.

The most relevant findings to the PICO(T) question and likely to lead to positive outcomes in the hospital are those related to evidence-based interventions (Patty et al., 2021) and the understanding of risk factors (Kim et al., 2022). Applying these findings to the development of targeted prevention strategies and the adoption of evidence-based practices will enable nurses to effectively reduce HAP incidence and improve patient outcomes. In conclusion, the findings from the chosen sources of evidence provide a strong foundation for informed decision-making related to the PICO(T) question. They emphasize the importance of timely and accurate diagnosis, understanding of risk factors, and the implementation of evidence-based interventions in reducing HAP incidence in the hospital. Incorporating this information into clinical practice is required for nurses to greatly improve patient outcomes and the quality of care delivered in the hospital to prevent similar unfavorable incidences from occurring in the future. Consequently, the hospital will provide the safe environment required for effective and quality evidence-based care.

References

Baker, D., & Quinn, B. (2018). Hospital-acquired pneumonia prevention initiative-2: Incidence of non-ventilator hospital-acquired pneumonia in the United States. American Journal of Infection Control, 46(1), 2–7. https://doi.org/10.1016/j.ajic.2017.08.036

Jitmuang, A., Puttinad, S., Hemvimol, S., Pansasiri, S., & Horthongkham, N. (2022). A multiplex pneumonia panel for diagnosis of hospital-acquired and ventilator-associated pneumonia in the era of emerging antimicrobial resistance. Frontiers in Cellular and Infection Microbiology, 12, 977320–977320. https://doi.org/10.3389/fcimb.2022.977320

Kim, B.-G., Kang, M., Lim, J., Lee, J., Kang, D., Kim, M., … Jeon, K. (2022). Comprehensive risk assessment for hospital-acquired pneumonia: Sociodemographic, clinical, and hospital environmental factors associated with the incidence of hospital-acquired pneumonia. BMC Pulmonary Medicine, 22(1), 21–21. https://doi.org/10.1186/s12890-021-01816-9

McClinton, T. D. (2022). A guided search: Formulating a PICOT from assigned areas of inquiry. Worldviews on Evidence-Based Nursing, 19(5), 426–427. https://doi.org/10.1111/wvn.12598

Patty, C. M., Sandidge-Renteria, A., Orique, S., Dixon, C., Camarena, E., Newsom, R., & Schneider, A. (2021). Incidence and predictors of non-ventilator hospital-acquired pneumonia in a community hospital. Journal of Nursing Care Quality, 36(1), 74–78. https://doi.org/10.1097/NCQ.0000000000000476

Ten, W. (2022). Assisting nurses with evidence-based practice: A case for the knowledge-to-action framework. Health SA Gesondheid, 27(7), 2118–2118. https://doi.org/10.4102/hsag.v27i0.2118