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NURS FPX 6030 Assessment 2 Problem Statement (PICOT)

Student Name Capella University NURS-FPX 6030 MSN Practicum and Capstone Prof. Name Date Problem Statement The increasing incidence of falls among the geriatric community is a notable public health concern. These falls result in physical injuries and psychological distress, diminishing the overall quality of life. Current standard care needs to be revised in its approach. Thus, our research pivots around the PICOT question: “In geriatric patients living in community settings with a history of falls and multiple comorbidities, does a tailored community-based fall prevention program reduce falls over eight months compared to standard care?” This central inquiry aims to explore more effective, individualized interventions for our elderly population. Needs Assessment  The pressing need the project endeavors to tackle is threefold: health promotion, quality improvement, and prevention. Specifically, the project hones in on geriatric falls within community settings. The importance of this need is paramount. Geriatric falls are a medical issue and a public health concern. With advancing age, the likelihood of falls and the resulting comorbidities surge. When elderly individuals experience a fall, they do not just suffer physical repercussions. Their mental well-being often takes a toll, as the fear of recurrent falls can lead to reduced mobility, social isolation, and diminished overall life quality. Addressing this need is therefore vital to prevent physical injuries and ensure the mental and emotional well-being of the elderly. The World Health Organization provides a pivotal piece of numerical evidence underscoring the urgency of this need: Adults aged 65 and older experience the highest number of fatal falls, with falls ranking as the second leading cause of unintentional injury-related deaths globally (WHO, 2021). Additionally, data from the Centers for Disease Control and Prevention reveals that 25% of seniors fall each year, and once they experience a fall, their likelihood of falling again doubles (CDC, 2021). Underpinning this analysis is the assumption that a community-based fall prevention program, individualized to cater to each senior’s specific needs, will lead to a marked reduction in fall incidences among the elderly over eight months in comparison to the results achieved via standard care. This premise is grounded in the belief that interventions, when tailored according to the unique health profiles and requirements of the elderly, can bring about more productive outcomes in preventing falls. Population and Settings  Our project targets geriatric patients in community settings with a history of falls and managing multiple comorbidities. This population stands out as critical because they experience an intersection of vulnerabilities: the natural frailties that come with aging, the heightened risk from previous falls, and the complexities of managing multiple health conditions simultaneously. Addressing fall prevention in this group is imperative as they face the highest risk of severe injuries and complications, which can drastically reduce their quality of life. The community setting was chosen for intervention primarily because these environments often lack the specialized infrastructure or protocols in healthcare or assisted living facilities. Within such settings, the elderly are more exposed to common hazards and may not have immediate access to professional medical assistance post-fall. Focusing our project on these community settings aims to create a protective shield around our most vulnerable population right where they live, making their everyday environment safer. The quality improvement method we propose is introducing a community-based fall prevention program, individualized to cater to the specific needs of each participant. This program would integrate evidence-based interventions like exercise routines, strength training, and balance enhancement exercises (Gahimer & Bates, 2021). However, rolling out such an initiative has its challenges. Given the diverse health statuses and physical abilities within the elderly population, ensuring that the program fits each individual’s needs will be complex. Additionally, we must anticipate and address hurdles to consistently adhere to the program, overcome potential reluctance towards new interventions, and navigate any resistance from existing standard care practices in the community. Intervention Overview To address the pressing need for falls among the geriatric population in community settings, a trio of interventions is proposed: personalized exercise routines tailored to individual health profiles, targeted strength training programs, and structured balance training sessions. These interventions are particularly suited to our elderly demographic as they focus on enhancing physical capacity and improving balance – two primary deterrents of falls. Moreover, introducing these within community settings is strategic because such locations often need specialized fall prevention programs. Nevertheless, the success of these interventions has its challenges. Implementation requires access to specialized trainers, consistent monitoring mechanisms to gauge progress, and robust engagement strategies to ensure elderly participation. Additionally, some individuals may have medical conditions that limit their participation in certain activities, thus necessitating further customization of these interventions. Comparison of Approaches Considering the initially proposed interventions, we identify three distinct interprofessional alternatives. Firstly, a comprehensive medication review spearheaded by pharmacists can address potential drug-induced dizziness or balance issues. Such an approach emphasizes collaborative care, as pharmacists work closely with physicians and patients (Eckert et al., 2023). Secondly, physical therapy sessions, directed by specialized therapists, can target specific balance and strength deficiencies unique to each elderly individual (Tapley et al., 2021). Thirdly, occupational therapists can undertake in-depth home hazard assessments, recommending modifications to reduce fall risks in the domestic setting (Ziebart et al., 2021). While these alternatives highlight the value of an interprofessional approach, they present challenges. The hiring of diverse professionals incurs additional costs. Patients might resist medication adjustments, fearing side effects or treatment inefficacy. Lastly, practical challenges, including costs and logistics of home modifications, could deter some elderly individuals from opting for such interventions. Initial Outcome Draft The primary outcome of our intervention is to achieve a noticeable reduction of at least 20% in fall incidents among the geriatric population within community settings over eight months. This outcome delineates our project’s purpose and aspiration: to significantly enhance safety standards for elderly individuals and promote their overall well-being. Furthermore, this outcome not only emphasizes our commitment to quality improvement and injury prevention but also sets a clear benchmark against which our success can be measured. For a comprehensive assessment of

NURS FPX 4030 Assessment 3 Pico(t) Questions And An Evidence Based Approach

Student Name Capella University NURS FPX4030 Making Evidence-Based Decisions Prof. Name Date PICO (T) Questions and an Evidence-Based Approach In the realm of healthcare research, the PICO (T) methodology functions as a framework for formulating and addressing clinical inquiries. PICO (T) encompasses Patient/Population/Problem, Intervention, Comparison, Outcome, and Time if applicable. It delineates a systematic approach to defining the key components of a potential study or investigation. The “P” designates the patient or population under consideration, while the “I” denotes the intervention being evaluated. The “C” involves the comparison of interventions or controls, and the “O” points to the desired outcomes. Finally, “T,” if pertinent, relates to the time frame over which the intervention’s effects are scrutinized. This framework serves as a strategy for constructing research questions and guiding the search for clinical evidence, thereby fostering evidence-based healthcare practices. Practice Issue of Type II Diabetes Management The investigation centers on the management of Type 2 diabetes—a complex condition significantly impacting a substantial global population, thereby exerting notable strain on both quality of life and healthcare systems (Westman, 2021). To effectively address this issue, the application of a PICO (T) approach proves advantageous. This systematic framework streamlines the research process by focusing on pivotal facets of the concern. NURS FPX 4030 Assessment 3 Pico(t) Questions And An Evidence Based Approach A PICO (T)-formatted research question could be: “In adults with Type 2 diabetes (P), does a lifestyle intervention program focusing on dietary changes and physical activity (I), compared to standard care (C), lead to notable improvements in hemoglobin A1C levels (O) over a 12-month period (T)?”. The PICO (T) approach clarifies and focuses the research question, aiding in the development of a more targeted research strategy and facilitating the location of relevant evidence efficiently. This refined focus enhances the likelihood of producing high-quality research leading to improved patient outcomes and more effective healthcare policies and procedures. Identification of Sources of Evidence Various sources can provide valuable insights for addressing the PICO (T) question concerning the impact of lifestyle interventions on hemoglobin A1C levels in individuals diagnosed with Type 2 diabetes. Esteemed publications such as Diabetes Care, The American Journal of Clinical Nutrition, and the Journal of the American Medical Association regularly release current, peer-reviewed studies on interventions for Type 2 diabetes. Authoritative governmental websites like the American Diabetes Association (ADA), the World Health Organization (WHO), and Clinical Trials offer valuable data on ongoing and successful studies related to lifestyle management in diabetes. Additionally, databases such as the Cochrane Database of Systematic Reviews, PubMed, and CINAHL provide an abundance of pertinent studies. To assess the credibility and suitability of sources, the CRAAP test, evaluating Currency, Relevance, Authority, Accuracy, and Purpose, proves invaluable. This ensures that the sources utilized are current, pertinent, authoritative, accurate, and aligned with the intended purpose (Lowe et al., 2021). Combining the CRAAP test with the PICO question presents a beneficial strategy for healthcare professionals. It ensures credible and meaningful information leads to improved patient outcomes and enhanced quality of care. Findings from the Relevant Sources Research into the management of Type 2 diabetes has predominantly focused on lifestyle interventions as a pivotal approach. An authoritative source, the American Diabetes Association (2020), provides valuable insights into programs centered around lifestyle changes targeting Type 2 diabetes. The article underscores the significance of structured interventions promoting modest weight loss, yielding notable enhancements in blood glucose levels among adults with Type 2 diabetes.  Another pertinent contribution comes from Zou et al. (2020), who provide evidence supporting the enduring advantages of lifestyle interventions for adults with Type 2 diabetes. The research utilizes predictive models derived from data acquired from the Da Qing Impaired Glucose Tolerance (IGT) and Diabetes Study, suggesting a potential impact on reducing hemoglobin A1C levels. In related work, Yang et al. (2023) offer a comprehensive assessment of various randomized controlled trials focusing on lifestyle interventions, indicating a notable decrease in HbA1C levels among overweight and obese individuals with Type 2 diabetes across various ethnic groups. Decision-Making on the PICO(t) Question Using the Findings The findings from the selected sources are highly relevant when making decisions related to the PICO(T) question. The information provided by the American Diabetes Association (2020) serves as a comprehensive guideline, outlining the significance and functionality of lifestyle interventions in treating Type 2 diabetes. This validates the choice of intervention in the PICO(T) question. Investigations like Zou et al. (2021) and Yang et al. (2023) underscore the effectiveness of lifestyle interventions on long-term diabetes management and lowering HbA1C levels. The congruence among sources regarding the benefit of lifestyle interventions indicates the potential for positive outcomes. Especially supported by the critical review of randomized controlled trials, it can be inferred that lifestyle modifications are impactful in managing Type 2 diabetes outcomes, underscoring the utility of the PICO(T) question focusing on dietary changes and physical activity. Conclusion In conclusion, the PICO (T) framework is a vital strategy for formulating research questions and directing an evidence-based approach to healthcare issues. This method enables the precise definition of patient problems, intervention, comparison, and outcomes, facilitating efficient literature search and application of relevant information. Utilizing evidence-based practice, such as PICO (T), helps translate research findings into meaningful clinical practices, leading to improved patient outcomes and healthcare efficiency. It underscores the importance of selecting credible sources, interpreting findings, and applying these to clinical decision-making. References American Diabetes Association. (2020). Standards of medical care in diabetes-2020 abridged for primary care providers. Clinical Diabetes, 38(1), 10–38. Lowe, M. S., Macy, K. V., Murphy, E., & Kani, J. (2021). Questioning CRAAP. Journal of the Scholarship of Teaching and Learning, 21(3). Westman, E. C. (2021). Type 2 diabetes mellitus: A pathophysiologic perspective. Frontiers in Nutrition, 8. NURS FPX 4030 Assessment 3 Pico(t) Questions And An Evidence Based Approach Yang, J., Xia, Y., Sun, Y., Guo, Y., Shi, Z., do Vale Moreira, N. C., Zuo, H., & Hussain, A. (2023). Effect of lifestyle intervention on HbA1c levels in overweight and obese adults with type 2 diabetes