NURS-FPX4025 Assessment 3 Applying the PICO(T) Process – Step-by-Step Guide With Example Answer
The first step before starting to write the NURS-FPX4025 Assessment 3 Applying the PICO(T) Process is to understand the requirements of the assignment. The first step is to read the assignment prompt carefully to identify the topic, the length and format requirements. You should go through the rubric provided so that you can understand what is needed to score the maximum points for each part of the assignment.
It is also important to identify the paper’s audience and purpose, as this will help you determine the tone and style to use throughout. You can then create a timeline to help you complete each stage of the paper, such as conducting research, writing the paper, and revising it to avoid last-minute stress before the deadline. After identifying the formatting style to be applied to the paper, such as APA, review its use, including writing citations and referencing the resources used. You should also review the formatting requirements for the title page and headings in the paper, as outlined by Capella University.
How to Research and Prepare for NURS-FPX4025 Assessment 3 Applying the PICO(T) Process
The next step in preparing for your paper is to conduct research and identify the best sources to use to support your arguments. Identify a list of keywords related to your topic using various combinations. The first step is to visit the Capella University library and search through its database using the important keywords related to your topic. You can also find books, peer-reviewed articles, and credible sources for your topic from the Capella University Library, PubMed, JSTOR, ScienceDirect, SpringerLink, and Google Scholar. Ensure that you select the references that have been published in the last 5 years and go through each to check for credibility. Ensure that you obtain the references in the required format, such as APA, so that you can save time when creating the final reference list.
You can also group the references according to their themes that align with the outline of the paper. Go through each reference for its content and summarize the key concepts, arguments and findings for each source. You can write down your reflections on how each reference connects to the topic you are researching. After the above steps, you can develop a strong thesis that is clear, concise and arguable. Next, create a detailed outline of the paper to help you develop headings and subheadings for the content. Ensure that you plan what point will go into each paragraph.
How to Write the Introduction for NURS-FPX4025 Assessment 3 Applying the PICO(T) Process
The introduction of the paper is the most crucial part, as it helps provide the context of your work and determines whether the reader will be interested in reading through to the end. Begin with a hook, which will help capture the reader’s attention. You should contextualize the topic by offering the reader a concise overview of the topic you are writing about so that they may understand its importance. You should state what you aim to achieve with the paper. The last part of the introduction should be your thesis statement, which provides the main argument of the paper.
How to Write the Body for NURS-FPX4025 Assessment 3 Applying the PICO(T) Process
The body of the paper helps you to present your arguments and evidence to support your claims. You can use headings and subheadings developed in the paper’s outline to guide you on how to organize the body. Start each paragraph with a topic sentence to help the reader know what point you will be discussing in that paragraph. Support your claims using the evidence collected from the research, and ensure that you cite each source properly using in-text citations. You should analyze the evidence presented and explain its significance, as well as how it relates to the thesis statement. You should maintain a logical flow between paragraphs by using transition words and a flow of ideas.
How to Write the In-text Citations for NURS-FPX4025 Assessment 3 Applying the PICO(T) Process
In-text citations help readers give credit to the authors of the references they have used in their work. All ideas that have been borrowed from references, any statistics and direct quotes must be referenced properly. The name and date of publication of the paper should be included when writing an in-text citation. For example, in APA, after stating the information, you can put an in-text citation after the end of the sentence, such as (Smith, 2021). If you are quoting directly from a source, include the page number in the citation, for example (Smith, 2021, p. 15). Remember to also include a corresponding reference list at the end of your paper that provides full details of each source cited in your text. An example paragraph highlighting the use of in-text citations is as below:
“The integration of technology in nursing practice has significantly transformed patient care and improved health outcomes. According to Morelli et al. (2024), the use of electronic health records (EHRs) has streamlined communication among healthcare providers, allowing for more coordinated and efficient care delivery. Furthermore, Alawiye (2024) highlights that telehealth services have expanded access to care, particularly for patients in rural areas, thereby reducing barriers to treatment.”
How to Write the Conclusion for NURS-FPX4025 Assessment 3 Applying the PICO(T) Process
When writing the conclusion of the paper, start by restating your thesis, which helps remind the reader what your paper is about. Summarize the key points of the paper by restating them. Discuss the implications of your findings and your arguments. Conclude with a call to action that leaves a lasting impression on the reader or offers recommendations.
How to Format the Reference List for NURS-FPX4025 Assessment 3 Applying the PICO(T) Process
The reference helps provide the reader with the complete details of the sources you cited in the paper. The reference list should start with the title “References” on a new page. It should be aligned center and bolded. The references should be organized in an ascending order alphabetically, and each should have a hanging indent. If a source has no author, it should be alphabetized by the title of the work, ignoring any initial articles such as “A,” “An,” or “The.” If you have multiple works by the same author, list them in chronological order, starting with the earliest publication.
Each reference entry should include specific elements depending on the type of source. For books, include the author’s last name, first initial, publication year in parentheses, the title of the book in italics, the edition (if applicable), and the publisher’s name. For journal articles, include the author’s last name, first initial, publication year in parentheses, the title of the article (not italicized), the title of the journal in italics, the volume number in italics, the issue number in parentheses (if applicable), and the page range of the article. For online sources, include the DOI (Digital Object Identifier) or the URL at the end of the reference. An example reference list is as follows:
References
Morelli, S., Daniele, C., D’Avenio, G., Grigioni, M., & Giansanti, D. (2024). Optimizing telehealth: Leveraging Key Performance Indicators for enhanced telehealth and digital healthcare outcomes (Telemechron Study). Healthcare, 12(13), 1319. https://doi.org/10.3390/healthcare12131319
Alawiye, T. (2024). The impact of digital technology on healthcare delivery and patient outcomes. E-Health Telecommunication Systems and Networks, 13, 13-22. 10.4236/etsn.2024.132002.
NURS-FPX4025 Assessment 3 Applying the PICO(T) Process Instructions
Create a 3–5 page submission in which you develop a PICO(T) question for the diagnosis you worked with in the first two assessments and analyze the evidence you locate to answer the question.
Introduction
PICO(T) is an acronym that helps researchers and practitioners define aspects of a potential study or investigation.
It stands for:
- P – Patient/population/problem.
- I – Intervention.
- C – Comparison (of potential interventions, typically).
- O – Outcomes.
- T – Time frame (if time frame is relevant).
The end goal of applying PICO(T) is to develop a question that can help guide the search for evidence (Boswell & Cannon, 2015). From this perspective, a PICO(T) question can be a valuable starting point for nurses who are beginning to apply an evidence-based model. By taking the time to precisely define the areas in which the nurse will be looking for evidence, searches become more efficient and effective. Essentially, by precisely defining the types of evidence within specific areas, the nurse will be more likely to discover relevant and useful evidence during their search. When applying the PICO(T) approach, the nurse can isolate the interventions of interest and compare to other existing interventions for the evidenced impact on the outcome of the concern.
Reference
Boswell, C., & Cannon, S. (2015). Introduction to nursing research. Jones & Bartlett Learning.
Professional Context
As a baccalaureate-prepared nurse, you will be responsible for locating and identifying credible and scholarly resources to incorporate the best available evidence for the purposes of enhancing clinical reasoning and judgement skills. When reliable and relevant evidence-based findings are utilized, patients, healthcare systems, and nursing practice outcomes are positively impacted.
PICO(T) is a framework that can help you structure your definition of the issue, potential approach that you are going to use, and your predictions related to the issue. Word choice is important in the PICO(T) process because different word choices for similar concepts will lead you toward different existing evidence and research studies that would help inform the development of your initial question. When writing a PICO(T)-formatted research question, you want to focus on the impact of the intervention and the comparison on the outcome you desire.
Scenario
For this assessment, please use the diagnosis you worked with in the first two assessments.
Instructions
After reviewing the materials you created to research a specific diagnosis in the first two assessments, apply the PICO(T) process to develop a research question and research it.
Your initial goal is to define the population, intervention, comparison, and outcome. In some cases, a time frame is relevant and you should include that as well, when writing a question you can research related to your issue of interest. After you define your question, research it, and organize your initial findings, select the two sources of evidence that seem the most relevant to your question and analyze them in more depth. Specifically, interpret each source’s specific findings and best practices related to your chosen diagnosis, and explain how the evidence would help you plan and make decisions related to your question.
If you need some structure to organize your initial thoughts and research, the PICO(T) Question and Library Search template (accessible from the Create PICO(T) Questions page) might be helpful.
In your submission, make sure you address the following:
- Review the PICO(T) process.
- Explain your diagnosis from Assessment 1 in terms of outcomes, risks, and complications. In your explanation, be sure to include the risks and complications for vulnerable populations or those affected by healthcare disparities and the impact of those disparities.
- Consider your diagnosis from Assessment 1. Develop a research question using the PICO(T) process to address an issue of your choosing related to your diagnosis.
- Properly format your PICO(T) question to guide your search of the literature.
- Describe your search of the literature, noting search engines, key words, and credibility factors.
- Locate evidence that explores your intervention and comparison of your PICO(T) question with an emphasis on your specific outcome (at least three diagnosis-issue-specific sources of evidence (scholarly articles)).
- Explain the content of each of your scholarly articles.
- Explain the credibility and relevance of each of the articles you chose to your diagnosis issue.
- Analyze the evidence. Determine the answer to your PICO(T) question based on your analysis of the evidence.
Additional Requirements
Your assessment should also meet the following requirements:
- Length of submission:Create a 3–5-page submission focused on defining a research question and interpreting evidence relevant to answering it.
- Number of references:Cite a minimum of four sources of scholarly or professional evidence that support your findings and considerations. Resources should be no more than 5 years old.
- APA formatting: Format references and citations according to the current APA style.
Competencies Measured
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:
- Competency 1: Interpret findings from scholarly quantitative, qualitative, and outcomes research articles and studies.
- Describe a search of the literature noting search engines, key words, and credibility factors.
- Competency 2: Analyze the relevance and potential effectiveness of evidence when making a decision.
- Explain a diagnosis in terms of outcomes, risks, and complications, including the risks and complications for vulnerable populations or those affected by healthcare disparities, and the impact of those disparities.
- Explain the content of at least three sources of evidence, including the credibility and relevance of the articles to a specific diagnosis issue.
- Competency 4: Plan care based on the best available evidence.
- Describe a research question developed using the PICO(T) process to address a chosen issue related to a diagnosis.
- Analyze evidence to explain the answer to a PICO(T) question.
- Competency 5: Apply professional, scholarly communication strategies to lead practice changes based on evidence.
- Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.
- Apply APA formatting to in-text citations and references, exhibiting adherence to most aspects of APA format.
NURS-FPX4025 Assessment 3 Applying the PICO(T) Process Example
Applying the PICO(T) Process
The PICOT process is the initial part of a clinical inquiry that helps formulate research questions. PICOT guides evidence-based practice, enabling care professionals to implement standardized and organized research methods that facilitate the investigation and resolution of clinical issues through answerable questions for research or clinical decision-making. The diagnosis of interest is hyperemesis gravidarum, a debilitating problem in problems marked by persistent nausea and vomiting, electrolyte imbalance, dehydration, and weight loss.
The clinical issues associated with the problem are psychological issues, which result from the disease process, distorted family dynamics, inability to fulfill roles, and a sense of loss of identity. This paper reviews the diagnosis and associated issues, develops a research question using the PICOT process, appraises relevant research, and analyzes evidence to help answer the PICOT question.
Explanation of the Diagnosis from Assessment 1
The issue selected relating to the diagnosis is psychological issues. The previous assessments revealed that patients with hyperemesis gravidarum are at higher risk for mental health issues such as depression and anxiety, and these symptoms often persist years later after hyperemesis gravidarum. HG leads to outcomes such as electrolyte imbalance, weight loss, distorted family dynamics from admissions, and loss of productivity due to the inability to perform routine tasks (Popa et al., 2021).
The condition also affects fetal health and can lead to poor health outcomes such as small gestation-age babies or experiencing growth restrictions, primarily due to maternal malnutrition. A recent study by Nana et al. (2022) showed that hyperemesis gravidarum is associated with an increased rate of pregnancy termination (10%) and increased suicidal ideation among women.
Evidence from the research also indicates that prolonged vomiting in HG can lead to electrolyte imbalances and, in severe cases, Wernicke’s encephalopathy, esophageal tears, preterm labor, placenta abruption, and preeclampsia (Popa et al., 2021). These complications can worsen pregnancy and can lead to chronic gastrointestinal issues and psychological challenges that can persist into the postpartum period. Mental health issues complicate the recovery period and maternal health outcomes, necessitating care interventions.
Vulnerable groups, such as those from poor backgrounds and with limited access to healthcare services, those with preexisting mental health issues, and patients with nutritional deficiencies, are at higher risk. Poor access to care can lead to worsening symptoms due to delayed diagnosis and treatment. Patients with mental health challenges are at risk for exacerbation, as changes such as electrolyte imbalances can lead to neurological issues and trigger mental health issues (Nijsten et al., 2022).
Mahato et al. (2023) note that fetal complications such as preterm labor and underweight babies are common in HG patients with poor access to care services. In some cases, miscommunication and stigma around HG may also prevent individuals from seeking appropriate care. In addition, structural issues such as insurance coverage gaps and discriminatory practices can disproportionately impact marginalized groups, further exacerbating the risk of HG. Health disparities can aggravate the care of HG, hence the need for its proactive management.
Research Question Using PICOT
The PICOT question selected is: In patients with hyperemesis gravidarum (P), how does cognitive behavioral therapy, in addition to medications (I), compared to routine practices (C), affect mental health outcomes (prevalence and recovery) (O) within 2 months (T)?
Literature Search Process
The literature research was conducted in reputable databases and journals. The databases used include Google Scholar, ESBCO, PubMed, CINAHL, and Wiley Library. These websites feature high-quality research resulting from a proactive appraisal process before publishing. A preference for reputable, peer-reviewed, and open-access journals was employed to ensure full access to the articles for appraisal. Only full articles published from 2021 to the present were considered in the study. Keywords such as “hyperemesis gravidarum,” “CBT in hyperemesis gravidarum,” and “psychological issues in pregnancy” were used for the study.
Diagnosis-issue-specific Evidence Sources
Emami-Sahebi, A., Elyasi, F., Yazdani-Charati, J., Zamaniyan, M., Rahmani, Z., & Shahhosseini, Z. (2021). The effects of individual cognitive behavior therapy on nausea and vomiting of pregnancy: A quasi-experimental study. Advances in Integrative Medicine, 8(3), 203-209.
Emami-Sahebi et al. (2021) conducted a quasi-experimental study to examine the impact of CBT on women with moderate to severe nausea and vomiting in pregnancy (HG). The study included 52 participants in the intervention group, who received individual cognitive-behavioral therapy in six sessions in addition to their usual prenatal care. The questionnaire was used to collect data using tools such as the Pregnancy-Unique Quantification of Emesis/Nausea scale, the Spielberger State-Trait Anxiety Inventory, and the Edinburg Postnatal Depression Scale. The study showed that CBT is an effective intervention for managing the physical and psychological symptoms of hyperemesis gravidarum (reduces prevalence of vomiting episodes and anxiety and depression symptoms). However, the small sample size limited the generalizability of the study results.
Li, X., Laplante, D. P., Paquin, V., Lafortune, S., Elgbeili, G., & King, S. (2022). Effectiveness of cognitive behavioral therapy for perinatal maternal depression, anxiety, and stress: A systematic review and meta-analysis of randomized controlled trials. Clinical Psychology Review, 92, 102129. https://doi.org/10.1016/j.cpr.2022.102129
Li et al. (2022) conducted a systematic review to determine the effectiveness of cognitive behavioral therapy in the management of perinatal mental health issues in pregnancy, such as depression, stress, and anxiety. One of the study’s limitations is its broad focus, as it does not eliminate other causes of mental health issues. However, the study is a high-quality research that focuses on the proposed interventions to address mental health issues, hence its relevance to the PICOT. The study results showed that CBT had a short-term impact on perinatal depression, short and long-term effects on anxiety, and short-term efficacy for perinatal stress (Li et al., 2022). Overall, CBT is an effective strategy for managing perinatal depression, anxiety, and stress.
Pettman et al. (2023) evaluated the effectiveness of CBT-based interventions in the management of perinatal maternal depression, which is among the complications of hyperemesis gravidarum. One of the study’s limitations is its focus on all-cause maternal depression without a primary focus on hyperemesis gravidarum. However, the study is of high quality, being a systematic review and meta-analysis.
The study evaluated 31 studies (5291 participants) in the systematic review and 26 studies (4658 patients) in the meta-analysis. The study showed that CBT-based interventions are effective in addressing anxiety, stress, and perceived social support among perinatal women with depression. The researchers also noted that the type of CBT and healthcare professionals involved were positive predictors of outcomes. However, the study’s results showed high heterogeneity but low quality, hence the need to use the intervention cautiously.
Evidence Analysis
There is a significant gap in research on interventions to manage mental health issues in pregnancy. Very few scholars have studied the impact of mental in hyperemesis gravidarum and the practical interventions to address it despite its significant burden on HG patients. While evidence from research supports the burden of mental health issues in hyperemesis gravidarum, few studies investigating the effectiveness of interventions to address these issues exist, affecting research into these issues. Li et al. (2022) showed that cognitive behavioral therapy is an effective intervention in managing depression, anxiety, and stress among perinatal women. Hyperemesis gravidarum and other pregnancy complications are among the leading causes of maternal mental health issues.
The research articles show that psychological issues in hyperemesis gravidarum in pregnancy are rampant. Cognitive behavioral therapy and its derivatives, such as trauma-informed care, emerge as effective interventions for the prevention and management of mental health/psychological issues HG. Emami-Sahebi et al. (2021) found that CBT interventions are also effective in addressing HG symptoms and can thus serve as an effective adjunct therapy to medications and other care interventions.
Pettman et al. (2023) note that CBT is effective in managing perinatal maternal depression. The effectiveness of CBT and other interventions for hyperemesis gravidarum is not highly tested, which can explain the high burden of mental health issues in HG. The evidence gathered can be used to guide the PICOT and shows that CBT is a promising intervention in addressing mental health issues in HG and other complications.
Hyperemesis gravidarum is a severe illness in pregnancy with various complications. Mental health issues are common in HG, and some persist into the postpartum period. The most common mental health issues include depression, anxiety, and stress. Cognitive behavioral therapy is an effective intervention in managing mental health issues in the perinatal period, and evidence from research shows it is effective in addressing the psychological and physical symptoms of HG. There is a significant research gap in the management of mental health issues, which can explain the significant burden of these mental health issues. The PICOT focuses on CBT in hyperemesis gravidarum, and evidence from research shows it is a promising intervention to address mental health issues perinatally.
References
Li, X., Laplante, D. P., Paquin, V., Lafortune, S., Elgbeili, G., & King, S. (2022). Effectiveness of cognitive behavioral therapy for perinatal maternal depression, anxiety, and stress: A systematic review and meta-analysis of randomized controlled trials. Clinical Psychology Review, 92, 102129. https://doi.org/10.1016/j.cpr.2022.102129
Mahato, S., Shrestha, A., Younjan, S., Mahato, A., Mahaseth, A., & Gautam, R. (2023). Hyperemesis Gravidarum: Fetal and maternal complications in a tertiary hospital in Nepal. International Journal of Public Health Asia Pacific. https://doi.org/10.62992/ijphap.v2i2.35
Nana, M., Tydeman, F., Bevan, G., Boulding, H., Kavanagh, K., Dean, C., & Williamson, C. (2021). Hyperemesis gravidarum is associated with increased rates of termination of pregnancy and suicidal ideation: results from a survey completed by> 5000 participants. American Journal of Obstetrics and Gynecology, 224(6), 629–631. https://doi.org/10.1016/j.ajog.2021.03.006
Nijsten, K., van der Minnen, L. M., Dean, C., Bais, J. M., Ris-Stalpers, C., van Eekelen, R., Bremer, H. A., van der Ham, D. P., Heidema, W. M., Huisjes, A., Kleiverda, G., Kuppens, S. M., van Laar, J. O. E H., Langenveld,J., van der Made, F., Papatsonis, D., Pelinck, M., Pernet, P. J., van Rheenen-Flach, L., and Painter, R. C. (2022). Depression, anxiety, and post-traumatic stress disorder symptoms after hyperemesis gravidarum: A prospective cohort study. The Journal of Maternal-Fetal & Neonatal Medicine, 35(25), 10055-10063. https://doi.org/10.1080/14767058.2022.2089550
Pettman, D., O’Mahen, H., Blomberg, O., Svanberg, A. S., von Essen, L., & Woodford, J. (2023). Effectiveness of cognitive behavioral therapy-based interventions for maternal perinatal depression: A systematic review and meta-analysis. BMC Psychiatry, 23(1), 208. https://doi.org/10.1186/s12888-023-04547-9
Popa, S. L., Barsan, M., Caziuc, A., Pop, C., Muresan, L., Popa, L. C., & Perju-Dumbrava, L. (2021). Life-threatening complications of hyperemesis gravidarum. Experimental and Therapeutic Medicine, 21(6), 642. https://doi.org/10.3892/etm.2021.10074