EBP 4
Herealshi
PICOTandEBPrevised1.pptxEBP Student’s Name Institution Affiliation
Evidence based practice (EBP)
Clinical Issue
There are multiple of the mental illness which are common such Generalized Anxiety Disorder, Bipolar, Dementia, Schizophrenia and list continues.
There are various models of the treatment such Cognitive behavioral therapy, exposure therapy and medication such as use of antidepressants.
Globally, mental illnesses account for 33% of the disability that adult get due to health problems.
Therefore, narrowing down to Generalized anxiety disorder, my concern is to establish effectiveness of the psychotherapy method of treatment used and specifically cognitive behavioral therapy.
Mental disorder has been global problem that which affects over 900 million people in the world.
Global burden cuts across high income countries to low income countries.
Correct method of treatment of mental illness is important and can be helpful to persons.
Treatment of the mental disorders is put into two categories which are; psychotherapy- behavioral therapy, cognitive therapy, interpersonal therapy, Psychodynamic therapy, Group therapy and Family therapy.
Second category is medication-Antidepressants, Antipsychotics, Mood stabilisers and Sleeping pills and minor tranquillisers.
Choice of the method of treatment is determined by its effictiveness.
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Development of PICOT
Picot is method of developing of clinical question which was introduced in 1995 (Davies, 2011).
In was developed to help in carrying out the research where relevant information ought to be collected depending on the components of the clinical question that was formulated.
In view of this, PICOT has been basis of formulation of the clinical questions that guides in coming up with evidence based practice which is used in making in making clinical decisions.
Clinicians deal with human life and it is critically important they make decision on the medication that they should give based on the level of the evidence that is available which influence delivery of quality healthcare.
In conducting the research in clinical setting, clinical questions must be formulated.
To ensure that relevant data is corrected, clinical questions is collected using the format of the question known as PICOT.
PICOT has been used since 1995 and has confirmed as an effective way to formulate clinical questions that help to collect data that is analyzed, tested and later inform desion making for better delivery of the quality care.
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Cont.…
Considering the clinical issue discussed in the second slide, Picot clinical question will be, for generalized anxiety disorder patient, how does cognitive behavioral therapy against antidepressants affects anxiety level within first 8 weeks?
In breaking down the picot question to individual components, P ( patient population): generalized anxiety disorder patient.
I(intervention): cognitive behavioral therapy.
C(comparison): antidepressants
O (Outcome): affects anxiety level
T (time): first 8 weeks
Correct patient population must be identified so that conclusion that is reached after collection of information will be relevant.
There are many option that can be employed but is important for clinicians to be certain on the particular intervention that they want to use so that they can be compared against others.
Desired results must be stated clearly and measurement must be done to establish whether intervention applied meets desired objectives.
Timeframe is important when formulating clinical questions so that conclusiojn of the matter under investigation can made.
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Cont.…
According to the PICOT question, it is therefore clear and specific to the clinicians and other researchers in the medical field on the information that will be collected.
For one, there will need to identify patients suffering from GAD.
Second, will need to administer CBT and Antidepressants two groups of patients.
Third, they will measure the anxiety levels after 8 weeks of application of two types of the treatments.
Lastly, depending on results which, decision will be reached about which is most effective method that should be used to treat GAD.
In determining effectiveness of the method that is used, two groups are used where one is administered with CBT and another with antidepressants.
CBT is psychotherapy method of treatment while Antidepressants is medication method of treatment.
Essentially, data is collected and analysed for two cases which inform best EBP between medication and psychotherapy.
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Levels of evidences
First, from one source I leant of the importance of the Evidence Based Practice. It is important for the clinicians question relevancy and accuracy of the practices that they are using.
In 2020, it argued that 90% of the clinical decisions and practices that will be applied in the USA will be EBP and this underpins the importance of the EBP in the delivery of quality health care and also has high level of evidence (Melnyk et al…, 2009). In this article, it has level 1 evidence.
Article focuses on the EBP where nurses who engages in EBP are deemed to deliver quality care and also enhance job satisfaction (Melnyk et al…,2009).
Second, formulation of the PICOT clinical question is very important.
In nursing, level of evidence to studies based on quality of research design method that is used, validity and applicability to patient care.
Level I contains evidence from systematic reviews, meta-analyses of RCT or EBP clinical practice guidelines based on systematic reviews.
Level II -Evidence obtained from at least one well-designed RCT.
Level III- Evidence obtained from well-designed controlled trials without randomization.
Level IV-Evidence from well-designed case-control or cohort studies.
Level V-Evidence from systematic reviews of descriptive and qualitative studies.
Level VI-Evidence from a single descriptive or qualitative study.
Level VII-Evidence from the opinion of authorities and/or reports of expert committees.
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Cont.…
PICOT clinical must specifically identify the patient population whose is investigated, specific intervention that is will be used and under interrogation, alternative intervention or condition to be compared with primary intervention, desired outcome and timeframe upon which results investigation or research will be carried out (Stillwell et al…,2010; Davies, 2011).
In the two article, they have level 1 evidence. This is because in the according to Stillwell et al..,2010, use EBP to determine how PICOT clinical question should be developed while according to Davies (2011), consider formulation of the PICOT in various scenarios that support EBP.
Additionally, it look at refined strategies which is the basis for search of the data and information in the endeavor to come up with EBP.
Effectiveness of the research design and applicability to the patients care is the main reason that makes two articles to fall in classification of level 1 evidence.
Two methods provides information that is paramount and guides well in development of PICOT clinical question and EBP.
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Cont.…
Lastly, searching for evidence is important because quality and level of evidence will determine confidence that clinicians have in making decisions (Stillwell et al,2010). In this article, it has level 1 evidence. This is because it support by considering search strategies that should be employed to deliver EBP that will enhance quality delivery of care.
In general, four sources are critical because they guide on formulation of PICOT question and coming up with efficient and reliable EBP and have level 1 of evidences. They present evidence from EBP which are based on the systematic reviews.
Search strategies that are employed in searching for the information play critical role in developing EBP.
Correct search strategies ensure that relevant information is collected.
Level of the evidence is also dependent on the search strategies that are used.
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References
Davies, K. S. (2011). Formulating the evidence based practice question: a review of the frameworks. Evidence Based Library and Information Practice, 6(2), 75-80. Retrieved from https :// ejournals.library.ualberta.ca/index.php/EBLIP/article/viewFile/9741/8144
Melnyk, B. M., Fineout-Overholt, E., Stillwell, S. B., & Williamson, K. M. (2009). Evidence-based practice: Step by step: Igniting a spirit of inquiry. American Journal of Nursing, 109(11), 49–52. doi:10.1097/01.NAJ.0000363354.53883.58. Retrieved from https://journals.lww.com/ajnonline/fulltext/2009/11000/Evidence_Based_Practice__Step_by_Step__Igniting_a.28.aspx
Cont.…
Stillwell, S. B., Fineout-Overholt, E., Melnyk, B. M., & Williamson, K. M. (2010a). Evidence-based practice, step by step: Asking the clinical question: A key step in evidence-based practice. American Journal of Nursing, 110(3), 58–61. doi:10.1097/01.NAJ.0000368959.11129.79. Retrieved from https://journals.lww.com/ajnonline/Fulltext/2010/03000/Evidence_Based_Practice,_Step_by_Step__Asking_the.28.aspx
Stillwell, S. B., Fineout-Overholt, E., Melnyk, B. M., & Williamson, K. M. (2010b). Evidence-based practice, step by step: Searching for the evidence. American Journal of Nursing, 110(5), 41–47. doi:10.1097/01.NAJ.0000372071.24134.7e. Retrieved from https://journals.lww.com/ajnonline/Fulltext/2010/05000/Evidence_Based_Practice,_Step_by_Step__Searching.24.aspx
