Case Study

Student 1

· When reviewing the case study there are a many key points that are discussed in

regards recovering from a pediatric cardiac surgery and the risk for a cardiac tamponade after

the removal of a pulmonary artery catheter. There are a few pieces of information in this case

study that are critical in determining how one would find the evidence, that is most

appropriate, to determine how a complication, such as a cardiac tamponade, could occur in an

infant only four days after an operative procedure. The key clues include: an infant who is

four days postoperative after a cardiac surgery, abnormal clotting profile, removal of a

pulmonary artery catheter with drainage and ooze, followed by a deterioration in the patient’s

status, which ultimately leads to a diagnosis of a cardiac tamponade (Melnyk & Fineout-

Overholt, 2015). To enhance the likelihood of the most reliable evidence and helpful research,

one would use a PICOT formation, to formulate a research question. The P in PICOT stands

for the population at interest (Melnyk & Fineout-Overholt, 2015). In this case study, the

population the study is aiming toward is an infant four days postoperative (Melnyk & Fineout-

Overholt, 2015). The next searchable topic would be the I, C, and O, which would indicate the

issue at hand, the comparison of that issue, and the affect this event would have on the

outcome; this would include questioning the frequency of removing a pulmonary artery

catheter, or not removing the catheter, and the affects this procedure has on influencing a

cardiac tamponade (Melnyk & Fineout-Overholt, 2015). The next, and final step would be to

determine the T, which delivers a timeline for an event to occur (Melnyk & Fineout-Overholt,

2015). In this case study, the timeline would be four days after surgery, which one would

possibly be able to broaden to a week, to better serve research results. In a study conducted in

· 2012, the authors described the importance of formulating a comprehensive PICOT when

researching a topic at hand (Riva et al.). This study discovered that the more detailed and

specific a PICOT was, the more evidence and research was exposed to better enhance the

topic of understanding (Riva et al., 2012). This study also concluded, the more likely the

researchers used the PICOT formation, the more likely one would develop a more appropriate

and specific research yield (Riva et al., 2012). With all this information, the most suitable

PICOT formulated question, to determine the likelihood of an event similar to this would be:

In an infant who recently had cardiac surgery, what is the frequency of cases regarding the

removal of a pulmonary artery catheter, versus not removing the catheter within a week, have

on the affect of developing a cardiac tamponade within the first week of surgery? This

formation of questions and information would best suit the research topic at hand.

References

· Melnyk, B. M., & Fineout-Overholt, E. (2015). Evidence-based practice in nursing &

healthcare: A guide to best practice (3rd edition). Philadelphia, PA: Wolters Kluwer

Health.

Riva, J. J., Malik, K. M., Burnie, S. J., Endicott, A. R., & Busse, J. W. (2012). What is your

research question? An introduction to the PICOT formation for clinicians. Journal of

the Canadian Chiropractic Association, 56(3), 167-171. Retrieved from

http://eds.b.ebscohost.com.lib.kaplan.edu/eds/pdfviewer/pdfviewer?

vid=4&sid=7a00d36e-280b-4d06-9d43-9e7bc0f137e1%40sessionmgr104