Nowadays, the number of older adults increases all over the world caused by longer life expectancy and lower birth rates. The aging population tends to be more prone to various chronic diseases such as diabetes, obesity, and cardiovascular issues. The mentioned diseases are among the most critical conditions that promote the emergence of pressure ulcers, especially in recumbent patients (Parnham, Pankhurst, & Dabell, 2015).
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While some of them are hospitalized to manage their diseases, others are homebound, and their family members become their primary caregivers. However, it may be rather challenging to care for such patients since the latter have no special education and experience. Riva, Malik, Burnie, Endicott, and Busse (2012) consider that it is expected that clinicians should conduct research to practice evidence-based interventions. To explore this area of interest, it seems appropriate to create a PICOT question.
In-home care, nurses manage their patients by visiting them periodically, while family members provide the most of the required services. Therefore, the family needs to timely recognize the early signs of pressure ulcers and, most importantly, try to prevent them to avoid complications. In their article, Low, Ng, Tan, and Vasanwala (2016) state that many families consider that pressure ulcers are normal since their family member has to sit or lay in the same position for a long time.
Another widespread misunderstanding is associated with the fact that caregivers perceive pressure ulcers as the expected result of poor circulation. In other words, it becomes evident that there is a need to increase awareness among those who care for homebound patients to assist them in understanding how to better manage them.
Given the needs discussed above, the following PICOT question may be formulated:
- (P) – Population: Homebound older adults with a high risk of pressure ulcers;
- (I) – Intervention: A caregiver awareness increase program provided to families;
- (C) – Comparison: A standardized care of family members without any special program;
- (O) – Outcome: Decrease in the incidence of pressure ulcers measured by the number of cases;
- (T) – Time: The outcome is to be evaluated after six months from the intervention implementation.
PICOT: Will in homebound older adults with a high risk of pressure ulcers a caregiver awareness increase program provided to families decrease in the incidence of pressure ulcers in six months?
In consistence with the structure of the PICOT framework, this question comprises all the aspects required to properly evaluate the situation. In particular, older adults are selected as the target population since they are most vulnerable to pressure ulcers due to their age and chronic diseases. The chosen intervention seems to be relevant to modern conditions when prevention is declared as one of the main priorities in healthcare.
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Also, it is pertinent to advanced nursing practice, one of the aims of which is to increase the quality of care. Parnham et al. (2015) state that pressure ulcers are an avoidable problem that cannot be addressed without new strategies. The comparison with traditional care for homebound patients will demonstrate the difference in their outcomes measured in the incidence rates. Half a year is identified as the timeframe since this period will show initial changes, which can be extended if required. Thus, the described PICOT question will be important for revealing how special awareness increases program will impact patients at risk of pressure ulcers and, accordingly, improve their quality of life.
Low, S. G., Ng, L. C. L., Tan, J. S. W., & Vasanwala, F. F. (2016). How to care for homebound patients? Proceedings of Singapore Healthcare, 25(3), 181-184.
Parnham, A., Pankhurst, S., & Dabell, W. (2015). Reducing avoidable pressure ulcers in the community. Nursing Standard (2014+), 29(26), 62-70.
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 format for clinicians. The Journal of the Canadian Chiropractic Association, 56(3), 167-171.