Introduction
Nursing practice is no longer just an auxiliary function and is complementary to the attending physician’s work, and the staff in this area is becoming increasingly important to the clinical environment. To a large extent, this is achieved by expanding the range of tasks attributed to the modern nurse (“The role,” 2017). Thus, in addition to traditional work formats, a qualified nurse can independently diagnose a patient and prescribe treatment based on evidence-based practice. Of great importance for the successful and effective implementation of these actions is the PICOT question, which systematizes and summarizes known assumptions about the clinical environment.
PICOT
For patients requiring constant 24-hour nursing care, will full nursing support, compared to scheduled one, be effective for a faster recovery within one month?
Description
Some patients require close supervision, as even natural physiological needs can be difficult to meet. For example, a nurse often needs to perform feeding and hygiene of an incapacitated patient. Due to the general problem of shortage of nurses in the USA, it is advisable to examine whether this almost round-the-clock support of patients brings results or only takes up valuable resources of time (Friedrich, 2017). Thorough research requires the development of a methodology, the evaluation of results, and their interpretation.
In order to find an evidence-based solution to this problem, it was proposed to conduct an evaluation on two groups of patients with different degrees of care. Thus, the first group should permanently receive the whole necessary range of medical services, while the second group only periodically, according to the schedule. Thus, the depth of interaction between nurse and patient is a controlled variable. More specifically, such nursing interventions can include regular health monitoring, medication reminders, nutrition, hygiene monitoring, meeting the need for communication, and teaching the patient the necessary foundations for a more stable recovery. On the contrary, scheduled work offers periodic patient monitoring, for example, once per hour, to meet the patient’s current needs.
In order to achieve high reliability of the results, it is important to consider the patient’s diagnosis, because if there are great differences between the two groups of patients — and thus the degree of care required — the data will therefore not be representative. Thus, both groups should have similar signs of disease and need similar care. Meanwhile, particular attention should be given to the discussion of patient turnover. The average time spent by patients in the clinic is 4.5 days (“Decreasing,” 2020; “How long is,” 2020). In other words, during the control month, a nurse can serve at least six patients. It is crucial to avoid that this turnover affects the results of the study: new patients should be informed about the current experiment.
Finally, an important discussion should focus on the nature of the assessment, which signals a correlation between the depth of nursing care and the recovery of patients. For the study’s width, it is suggested to measure several control variables at once, the examination of which can answer the question posed by PICOT. In addition, the diversity of data collected may have the potential to open up some of the non-targeted trends, which is also a significant advantage of this approach. Thus, the first thing to do is to measure and compare patient time spent in the clinic. In the group where this time was minimal, all other variables being equal, care was most effective. Secondly, it is necessary to survey nurses, which will show how their nature of the intervention affects the workload and stress. It is expected that 24-hour patient management takes more energy and effort from nurses. In addition, the opinion of patients about their treatment will be a useful metric: if the survey shows that patients were dissatisfied with the periodic nature of the observation, it could therefore hurt their treatment and the reputation of the clinic. Finally, the evaluation of clinical resources that were spent by nurses on 24-hour care is interesting data. Summarizing these data and interpreting them, it is possible to conclude whether virtually permanent nursing support for patients is appropriate or whether there is enough work on schedule.
References
Decreasing the patient length of stay. (2020). Centrak.
Friedrich, B. (2017). What happens to patient care when there are not enough nurses? KeloggInsight.
How long is a hospital stay on average in the EU? (2020). EuroStat.
The role of a professional nurse today. (2017). State.