NURS FPX 4030 Assessment 3 Picot Questions and an Evidence Based Approach

NURS FPX 4030 Assessment 3 Picot Questions and an Evidence Based Approach

Name

Capella University

NURS-FPX 4030 Making Evidence-Based Decisions

Prof. Name

Date

PICO(T) Questions and an Evidence-Based Approach

Healthcare issues can be more effectively examined and addressed using the PICOT question strategy, which stands for Population, Intervention, Comparison of Strategies, Outcomes, and Time frame. This method allows nurses to compare different approaches and perform comprehensive research to identify the most useful and practical evidence for resolving healthcare issues for a particular patient or population (McClinton, 2022). This assessment will utilize the PICOT question approach to investigate a specific healthcare issue and evaluate evidence-based care practices that are best suited to address the problem.

Exploring the Healthcare Issue with the PICOT Approach

Urinary Tract Infections (UTIs) are a common and significant healthcare issue that can lead to severe complications if not effectively managed. Exploring UTIs using the PICOT approach allows for a structured and comprehensive analysis to identify the most effective interventions for prevention and treatment. The societal costs associated with UTIs, including healthcare expenses, are estimated to be around US$3.5 billion annually in the United States. This highlights the urgency of addressing UTIs efficiently (Pinto et al., 2021).

A specific PICOT-formatted research question for this issue is: 

In adult patients prone to recurrent urinary tract infections (Population), does the use of cranberry supplements (Intervention) compared to antibiotics (Comparison) reduce the recurrence rate of UTIs (Outcome) over 6 months (Time-Frame)? 

 Using the PICOT approach benefits the exploration of UTIs in several ways. It ensures that the research is focused and specific, helping to identify relevant studies and data that directly address the issue of UTI recurrence. By clearly defining the intervention and comparison, the approach allows for a direct comparison of the effectiveness of different treatment strategies. The emphasis on measurable outcomes, in this case, the recurrence rate of UTIs, facilitates an evidence-based assessment of the intervention’s success. Specifying a 6-month time frame provides a precise period for evaluating the effectiveness of the interventions, ensuring the results are timely and relevant. Focusing on adult patients prone to recurrent UTIs helps tailor the interventions to the needs of this specific group, potentially improving patient care and outcomes. By exploring UTIs through the PICOT approach, healthcare providers can systematically review and implement the most effective evidence-based practices, ultimately enhancing patient care and reducing the burden of UTIs (Cai, 2021).

Sources of Evidence to Answer PICO(T) Question

One can explore various evidence-based resources using different databases, journals, and websites. To gather substantial evidence on urinary tract infections (UTIs) and their treatment, valuable databases include Google Scholar, PubMed, ProQuest, Cochrane Library, CINAHL, MEDLINE, and the Capella University Library. Specific journals for UTI research include the “International Journal of Urological Nursing,” “American Urological Association (AUA),” “American Journal of Kidney Diseases,” and “Clinical Kidney Journal.” These journals feature evidence-based studies on UTIs and related topics. Useful websites for answering the PICOT question on UTIs include those of the American Urological Association (AUA), the Centers for Disease Control and Prevention (CDC), and the World Health Organization (WHO).

The CRAAP criteria, which stand for Currency, Relevance, Authority, Accuracy, and Purpose, are used to assess the potential of these sources to answer the PICOT question. These criteria help nurses evaluate the relevance and reliability of a resource for their research (Muis et al., 2022). Applying these criteria to the PICOT question ensures that the selected resources provide current, pertinent, and accurate information from credible and intentional publications, effectively supporting evidence-based practice in managing UTIs.

 Findings from Articles or Evidence-Based Sources

Research on cranberry supplementation for prevention of urinary tract infection (UTI) reveals promising results. A prospective study observed a significant decrease in UTI frequency among women taking cranberry supplements over six months and a notable reduction in antibiotic use. Over six months, participants reported a significant decrease in UTIs from 2.2 to 0.5 on average and a 68% reduction in antibiotic use (Jeitler et al., 2022).  This study’s controlled design and significant findings highlight cranberry’s potential efficacy in UTI prevention. Additionally, patient surveys indicate widespread use of cranberry supplements for RUTI prevention, particularly among younger age groups (de Llano et al., 2020). Another meta-analysis focused on outcome-specific measures and found promising results. It revealed that cranberry extract significantly reduced the risk of recurrent UTIs by 30%, specifically for culture-confirmed UTIs.

These findings corroborate previous research indicating cranberry’s potential effectiveness in UTI prevention (Havranova et al., 2020). A review article discussed various non-antimicrobial and non-pharmacologic strategies for preventing recurrent UTIs, including cranberry products, D-mannose, probiotics, and behavioural modifications. The review highlighted the limited evidence from observational studies and small randomized trials, raising concerns about product purity and potential interactions of over-the-counter nutraceuticals (Finney et al., 2022). All of these evidence-based resources are deemed credible as they satisfy the CRAAP criteria and offer relevant information about urinary tract infections (UTIs) and the PICOT question.

Relevance of Findings and Decision-Making

The findings from the chosen sources of evidence provide valuable insights into making decisions related to a PICOT(T) question concerning urinary tract infections (UTIs) and their prevention. The prospective study by Jeitler et al. (2022) highlights the significant decrease in UTI frequency among women taking cranberry supplements over six months and a notable reduction in antibiotic use. This controlled study design and its significant findings underscore cranberry’s potential efficacy in UTI prevention, making it a highly relevant and likely contributor to positive outcomes. Similarly, patient surveys conducted by de Llano et al. (2020) indicate widespread use of cranberry supplements for recurrent UTI prevention, particularly among younger age groups.

This real-world evidence supports the practical utility and acceptance of cranberry supplementation as a preventive measure against UTIs, adding to its relevance and potential for positive outcomes. Furthermore, the meta-analysis by Havranova et al. (2020) emphasizes the effectiveness of cranberry extract in reducing the risk of recurrent UTIs by 30%, particularly for culture-confirmed UTIs. These findings corroborate previous research, strengthening the case for cranberry supplementation as an effective strategy for UTI prevention. 

However, it’s essential to consider the review article by Finney et al. (2022), which highlights the limited evidence from observational studies and small randomized trials on non-antimicrobial and non-pharmacologic strategies for preventing recurrent UTIs. This cautious perspective reminds us to evaluate the available evidence and potential limitations when deciding on UTI prevention strategies. Overall, the findings from these sources collectively underscore the relevance and possible positive outcomes associated with cranberry supplementation as a preventive measure against recurrent UTIs. The prospective study, patient surveys, and meta-analysis findings provide robust evidence supporting the efficacy of cranberry supplementation.

Conclusion

In conclusion, the PICOT framework, combined with evidence-based research, offers crucial insights into addressing healthcare challenges like UTIs. The evidence presented, including studies and surveys, underscores the potential of cranberry supplementation in reducing UTI recurrence rates. While promising, it’s essential to acknowledge research limitations. By synthesizing diverse evidence, healthcare providers can make informed decisions to improve patient care and mitigate the UTI burden effectively.

References

Cai, T. (2021). Recurrent uncomplicated urinary tract infections: Definitions and risk factors. GMS Infectious Diseases, 9(3). https://doi.org/10.3205/id000072 

de Llano, D. G., Moreno-Arribas, M. V., & Bartolomé, B. (2020). Cranberry polyphenols and prevention against urinary tract infections: Relevant considerations. Molecules, 25(15), 3523. https://doi.org/10.3390/molecules25153523 

Finney, E. L., Pagura, E. J., & MacLachlan, L. S. (2022). Efficacy and safety of alternative treatments for the prevention of recurrent urinary tract infections. Current Bladder Dysfunction Reports, 18(1), 42–50. https://doi.org/10.1007/s11884-022-00678-z 

Havranova, J., Cardio, S., Krinock, M., Widawski, M., Sluder, R., Kumar, A., Hippen, J., & Goel, H. (2020). Cranberry extract for preventing recurrent urinary tract infections: An outcome-specific meta-analysis of prospective trials. Journal of Womens Health and Development, 3(3), 222–242. https://www.fortuneonline.org/articles/cranberry-extract-for-preventing-recurrent-urinary-tract-infections-an-outcomespecific-metaanalysis-of-prospective-trials.html?url=cranberry-extract-for-preventing-recurrent-urinary-tract-infections-an-outcomespecific-metaanalysis-of-prospective-trials 

NURS FPX 4030 Assessment 3 Picot Questions and an Evidence Based Approach

Jeitler, M., Michalsen, A., Schwiertz, A., Kessler, C. S., Koppold-Liebscher, D., Grasme, J., Kandil, F. I., & Steckhan, N. (2022). Effects of a supplement containing a cranberry extract on recurrent urinary tract infections and intestinal microbiota: A prospective, uncontrolled exploratory study. Journal of Integrative and Complementary Medicine, 28(5), 399–406. https://doi.org/10.1089/jicm.2021.0300

Muis, K. R., Denton, C., & Dubé, A. (2022). Identifying CRAAP on the internet: A source evaluation intervention. Advances in Social Sciences Research Journal, 9(7), 239–265. https://doi.org/10.14738/assrj.97.12670

Pinto, H., Simões, M., & Borges, A. (2021). Prevalence and impact of biofilms on bloodstream and urinary tract infections: A systematic review and meta-analysis. Antibiotics, 10(7), 825. https://doi.org/10.3390/antibiotics10070825