PICOT Question and Clinical Problem Scenario Essay.

PICOT Question and Clinical Problem Scenario Essay.

 

My instructor gave is a template in APA format to create a PICOT Queston and clinical problem scenario. I dont have a topic and the patient is due tonight ID & Describe a Clinical Problem Identify and describe a clinical problem that has occurred or is occurring in your practice setting.PICOT Question and Clinical Problem Scenario Essay.

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Describe the problem/scenario in 1 or 2 paragraphs. Use keywords in your description that clearly outline what is occurring and why it is a problem for nurses, nursing care, and patients. Your PICOT question will be the FIRST STEP in a series of assignments as you progress through the course. 35.0 pts This criterion is linked to a Learning Outcome Compose the PICOT Question Compose your PICOT question using keywords which reflect the population, intervention, comparison to current practice, and outcome being considered. 30.0 pts This criterion is linked to a Learning Outcome Diagram the PICOT Diagram your PICOT question and identify each element or part of the question.PICOT Question and Clinical Problem Scenario Essay.

Identification of Clinical Problem
The most significant clinical problem witnessed in the author’s organization is HAIs (Healthcare-Associated Infections), particularly VAP (Ventilator-Associated Pneumonia). It has negatively impacted the organization’s financial performance, increased healthcare-related costs, and prolongs ICU los. It has thus become a priority area for the organization to address to safeguard patient safety and provide quality care.PICOT Question and Clinical Problem Scenario Essay.
Description of Clinical Problem
According to Enwere et al. (2016), more than 200,000 patients in the US undergo mechanical ventilation annually, increasing their risk of VAP. It usually presents within 48 hours of intubation in the initial four days of ventilation. The researchers further estimate that more than 15% of mechanically ventilated patients are likely to have VAP which ultimately prolongs hospital los, increases healthcare-related costs and for those who survive admission, it increases their disability risk (Enwere et al., 2016). In the author’s organization, previous efforts to decrease VAP development used to focus on trials for spontaneous breathing, prophylaxis for venous thromboembolism and stress ulcers, oral, hygiene, breathing trials, and elevating the head of the bed. However, we still recorded high incidences of VAP. However, Villar et al. (2016) highlight that; an integral factor to consider about the occurrence of VAP is the colonization of the oropharynx, which providers can address through proper oral hygiene.PICOT Question and Clinical Problem Scenario Essay.
Enwere et al. (2016) recommends the use of oral chlorhexidine, which is a topical antibiotic active against gram-negative and positive organisms and has proven to be highly efficacious in preventing VAP. More specifically, the use of oral chlorhexidine 0.12% reduced the rates of nosocomial infections and VAP incidences significantly. Similarly, the SCCM (Society of Critical Care Medicine) highly recommends using VAP bundles. Part of this bundle includes oral chlorhexidine for oral hygiene. Zuckerman (2016) emphasizes this further by highlighting that, before using oral chlorhexidine, providers must comprehend its appropriate use. PICOT Question and Clinical Problem Scenario Essay.He further states that it is administered by mouth using a sponge swab, which is wiped, round the oral cavity of all patients under ventilation. Providers must initiate therapy immediately after intubation and progress until extubation and applied four times every day.
PICOT Question and Identification of Key Terms
PICOT Question: Among mechanically ventilated patients in the ICU aged 18 years or older, does the use of oral chlorhexidine gluconate compared to no chlorhexidine gluconate prevent VAP within six weeks?
Key terms: VAP, chlorhexidine, ICU
Diagram of PICOT Question
Population Mechanically ventilated patients in the ICU aged 18 years or older
Intervention Oral chlorhexidine gluconate
Comparison No use of oral chlorhexidine gluconate
Outcome prevent VAP
Time 6 weeks

References
Enwere, E. N., Elofson, K. A., Forbes, R. C., & Gerlach, A. T. (2016). Impact of chlorhexidine mouthwash prophylaxis on probable ventilator-associated pneumonia in a surgical intensive care unit. International Journal of Critical Illness and Injury Science, 6(1), 3.PICOT Question and Clinical Problem Scenario Essay.
Villar, C. C., Pannuti, C. M., Nery, D. M., Morillo, C. M., Carmona, M. J. C., & Romito, G. A. (2016). Effectiveness of intraoral chlorhexidine protocols in the prevention of ventilator-associated pneumonia: a meta-analysis and systematic review. Respiratory care, 61(9), 1245-1259.
Zuckerman, L. M. (2016). Oral chlorhexidine use to prevent ventilator-associated pneumonia in adults: a review of the current literature. Dimensions of Critical Care Nursing, 35(1), 25-36.PICOT Question and Clinical Problem Scenario Essay.