PICOT Paper: Evidence-Based Practice Project

NUR 550 Benchmark – Evidence-Based Practice Project: PICOT Paper

NUR 550 Benchmark – Evidence-Based Practice Project: PICOT Paper

NUR 550 Benchmark – Evidence-Based Practice Project: PICOT Paper

Engaging in evidence-based practice (EBP) projects is among the most practical interventions for addressing health problems. Nurses use nursing interventions founded on research to enhance health outcomes. This paper describes the population, intervention, and expected outcome It also explains the implementation time and the application of nursing science, social determinants of health, and epidemiologic, genomic, and genetic data in supporting the health management of children with obesity.

Population’s Demographics and Health Concerns

The focus population for the project is children usually categorized as preschool-aged children (2-5 years) and school-aged children (6-11 years). Preschool-aged children are usually highly dependent on parents’ choices, including nutritional health, hobbies, and general lifestyle. As they move from pre-

school to school age, children become somewhat dependent on some choices. They start choosing hobbies and establish relationships that influence their daily habits.

Childhood obesity is a serious health concern in the United States whose prevalence is increasing and putting children at risk of poor health. Skinner et al. (2018) found that childhood obesity’s prevalence is still high in the US since 1 in every 5 children has obesity. As the prevalence of obesity increases, children are more exposed to immediate and long term risks of obesity. Vulnerability to heart disease, type 2 diabetes, and cancer is high in children with obesity (Lindberg et al., 2020). Overall, the quality of health declines and children are not productive as desired.

As the populace, government, and health care providers intensify measures to fight obesity, it is disappointing to experience a proportional risk in risk factors. According to Tester et al. (2018), lifestyle changes characterized by low physical activity are continuously exposing children to obesity. Fast foods’ consumption is another risk factor. Pearson et al. (2020) suggested that sedentary living characterized by too much screen time must be addressed to reduce childhood’s obesity prevalence. Gaming, watching television for extended periods, and social interaction through mobile phones can be blamed for the reduced physical activity among children. Regulation is necessary as parents, educators, and health care providers collaborate to encourage physical activity at homes, schools, and communities.

Evidence-Based Intervention

As proposed in the PICOT (Appendix 1), the identified intervention is educating parents and children on reducing screen time and increasing physical activity. Increased screen time increases obesity prevalence since it is associated with too much energy intake and low physical activity (Schwarzfischer et al., 2020). Educating parents and children is expected to trigger a positive behavior change as parents regulate children and children avoid spending too much time on the screens since they understand the implications. The intervention incorporates health policies and goals that support health equity for children since it focuses on ensuring that children attain their full health potential. Health equity is achieved when disadvantaged groups are protected from health disparities and helped to acquire a decent living standard. Keeping children free from obesity is a significant step towards achieving this critical goal.

Intervention Comparison to Previous Research

Previous research confirm that parents are responsible for modeling children’s behaviors by regulating screen time, and awareness to embrace this role is necessary. Pearson et al. (2020) found that shortage of parent- and home-focused interventions to address unhealthy behaviors such as intake of energy-dense snack foods and excessive screen time increases childhood obesity rates. Parental confidence and awareness of the association between screen time and unhealthy behaviors are also recommended. Goncalves et al. (2019) found that parental confidence and self-efficacy to reduce screen time is instrumental in addressing overweight problems among children. With research confirming the central role parents play in regulating screen time, it is essential to encourage them to embrace this critical role and serve as role models of healthy behaviors.

Expected Outcome

Educating parents and children on the implications of too much screen time is expected to be the foundation of behavior change. As a nursing intervention, the education program will improve knowledge on the connection between obesity in children and screen time as a risk factor. Minimizing screen time will lead to a proportional reduction in obesity rates among children, which has become a public health concern since its trend has taken an upward trajectory in the past decade (Skinner et al., 2018). The overall outcome is creating a healthy populace by reducing obesity rates among school-age children.

Time for Implementing and Evaluation

Implementation should be immediate. Since the focus population and intervention are known, parents and children’s education on screen time should be done instantly. Doing so will help to achieve the target objective within six months as proposed in the PICOT. Outcome evaluation will be progressive (monthly) and summative (after six months). Progressive evaluation will help to identify areas that need improvement, and summative evaluation will be used to deduce whether the target objectives were achieved.

Applying Nursing Science, SDOH, and Data

Population health management for children applies evidence, tools, and data from different sources. Nursing science helps to develop theories and practical concepts to manage conditions. It provides scientific ways to deliver better health services. Social determinants of health (SDOH) have much to do with living conditions. In this case, health care providers examine how environments where children are born and live, beliefs and socioeconomic status influence obesity and other illnesses and appropriate interventions. Epidemiological data is the basis for determining disease frequency and potential causes. Genomic and genetic data are closely related. Genomic data examines functional information in DNA as genetic data examines the acquired characteristics of children and their influence on health.

In conclusion, children deserve quality health and should be protected from vulnerabilities such as obesity. In response, nurses should use their knowledge and influence to promote quality public health. They should be centrally involved in identifying critical problems that hamper people’s productivity and invent lasting solutions. Addressing childhood obesity by educating parents and children on reducing screen time is an evidence-based lasting solution.

References

Goncalves, W. S. F., Byrne, R., Viana, M. T., & Trost, S. G. (2019). Parental influences on screen time and weight status among preschool children from Brazil: A cross-sectional study. International Journal of Behavioral Nutrition and Physical Activity, 16(1), 1-8. doi:

Lindberg, L., Danielsson, P., Persson, M., Marcus, C., & Hagman, E. (2020). Association of childhood obesity with risk of early all-cause and cause-specific mortality: A Swedish prospective cohort study. PLoS Medicine, 17(3), e1003078.

Pearson, N., Biddle, S. J., Griffiths, P., Sherar, L. B., McGeorge, S., & Haycraft, E. (2020). Reducing screen-time and unhealthy snacking in 9–11 year old children: the Kids FIRST pilot randomised controlled trial. BMC Public Health, 20(1), 1-14. doi: 

Schwarzfischer, P., Gruszfeld, D., Socha, P., Luque, V., Closa-Monasterolo, R., Rousseaux, D., … & Grote, V. (2020). Effects of screen time and playing outside on anthropometric measures in preschool aged children. PloS One, 15(3), e0229708. https://doi.org/10.1371/journal.pone.0229708

Tester, J. M., Phan, T. L. T., Tucker, J. M., Leung, C. W., Gillette, M. L. D., Sweeney, B. R., … & Eneli, I. U. (2018). Characteristics of children 2 to 5 years of age with severe obesity. Pediatrics, 141(3). doi: https://doi.org/10.1542/peds.2017-3228

Skinner, A. C., Ravanbakht, S. N., Skelton, J. A., Perrin, E. M., & Armstrong, S. C. (2018). Prevalence of obesity and severe obesity in US children, 1999–2016. Pediatrics, 141(3).

Benchmark – Evidence-Based Practice Project: PICOT Paper

Refer to the PICOT you developed for your evidence-based practice project proposal. If your PICOT required revision, include those revisions in this assignment. You will use your PICOT paper for all subsequent assignments you develop as part of your evidence-based practice project proposal in this course and in NUR-590, during which you will synthesize all of the sections into a final written paper detailing your evidence-based practice project proposal.

Write a 750-1,000-word paper that describes your PICOT.

1. Describe the population’s demographics and health concerns.
2. Describe the proposed evidence-based intervention and explain how your proposed intervention incorporates health policies and goals that support health care equity for the population of focus.
3. Compare your intervention to previous practice or research.
4. Explain what the expected outcome is for the intervention.
5. Describe the time for implementing the intervention and evaluating the outcome.
6. Explain how nursing science, social determinants of health, and epidemiologic, genomic, and genetic data are applied or synthesized to support population health management for the selected population.
7. Create an Appendix for your paper and attach the PICOT. Be sure to review feedback from your previous submission and revise your PICOT accordingly.
8. Complete the “APA Writing Checklist” to ensure that your paper adheres to APA style and formatting criteria and general guidelines for academic writing. Include the completed checklist as the final appendix at the end of your paper.

Refer to the “Evidence-Based Practice Project Proposal – Assignment Overview” document for an overview of the evidence-based practice project proposal assignments.

You are required to cite at least four to six peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.

Benchmark Information

This benchmark assignment assesses the following programmatic competencies:

MBA-MSN; MSN-Nursing Education; MSN Acute Care Nurse Practitioner-Adult-Gerontology; MSN Family Nurse Practitioner; MSN-Health Informatics; MSN-Health Care Quality and Patient Safety; MSN-Leadership in Health Care Systems; MSN-Public Health Nursing

MS Nursing: Public Health

MS Nursing: Education

MS Nursing: Acute Care Nurse Practitioner

MS Nursing: Family Nurse Practitioner

MS Nursing: Health Care Quality and Patient Safety

4.1: Synthesize nursing science, determinants of health, and epidemiologic, genomic, and genetic data in the management of population health.

Course Code Class Code Assignment Title Total Points
NUR-550 NUR-550-O503 Benchmark – Evidence-Based Practice Project: PICOT Paper 150.0

Criteria Percentage Unsatisfactory (0.00%) Less Than Satisfactory (80.00%) Satisfactory (88.00%) Good (92.00%) Excellent (100.00%)
Content 70.0%
Population Demographics and Health Concerns 5.0% The demographics and health concerns for the population are not described. The demographics and health concerns for the population are incorrect or only partially described. The demographics and health concerns for the population are summarized. More information and supporting evidence are needed. The demographics and health concerns for the population are described using sufficient evidence. The demographics and health concerns for the population are accurate and thoroughly described using substantial evidence.

Proposed Evidence-Based Intervention 13.0% The proposed evidence-based intervention is omitted. The proposed evidence-based intervention is incomplete. It is unclear how the proposed intervention incorporates health policies and goals that support health care equity for the population of focus. The proposed evidence-based intervention is outlined. Explanation of how the proposed intervention incorporates health policies and goals that support health care equity for the population of focus is general. Some aspects are unclear. More information is needed. The proposed evidence-based intervention is described. Explanation of how the proposed intervention incorporates health policies and goals that support health care equity for the population of focus is adequate. Some detail is needed for clarity or accuracy. The proposed evidence-based intervention is well-developed and clearly described. Explanation of how the proposed intervention incorporates health policies and goals that support health care equity for the population of focus is thorough.

Comparison of Intervention to Current Research 12.0% Comparison of intervention to previous practice or research is omitted. Comparison of intervention to previous practice or research is incomplete. Comparison of intervention to previous practice or research is generally presented. Some areas are vague. Comparison of intervention to previous practice or research is adequately presented. Comparison of intervention to previous practice or research is thorough and clearly presented.

Expected Outcome for Intervention 10.0% The expected outcome is for the intervention is omitted. The expected outcome is for the intervention is incomplete. The expected outcome is for the intervention is summarized. More information and supporting evidence is needed. The expected outcome for the intervention is explained using sufficient evidence. The expected outcome for the intervention is thoroughly explained using substantial evidence.

Required Sources 5.0% Sources are not included. Number of required sources is only partially met. Number of required sources is met, but sources are outdated or inappropriate. Number of required sources is met. Sources are current, but not all sources are appropriate for the assignment criteria and nursing content. Number of required resources is met. Sources are current and appropriate for the assignment criteria and nursing content.

Time Estimated for Implementing Intervention and Evaluating Outcome 10.0% A description of the timeline is not included. A description of the timeline is incomplete or incorrect. A description of the timeline is included but lacks evidence. A description of the timelines is complete and includes a sufficient amount of evidence. A description of the timeline is extremely thorough with substantial evidence.

Support for Population Health Management for Selected Population (C 4.1) 10.0% Explanation of how nursing science; social determinants of health; and epidemiologic, genomic, and genetic data are applied or synthesized to support population health management for the selected population is omitted. Explanation of how nursing science; social determinants of health; and epidemiologic, genomic, and genetic data are applied or synthesized to support population health management for the selected population is incomplete. There are major inaccuracies. Explanation of how nursing science; social determinants of health; and epidemiologic, genomic, and genetic data are applied or synthesized to support population health management for the selected population is summarized. More information and support are needed. Explanation of how nursing science; social determinants of health; and epidemiologic, genomic, and genetic data are applied or synthesized to support population health management for the selected population is adequate. Some detail is needed for accuracy or clarity. Explanation of how nursing science; social determinants of health; and epidemiologic, genomic, and genetic data are applied or synthesized to support population health management for the selected population is thorough. The narrative is insightful and demonstrates an understanding of how the various aspects contribute to population health management for selected populations.

Appendix 5.0% The appendix and required resources are omitted. The APA Writing Checklist and PICOT are attached, but an appendix has not been created. The paper does not reflect the use of the APA Writing Checklist during development. The APA Writing Checklist and PICOT are attached in the appendix. The APA Writing Checklist was generally used in development of the paper, but some aspects are inconsistent with the paper format or quality. The APA Writing Checklist and PICOT are attached in the appendix. It is apparent that the APA Writing Checklist was used in development of the paper. The APA Writing Checklist and PICOT are attached in the appendix. It is clearly evident by the quality of the paper that the APA Writing Checklist was used in development.

 

Organization and Effectiveness 20.0%
Thesis Development and Purpose 7.0% Paper lacks any discernible overall purpose or organizing claim. Thesis is insufficiently developed or vague. Purpose is not clear. Thesis is apparent and appropriate to purpose. Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose. Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.

Argument Logic and Construction 8.0% Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources. Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility. Argument is orderly, but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis. Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative. Clear and convincing argument that presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.

Mechanics of Writing (includes spelling, punctuation, grammar, language use) 5.0% Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used. Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) or word choice are present. Sentence structure is correct but not varied. Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct and varied sentence structure and audience-appropriate language are employed. Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech. Writer is clearly in command of standard, written, academic English.

Format 10.0%
Paper Format (Use of appropriate style for the major and assignment) 5.0% Template is not used appropriately or documentation format is rarely followed correctly. Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent. Template is used, and formatting is correct, although some minor errors may be present. Template is fully used; There are virtually no errors in formatting style. All format elements are correct.

Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style) 5.0% Sources are not documented. Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors. Sources are documented, as appropriate to assignment and style, although some formatting errors may be present. Sources are documented, as appropriate to assignment and style, and format is mostly correct. Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.

Topic 3 DQ 1

Discuss the ethical guidelines that would need to be implemented when conducting translational research. What are the ethical and legal considerations related to translating research into practice? Discuss what steps you would take as a member of a translational research team in order to establish ethical guidelines for conducting translational research.

Re: Topic 3 DQ 1

Many authors argue ethical issues faced by translational research are like the ones observed in basic clinical research, yet are diverse and complex (Mandal et al., 2017). Various ethical challenges depend on the various phases of the process. Like biomedical research, ethics such as informed consent, animal bioethics, conflicts of interest, social injustice, and risk analysis are part of the research process. During gaps, data transfer can suffer ethical issues with confidentiality. Resource and funding can also pose ethical issues, especially during the preapproval phase of the research. Financial interconnections between research scientists and fund supporters can act as cofounders due to patent issues, leading to such issues as nondisclosure risk information to participants and negative results in publications. Resource-rich countries researching resource-poor countries, while common, give rise to social injustice and disparity, especially when results are not expected to benefit the resource-poor country. One example includes research on diseases that result in inventions or products too expensive for developing countries to implement. Fund allocations tend to favor research processes with a higher chance of success and commercialization than those with a higher impact on public health but have fewer chances for success or are difficult to conduct.  Translational research ethics, a distinct field of biomedical ethics, is not completely new, but issues are necessary to identify and prevent unethical practices (Mandal et al., 2017). The priority should be the well-being of the research participants and to society rather than of the advancement of knowledge.

Amid rapidly developing technology, healthcare providers, including nurses, have a professional and social responsibility to ensure fairness and equity to patients, families, and communities (Badzek et al., 2013). Nurses should be mindful of and understand basic principles of ethics and laws surrounding human rights and the duty to warn, as it pertains to healthcare provider obligations.

Resources

Badzek, L., Henaghan, M., Turner, M. and Monsen, R. (2013), Ethical, legal, and social issues in the translation of genomics into health care. Journal of Nursing Scholarship, 45: 15-24. 

Mandal, J., Ponnambath, D. K., & Parija, S. C. (2017). Ethics of translational medical research. Tropical parasitology, 7(2), 62–64. https://doi.org/10.4103/tp.TP_47_17

Topic 3 DQ 2

Discuss the role of the Institutional Review Board. Discuss ethical research considerations specific to population health. How are respect for the persons, potential benefits and burdens of the research, and justice kept in balance? Provide an example.

Re: Topic 3 DQ 2

The Institutional Review Board (IRB) functions under the authority of the Federal Drug Administration (FDA) and is responsible for approving, rejecting, or requiring changes in a research study in order to gain approval (Parker, 2016). The IRB’s primary goal is to protect the rights, welfare, and security of the research subjects. Therefore, all research studies that involve human subjects must first seek approval from the IRB before implementation, although there are exceptions to this policy. Failure to seek approval from the IRB will result in disapproval and the results and data will be restricted from publication in a peer-reviewed journal (Parker, 2016).

Because there are multiple factors that influence the development of diseases in certain populations such as genetic, biological, environmental, and one’s lifestyle, it is vital that research is conducted to investigate causes and find solutions. Moreover, the research must be consistent and transparent in all phases with adherence to regulatory standards. In population health research, because some populations (elderly, minorities, disabled, etc.) are deemed vulnerable or disadvantaged, it is essential that additional safeguards are implemented to protect their rights and safety (Al Tajir, 2018).

Clinical researchers are obligated to adhere to ethical principles as delineated in the Belmont Report (Al Tajir, 2018). The principles of beneficence along with non-maleficence, respect, and justice are applied to informed consent, the evaluation of risks and benefits in research, and the selection of research participants (Al Tajir, 2018). Furthermore, in population health, there are additional ethical considerations because of the complexities involved, for example, in natural disasters and disease outbreaks (Al Tajir, 2018). To protect participants involved in a study, a risk-benefit analysis must be conducted (Al Tajir, 2018). A risk-benefit analysis is evaluation of the potential risks versus the benefits to the participants and the community (Al Tajir, 2018). When recruiting subjects for research, one should be mindful that all eligible participants’ health and welfare are equally important and should not be denied participation in research based on age, sex or race (Al Tajir, 2016). However, this provision may not apply to all situations. For example, I was enrolled in a clinical study that involved participants who were considered overweight or obese based on body mass index (BMI). The recruitment was fair and not discriminatory because the research drug was being studied for its efficacy in the treatment of obesity. Therefore, people who were not considered obese were excluded because they would not receive direct benefit from the study.

References

Al Tajir, G. K. (2018). Ethical treatment of participants in public health research. Journal of Public Health and Emergency, 2, 2-2. 

Parker G. E. (2016). A framework for navigating institutional review board (IRB) oversight in the complicated zone of research. Cureus, 8(10), e844.