Introduction to Quality and Safety Education for Nurses Essay

Introduction to Quality and Safety Education for Nurses Essay

PICO(T) Question

Chronic illnesses are on the rise globally, owing to an aging population and changes in lifestyle behaviors such as exposure to unhealthy diets and a lack of physical activity. Hypertension, a chronic condition, and the leading preventable risk factor for cardiovascular disease (Mills et al., 2020), is a major cause of morbidity, mortality, and economic burden. According to Mills et al. (2020), hypertension affected 31.1% (1.39 billion) of the world’s adult population in 2010. The World Health Organization (2021) estimates that 1.28 billion adults aged 30-79 years have hypertension worldwide, with the majority living in low- and middle-income countries. In terms of mortality, in 2010, the estimated number of all-cause deaths associated with systolic BP ≥110–115 mmHg was 10.7 million (19.2% of all deaths) and with systolic BP≥140 mm Hg was 7.8 million-14.0% of all deaths (Mills et al., 2020). Furthermore, Kirkland et al. (2018) report that in a 12-year pooled data set from 2003 to 2014, the unadjusted mean annual medical expenditure (all inflated to 2016 US dollars) attributable to hypertension patients was $9089, making it a costly condition to manage. All of the factors-morbidity, mortality, and cost-make hypertension a hot topic in health, and clinicians are constantly looking for effective interventions, which is why it was chosen for the subsequent PICO(T) discussion.

The PICO(T) Question

            Among adult hypertensive patients (P), does the telemedical approach to care (I) compared to the standard care/regular outpatient clinic visits (C) lead to better control of blood pressure (O)? Adult (18 years and older) patients of all genders with a known diagnosis of hypertension and living in low to middle-income countries will be considered in the following discussion. The blood pressure cut-offs for the diagnosis of hypertension are a systolic BP of ≥120 mm Hg, diastolic BP of ≥90 mm Hg, and/or current use of antihypertensive medication (Whelton et al., 2018; WHO, 2021). The total hypertensive adult population worldwide is 1.28 billion, aged 30-79 (WHO, 2021), with males having a slightly higher prevalence than females. Although the prevalence of hypertension varies by ethnicity, the target population for this PICO(T) is non-discriminatory of any ethnic group. In terms of intervention, telemedical care is defined as the remote exchange of medical data between a patient and a care provider for remote delivery of care, consultation, health education, or monitoring (Omboni et al., 2020). Because of the increased need for non-physical patient-care provider interaction, the telemedical approach to care has grown in popularity, particularly during the Covid19 pandemic. It employs data collection devices (such as blood pressure cuffs), data communication and transmission devices (such as mobile phones), and wired or wireless technologies such as Bluetooth and WIFI. Furthermore, clinicians use computers or laptops to receive data from patients, analyze it, and provide appropriate care. The comparison involves standard care, in which patients visit their primary care physicians regularly for further evaluation and treatment recommendations. The measurable outcome, in this case, is blood pressure, which will be monitored regularly in accordance with the patients’ and their care providers’ goals.

Facilitators and Barriers

            The Covid19 pandemic, which ravaged the healthcare sector, turned out to be a blessing in disguise, as interventions to continue care without patient-care provider physical interaction were developed. This has increased the adoption of telemedical approaches to care, allowing various healthcare services to use telemedicine in various aspects of care. Second, the introduction of health information technology, particularly in undergraduate nursing curricula, has increased the number of tech-savvy nurses in the job field, who embrace the implementation of technology in health (Chike-Harris et al., 2021). Potential barriers include the high cost of devices and the lack of infrastructure required to implement interventions. Furthermore, because the systems are potentially vulnerable to breaches, the implementation of telemedicine creates an increased need to protect the privacy and confidentiality of patients’ protected health information. This necessitates additional investment in skilled personnel and infrastructure to protect the systems, raising the implementation cost.

Conclusion

            As the global prevalence of chronic illnesses rises, there is a greater need to develop cost-effective interventions to combat them. Before developing an appropriate intervention, a prodromal phase of gathering evidence-based data to incorporate into care is required. A PICO(T) question is used to find credible evidence that can be applied in real-world nursing practice. The telemedical approach to adult hypertensive patients has raised hopes for effective care delivery, particularly in the Covid19 era. In the PICO(T) question developed above, telemedical approaches to adult hypertensive patients are compared to standard care, which includes regular outpatient clinic visits, to determine which one best lowers blood pressure control and decreases the risks of cardiovascular events.

 

References

Chike-Harris, K. E., Durham, C., Logan, A., Smith, G., & DuBose-Morris, R. (2021). Integration of telehealth education into the health care provider curriculum: A review. Telemedicine Journal and E-Health: The Official Journal of the American Telemedicine Association, 27(2), 137–149. https://doi.org/10.1089/tmj.2019.0261

Kirkland, E. B., Heincelman, M., Bishu, K. G., Schumann, S. O., Schreiner, A., Axon, R. N., Mauldin, P. D., & Moran, W. P. (2018). Trends in healthcare expenditures among US adults with hypertension: National estimates, 2003-2014. Journal of the American Heart Association, 7(11). https://doi.org/10.1161/JAHA.118.008731

Mills, K. T., Stefanescu, A., & He, J. (2020). The global epidemiology of hypertension. Nature Reviews. Nephrology, 16(4), 223–237. https://doi.org/10.1038/s41581-019-0244-2

Omboni, S., McManus, R. J., Bosworth, H. B., Chappell, L. C., Green, B. B., Kario, K., Logan, A. G., Magid, D. J., Mckinstry, B., Margolis, K. L., Parati, G., & Wakefield, B. J. (2020). Evidence and recommendations on the use of telemedicine for the management of arterial hypertension: An international expert position paper: An international expert position paper. Hypertension, 76(5), 1368–1383. https://doi.org/10.1161/HYPERTENSIONAHA.120.15873

Whelton, P. K., Carey, R. M., Aronow, W. S., Casey, D. E., Jr, Collins, K. J., Dennison Himmelfarb, C., DePalma, S. M., Gidding, S., Jamerson, K. A., Jones, D. W., MacLaughlin, E. J., Muntner, P., Ovbiagele, B., Smith, S. C., Jr, Spencer, C. C., Stafford, R. S., Taler, S. J., Thomas, R. J., Williams, K. A., Sr, … Wright, J. T., Jr. (2018). 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults. Journal of the American College of Cardiology, 71(19), e127–e248. https://doi.org/10.1016/j.jacc.2017.11.006

World Health Organization. (2021). Hypertension. Who.int. https://www.who.int/news-room/fact-sheets/detail/hypertension

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Overview
For this assignment, you will create a PICO(T) question. Your paper should be in APA 7th edition format, including title page and reference page. Address the following:
PARAGRAPH 1: Begin your paper with an introduction to your PICOT topic. This can be any clinical issue you choose -EXCEPT COVID-19 or hand hygiene.
Indicate what you will address in the rest of your paper (introductory statement)
Describe your topic
Describe its significance (this may include statistics on the problem, complications, etc.)
Essentially, explain WHY your problem needs to be addressed
PARAGRAPH 2, FIRST SENTENCE -Determine an appropriate PICO(T) question for addressing. Write your PICO(T) in correct question format. INTERVENTION PICO(T) only. Do not use other types of PICO(T)s. An intervention PICO(T) requires an intervention. For example: using one catheter type vs another, or using saline vs heparin, etc.
PARAGRAPH 2, In your text,
describe your population/patient (consider age, disease/condition, gender or biological sex, etc.)
describe the main intervention (the drug or other treatment you propose) AND the comparison (the main alternative to your drug/treatment intervention -the alternative could be NO treatment)
describe what your outcome (reduced complication – be specific; improved memory; reduced anxiety, etc.) – Whatever the outcome may be, but it must be specific and measurable. You cannot measure \”improvement\” or \”reduced complications\”. Be SPECIFIC.
PARAGRAPH 3: Identify and explain 2 facilitators and 2 barriers to implementing the practice you propose in your PICO(T) (What helps/what hinders?)
PARAGRAPH 4: Conclusion: Summarize your paper
Objectives
Develop a clinical question using proper PICO(T) format
Explain the components of a PICO(T) question
Identify facilitators and barriers to implementing a specific EBP practice
References
Minimum of three (3) total references: one (1) reference from required course materials and two (2) peer-reviewed references. All references must be no older than five years (unless making a specific point using a seminal piece of information).
References should support the reasoning behind the PICOT, the problem or the intervention.
Peer-reviewed references include references from professional data bases such as PubMed or CINHAL applicable to population and practice area, along with evidence based clinical practice guidelines.
**Examples of unacceptable references are Wikipedia, UpToDate, Epocrates, Medscape, WebMD, hospital organizations, insurance recommendations, & secondary clinical databases.

Style
Unless otherwise specified, all the written assignment must follow APA 7th edition formatting, citations, and references. Make sure you cross-reference the APA 7th edition manual as well before submitting the assignment.
Number of Pages/Words
Unless otherwise specified all papers should be between 500-600 words excluding the title and reference pages. Use size 12, Arial or Times New Roman font. Do not exceed 3 pages of text (excluding title and reference page).
Due Date: Sun, Aug 28 by 11:59 p.m. Eastern Standard Time (EST) of the US.