I need two answers, 200-300 words each, and they must include references, thank you

Nikka:Compelling clinical questions definition

Compelling clinical questions are well-structured queries that include information about a particular patient or group, an exposure or intervention, a comparative intervention, if appropriate, and the expected outcomes (Bell & O’Donovan, 2021). These inquiries help the healthcare professional focus so they can find and evaluate the most pertinent and high-quality evidence to guide their clinical practice. The PICO(T) framework, which stands for Patient/Population, Intervention, Comparison (where appropriate), Outcome, and Time, is frequently used to structure question formulation.

The Approach for Formulating Powerful Clinical Questions:

1. Identify the Clinical Domain: To begin, specify the clinical domain or area of interest in detail. Is the query concerning the etiology, prognosis, therapy, or diagnosis? This first action gives background and direction (Fandino, 2019).
2. Define the characteristics of the patient or population group being considered. Specify the elderly patient or aging population. This contains pertinent demographic information, medical conditions, and other factors that help to focus the question’s scope.
3. What the Intervention entailed: Give specifics about the evaluation’s intervention, exposure, or diagnostic procedure. Be specific about the procedure or measure that is being investigated (Fandino, 2019; Ratan et al., 2019).
4. Take into account the Comparison (if appropriate): If there is an alternative intervention or exposure that is pertinent to compare against, it should be mentioned. This aids in assessing the success of the targeted action (Ratan et al., 2019).
5. Choose the outcome: Specify the desired outcomes of interest, which may include patient preferences, clinical results, or other pertinent endpoints. These results ought to be quantifiable and of clinical importance.
6. (Optional) Describe the Time Frame: The timescale of interest may occasionally be pertinent, particularly when dealing with prognosis or long-term results (Fandino, 2019).
7. Bringing Everything Together: The PICO(T) framework can be used to combine the elements to create a comprehensive and well-structured clinical question. For instance, the following could be a question about a new medication’s effectiveness in lowering blood sugar in elderly patients with diabetes: “Does Drug A (I) lower blood sugar more effectively than Drug B (C) within a 12-week period (T), to prevent neuropathy (O)?”

References

Bell, S. G., & O’Donovan, P. (2021). Steps 1 and 2: Asking a Compelling Clinical Question and Searching for the Best Evidence. Neonatal Network, 40(4), 262–266. https://doi.org/10.1891/11-T-717

Fandino, W. (2019). Formulating a good research question: Pearls and pitfalls. Indian Journal of Anaesthesia, 63(8), 611–616. https://doi.org/10.4103/ija.IJA_198_19

Ratan, S. K., Anand, T., & Ratan, J. (2019). Formulation of research question–Stepwise approach.

Tammy: I have been a registered nurse for ten years. For over six years, I was a Circulator in the operating room (OR), where I gained a great deal of knowledge, understanding, and appreciation for evidence-based practice (EBP). During my nine-month training program for the OR, we were taught that EBP was the scientific evidence that guided our decisions and was translated into the care we provided for our patients. What I didn’t know is that EBP can help healthcare systems achieve the quadruple aim of reducing costs, better patient experience because of safety and high-quality care, highly desirable patient outcomes, and improving job satisfaction of healthcare staff (Melnyk & Fineout-Overholt, 2023).

Occasionally, when caring for patients, clinical questions arise among caretakers wanting to know if there is an evidence-based practice that could be employed to provide a certain type of better care for patients. One way to formulate a compelling clinical question is to use a format called PICOT. The PICOT format gives the user a step-by-step framework for conducting a search with a methodology to collect and assemble prime scientific evidence to direct a particular practice (Bell & O’Donovan, 2021). PICOT is an acronym that stands for the following (Bell & O’Donovan, 2021):

• P = The population, patient, or problem being addressed.
• I = The intervention or issue relating to the population, patient, or problem.
• C = The comparison the investigator is interested in.
• O = The outcome the investigator is expecting from the intervention.
• T = The time frame in which the outcome is expected to occur.

To contrive a well-developed clinical question, first the investigator should take note of a clinical issue that is not meeting expectations or standards based on data from their current practice. (Bell & O’Donovan, 2021). Then, the investigator can create an answerable question, in PICOT format, that will direct their literature search for guidance from EBP. The investigator will need to determine the components of the question for each aspect of the PICOT format as it pertains to the clinical question.

In my future role as a Nurse Practitioner, I plan to work in an orthopedic clinical specializing in total knee replacements. My PICOT is:

P – surgical patients receiving a total knee replacement

I – bathing with chlorhexidine soap the night before and morning of surgery

C – not bathing with chlorhexidine soap the night before and morning of surgery

O – affects surgical site infection

T – within 30 days after surgery