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

PICO(T) questions and an evidence-based approach are crucial in nursing for guiding clinical decision-making and improving patient outcomes. By focusing on specific patient populations, interventions, comparisons, outcomes, and timeframes, nurses can identify the most effective strategies for care. This method ensures that nursing practices are grounded in the best available evidence, leading to better patient care. This strategy will be utilized in this paper to address the issue of cholecystitis.

Exploring the Cholecystitis as Healthcare Issue with the PICOT Approach

Cholecystitis, the inflammation of the gallbladder, is a common practice issue in healthcare, often requiring timely and effective intervention to prevent complications like gallbladder rupture or sepsis. Exploring cholecystitis through a PICO(T) approach enables a structured investigation into the best treatment options. A PICO(T)-formatted research question for this issue is as follows:

“In adult patients diagnosed with acute cholecystitis (Population), how does early laparoscopic cholecystectomy (Intervention) compared to delayed surgery (Comparison) affect recovery time and complication rates (Outcome) within a one-month period (Time-frame)?”

The exploration of cholecystitis through a PICO(T) approach will benefit by providing a clear framework to evaluate various treatment strategies, enabling healthcare professionals to compare interventions such as early versus delayed surgery, and their outcomes (Vidyadharan et al., 2023). This method helps focus on specific patient populations, interventions, and outcomes, ensuring that clinical decisions are evidence-based and tailored to improving patient recovery and minimizing complications. Through systematic inquiry, the PICO(T) approach supports the identification of the most effective practices for managing cholecystitis.

Sources of Evidence to Answer PICO(T) Question

To explore evidence-based resources for cholecystitis, various databases, journals, and websites are available. Key databases like PubMed, Google Scholar, ProQuest, Cochrane Library, CINAHL, MEDLINE, and the Capella University Library can offer significant insights into standard treatment protocols and adjunct therapies for cholecystitis. Notable journals such as the “Journal of Gastrointestinal Surgery,” “Surgical Endoscopy”, “Hepatology,” “World Journal of Gastroenterology,” and the “American Journal of Surgery” regularly publish relevant research on gallbladder conditions and treatments.

Additionally, websites like the “American Gastroenterological Association,” “American College of Gastroenterology”, and “National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)” provide valuable information on this issue. The CRAAP criteria (Currency, Relevance, Authority, Accuracy, Purpose) are utilized to assess these sources’ potential in effectively answering the PICO(T) question related to cholecystitis, ensuring the selection of the most relevant and accurate resources (Muis et al., 2022).

Findings from Articles or Evidence-Based Sources

Research study demonstrates that early laparoscopic cholecystectomy is linked to shorter recovery times and fewer complications. This is contrasted with delayed surgery, which is associated with higher complication rates, including infections and bile duct injuries (Cheng et al., 2020). Study from the Surgical Endoscopy further support that early intervention allows for quicker recovery and a faster return to normal activities (Janjic et al., 2020). Early laparoscopic cholecystectomy is associated with a reduction in operating time and a shorter duration of hospital stay.

This approach not only minimizes the time patients spend in surgery but also expedites their recovery, leading to a quicker discharge from the hospital compared to delayed surgical interventions. The early intervention helps to address acute cholecystitis before it progresses, thereby reducing the overall complexity of the procedure and the likelihood of post-operative complications (Vidyadharan et al., 2023). Overall, the evidence suggests that early laparoscopic cholecystectomy is more effective in minimizing recovery time and reducing complications within the one-month timeframe outlined in the PICO(T) question.

Relevance of Findings and Decision-Making

The conclusions drawn from the chosen sources of information are extremely pertinent to addressing the PICO(T) question regarding the impact of early versus delayed approach of laparoscopic cholecystectomy on recovery time and complication rates. Research by Cheng et al. (2020) highlights that early laparoscopic cholecystectomy is linked to shorter recovery times and fewer complications, including infections and bile duct injuries, compared to delayed surgery. Janjic et al. (2020) further support this by demonstrating that early intervention leads to quicker recovery and a faster return to normal activities.

Vidyadharan et al. (2023) emphasize that early surgery reduces operating time and hospital stay, which not only minimizes patient discomfort but also decreases the risk of complications by addressing the condition before it escalates. These findings collectively indicate that early laparoscopic cholecystectomy is more effective in improving patient outcomes within the one-month timeframe specified in the PICO(T) question, making it a preferable choice for managing acute cholecystitis.

Conclusion

In conclusion, the PICO(T) approach provides a robust framework for evaluating the difference in management of acute cholecystitis between early and delayed laparoscopic cholecystectomy. The evidence gathered highlights that early intervention significantly reduces recovery time and lowers complication rates compared to delayed surgery. Studies such as those by Cheng et al. (2020) and Janjic et al. (2020) emphasize the advantages of early surgery in terms of faster recovery and reduced risk of complications, while Vidyadharan et al. (2023) underscores the benefits of shorter operating times and hospital stays. This evidence supports the implementation of early laparoscopic cholecystectomy as a more effective strategy for improving patient outcomes in the management of acute cholecystitis, ensuring that clinical decisions are informed by the best available data.

References

Cheng, X., Cheng, P., Xu, P., Hu, P., Zhao, G., Tao, K., Wang, G., Shuai, X., & Zhang, J. (2020). Safety and feasibility of prolonged versus early laparoscopic cholecystectomy for acute cholecystitis: A single-center retrospective study. Surgical Endoscopy, 35(5), 2297–2305. https://doi.org/10.1007/s00464-020-07643-z

Janjic, G., Simatovic, M., Skrbic, V., Karabeg, R., & Radulj, D. (2020). Early vs. delayed laparoscopic cholecystectomy for acute cholecystitis – single center experience. Medical Archives, 74(1), 34. https://doi.org/10.5455/medarh.2020.74.34-37

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