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Using a PICO(T) Framework and Evidence to Develop Care Practices
The PICO(T) evaluation criteria are a structured guide that allows the creation of care strategies that are science-based and human-focused. Our paper is devoted to the analysis of the usage of PICO(T) methodology as it relates to the case of chronic kidney disease (CKD) management. NURS FPX 4030 Assessment 3:, We are going to address the urgent need for developing a practice issue relevant to CKD and therefore crafting a PICO(T) format inquiry will help us to establish sources of evidence by critical scrutiny of available findings in numerous articles on the subject for substantiation of care plan in case CKD patients.
Use of the PICO(T) Approach When Caring for Patients with Dementia
NURS FPX 4030 Assessment 3: Practice Issue:
CKD is one of the chronic diseases that have continuously distorted the health of the American population for years.
PICO(T)-Formatted Research Question:
- P (Patient/Population/Problem): Lifestyle changes have to be made by adult patients who are diagnosed with Chronic Kidney Disease (CKD) Stage 3.
- I (Intervention): Implementing a program that provides structure to your exercise.
- C (Comparison): This intervention will consist of a comparison of physical activity and standard care.
- O (Outcome): Several physical aspects of one’s body are developed during this time; such as cardiorespiratory endurance, muscle strength, functional movement, flexibility, and balance.
- T (Time Frame): In the time frame of six months.
Exploration of Practice Issue:
A key practice problem here is the development of a treatment regime for CKD patients, this will focus on the psychosocial component to maximize physical function and the quality of life (QoL) through systematic exercise plans (Rao et al., 2021). Through the PICO(T) method we can put the target population (CKD cases), intervention (the structured exercise program), comparison (traditional physical activity or standard care), outcome (improvement of physical functioning and quality of life), and timeframe (over six months) more precisely than ever before.
NURS FPX 4030 Assessment 3:, This way of approach makes nurses generate a research question that shows evidence-based practice, enabling them to identify pertinent information and inform the decision-making regarding the parameters of the exercise regime for CKD patients. Investigating this theme through the PICO(T) approach increases the performance and improvement of evidence-based prevention and treatments for CKD management.
Identification of Sources of Evidence
Peer-Reviewed Journals:
Scholarly journals like “The Journal of Renal Nutrition” and “The American Journal of Kidney Disease” are resources endorsed for their quality in publications of research work related to CKD management and intervention (Smith, 2023). Studies from the journals are subjected to elaborate peer-reviewing processes, thus assuring the strength and truthfulness of the facts being presented.
Clinical Practice Guidelines:
For example, the National Kidney Foundation and KDIGO organizations have approved the guidelines based on research to give evidence for CKD management (Chen et al., 2019). These guidelines are developed in a structured way, through sequential analysis of scientific publications and taking the expert opinion into account; as such, they are considered pillars of EBP.
Randomized Controlled Trials (RCTs):
By using RCTs, we will be able to find out if the structured exercise programs improve CKD patients’ lives (Hellberg et al., 2019). We will have the necessary data to answer our PICO(T) question. Randomly dividing participants between the intervention and control groups helps set up the definitive conclusion about the role of the exercise interventions on fundamental functioning and improved quality of life measures.
Meta-Analyses and Systematic Reviews:
Meta-analyses and systematic reviews that accumulate data from multiple studies provide a better picture of how exercise intervention helps class 5 patients (Hu et al., 2020). They lead to pooled effect sizes across studies and identify possible sources of variation, thereby meeting the goal of understanding the overall impact of exercise among those with CKD.
Clinical Trials Registries:
Ascertaining an ongoing or forthcoming trial which is clinically investigating exercise strategies in proteinuria kidney patients can be done through looking up clinical trial registries like ClinicalTrials.gov (Cheung et al., 2021). Even though these resources are not necessarily the ones that directly address the TQ, they can award a glance into the latest updates in research and prospects on the topic being focused on.
Findings from Articles
People will learn to understand that sustainability should not merely be considered a lifestyle, but a responsibility that we collectively carry towards our planet.
American Journal of Kidney Diseases:
The American Journal of Kidney Diseases published a paper by Pasko and Kirby (2021), which presents revised competencies and expectations for medical dietitian nutritionists in the area of nephrology. The study pointed out the importance must be considered for making personalized dietetic plans as part of the CKD management process, remembering that nutritional value plays a vital role in minimizing disease progression and improving overall health outcomes (Kim & Jung, 2020). This strong evidence has a high credibility interestingly, a journal is respected for a peer-review of nephrology studies.
Journal of Renal Nutrition:
Statements from another established authority, the Journal of Renal Nutrition, which reports the study by Pace and Kirk, (2021) on the advantages of diets in CKD management, are also credible. The study demonstrates the outcomes of renal function and the general health of patients with chronic kidney disease (CKD) under dietary modifications. From this research, strategies for improving health outcomes through evidence-based nutrition are formulated and the evidential results are added to the credibility of the evidence.
National Kidney Foundation Guidelines:
The National Kidney Foundation stipulates various guidelines, which are supported by scientific evidence, for the management of patients with Chronic Kidney Disease. These recommendations suggest saving people’s lives and enabling healthy living conditions through early diagnosis, preventing lifestyle and drug implications at later stages as well (AbdulRaheem, 2023). This is partly made meaningful by advisory strategies that are conducted as a part of systematic reviews of the literature coupled with expert consensus which enhances the credibility of the evidence presented.
Meta-Analyses and Systematic Reviews:
A meta-analysis and a systematic review that identify commonalities and differences in various interventions are of importance in the comprehensive examination of the effectiveness of the different treatments in CKD management (Chu et al., 2021).
NURS FPX 4030 Assessment 3:These analyses allow cumulative effect sizes and identify the sources of heterogeneity. They elevate the level of public health knowledge and understanding of the effect of the programs on CKD outcomes. Although independent studies are endowed with the critical power that causes the same evidence, the meta-analysts and systematic reviewers have higher levels of evidence because of their broad and thorough approach to the synthesis of data.
Relevance of Findings from Articles
Impact on Intervention Selection:
The perfect results obtained from the chosen ascertained ideas are meaningful in making decisions for the interventions on CKD management. For instance, the CKD progression as well as the patient outcomes can be improved by following a diet plan. Several issues related to CKD progression and patient outcomes are highlighted in the American Journal of Kidney Diseases and the Journal of Renal Nutrition (Liu et al., 2021). These outcomes emphasize the necessity of having a customized dietary plan in the intervention plan that can signify an improvement in the function of the kidney and the lowering of the risk of complications.
Guideline Adherence:
The information presented in the evidence-based National Kidney Foundation guidelines is a source of up-to-date knowledge concerning the best care practices for patients with chronic kidney disease. Strictly following these policies lies between the finger-leading on the tip of the intervention’s thumb that is based on the best practices supported by strong evidence and expert consensus (Peters et al., 2021). Supplying healthcare professionals with the required guidelines that will assist them in making the right decisions is very imperative. This will promote applying appropriate interventions which result in the targeted better patient outcomes.
Informed Treatment Planning:
Meta-analyses and systematic reviews represent the ones opting for multi-scope research so that sports practitioners make rational treatment planning decisions based on these findings (Liu et al., 2021). From the theoretical analysis, the quarries give details on the efficacy of strong interventions and those that are most likely to lead to positive results. Issuing from a synthesis of data from several studies a meta-analysis gives a strong evidence base for decisions, policy making and consequently steering interventions that associate more closely with success in CKD management.
Identifying High-Impact Strategies:
A noteworthy and encouraging finding is that the studies focusing on the effectiveness of dietary interventions and compliance with dietary guidelines are of special importance to the makers. This further shows that CKD management schemes should first and foremost consider dietary modifications and adhering to the guidelines, as these are probably to bring a range of positive outcomes including improvement of renal function, reduction of disease progression, and ultimately corollary health of patients (Rao et al., 2021). For this reason, healthcare providers should primarily target functionally appropriate actions based on the findings in these studies when they are developing treatment plans for CKD patients.
Conclusion
The PICO(T) framework thereby proves to be an essential planning instrument for the creation of individual therapy concepts for patients suffering from CKD disease. Through the process of systematically delineating the population, intervention, comparison, outcome, and time frame, nurses can arrive at the focused research questions to guide them to appropriate evidence that can guide the nursing decision-making process.
The findings from trustworthy sources that are for instance peer-reviewed journals, clinical practice guidelines, and meta-analytic studies are a big source of knowledge regarding what strategies and interventions work best in managing these conditions and bettering patients’ outcomes. Developing integrated evidence-based practices drawn up through the PICOT strategy can lead to more precise and individualized care for CKD patients, allowing them to gain more pleasure from their life and better health.
References
AbdulRaheem, Y. (2023). Unveiling the significance and challenges of integrating prevention levels in healthcare practice. Unveiling the Significance and Challenges of Integrating Prevention Levels in Healthcare Practice, 14(3), 1–6. https://doi.org/10.1177/21501319231186500
Chen, T. K., Knicely, D. H., & Grams, M. E. (2019). Chronic kidney disease diagnosis and management. JAMA, 322(13), 1294. https://doi.org/10.1001/jama.2019.14745
Cheung, A. K., Chang, T. I., Cushman, W. C., Furth, S. L., Hou, F. F., Ix, J. H., Knoll, G. A., Muntner, P., Pecoits-Filho, R., Sarnak, M. J., Tobe, S. W., Tomson, C. R. V., & Mann, J. F. E. (2021). KDIGO 2021 clinical practice guideline for managing blood pressure in chronic kidney disease. Kidney International, 99(3), S1–S87. https://doi.org/10.1016/j.kint.2020.11.003
Chu, C. D., Chen, M. H., McCulloch, C. E., Powe, N. R., Estrella, M. M., Shlipak, M. G., & Tuot, D. S. (2021). Patient awareness of CKD: A systematic review and meta-analysis of patient-oriented questions and study setting. Kidney Medicine, 3(4), 576-585.e1. https://doi.org/10.1016/j.xkme.2021.03.014
Hellberg, M., Höglund, P., Svensson, P., & Clyne, N. (2019). Randomized controlled trial of exercise in CKD—The RENEXC study. Kidney International Reports, 4(7), 963–976. https://doi.org/10.1016/j.ekir.2019.04.001
Hu, M. X., Turner, D., Generaal, E., Bos, D., Ikram, M. K., Ikram, M. A., Cuijpers, P., & Penninx, B. W. J. H. (2020). Exercise interventions for the prevention of depression: A systematic review of meta-analyses. BMC Public Health, 20(1). https://doi.org/10.1186/s12889-020-09323-y
Kim, S. M., & Jung, J. Y. (2020). Nutritional management in patients with chronic kidney disease. The Korean Journal of Internal Medicine, 35(6), 1279–1290. https://doi.org/10.3904/kjim.2020.408
Liu, P., Quinn, R. R., Lam, N. N., Al-Wahsh, H., Sood, M. M., Tangri, N., Tonelli, M., & Ravani, P. (2021). Progression and regression of chronic kidney disease by age among adults in a population-based cohort in Alberta, Canada. JAMA Network Open, 4(6). https://doi.org/10.1001/jamanetworkopen.2021.12828
Peters, S. E., Jha, B., & Ross, M. (2021). Rehabilitation following surgery for flexor tendon injuries of the hand. Cochrane Database of Systematic Reviews, 1(1). https://doi.org/10.1002/14651858.cd012479.pub2
Rao, S. R., Vallath, N., Siddini, V., Jamale, T., Bajpai, D., Sancheti, N. N., & Rangaswamy, D. (2021). Symptom management among patients with chronic kidney disease. Indian Journal of Palliative Care, 27(1), S14–S29. https://doi.org/10.4103/ijpc.ijpc_69_21
Smith, W. (2023). History of nephrology archivi. GIN. https://giornaleitalianodinefrologia.it/tag/history-of-nephrology/
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