Evidence-Based Practices

Introduction

Normally, PICOT format is helpful in the formulation of questions in an evidenced based clinical practice. PICOT generated questions generally fall under four main categories of clinical practices. These include; therapy, prevention, diagnosis, etiology as well as Prognosis, which are the essential elements in PICOT questions. The PICOT format is valuable in addressing research questions comprehensively. Five elements that are normally addressed including; population, intervention, comparison, outcome and time as well (Riva, Malik, Burnie, Endicott, & Busse, 2012).

Summary of Case Study

The ever increasingly high incidence of breast cancer conditions has posed serious challenges in the nursing profession. Provision of appropriate healthcare to the cancer patients has been lacking leading to adverse effects of the proliferation of cancerous cells which further worsen the conditions of the patients. As primary care, clinicians have the responsibility to stressing providing healthcare services within healthcare facilities as well as monitoring treatment in home based facilities to help manage cancer condition. Most cancer patient need clinicians who practice evidence-based clinical practices (Riva, Malik, Burnie, Endicott, & Busse, 2012).

Research Question

In cancer patients receiving chemotherapy, will they have better white blood cell count monitoring with a follow-up at home versus follow-up at a health care facility during their treatment?

PICOT Format

1) P-Population: Patients aged 18-60 years-old, breast cancer who have not received chemotherapy in the past six months are subjected to the treatment. Patients with other serious health conditions such as heart diseases were excluded in the study. 30 patients, with 15patients stationed at the healthcare facility while the other 15 patients receiving home-based care, are expected to take part in the study.

2) I -Intervention: The patients will receive dosage based on the age, sex and health general body health as well as the stage of cancer cells proliferation in the body. The patients are required take the prescribed drugs at regular intervals. The subjects will be subjected to treatment under the same during the research study.

3) C-Comparison: All the subject regardless of variations in their level of dose requirement will be subjected to the same treatment for the same duration, 3months. Standardized treatment will be given to subjects with no extreme variations in their level of dose requirement and would be used as an active control group. Using this strategy, it will be possible to minimize the non-specific effects due to a group of the patient receiving treatment within the healthcare.

4) O-Outcome: The response in chemotherapy treatments will be check by examining the numbers of defective cancerous cells in the body tissues. The patients will report to the theatre in order to be examined by an oncologist. The results will be recorded in terms of improved seen in each patient and in the two categories, that those that received home-based care as well as those who received chemotherapy treatment within the healthcare facility (Stevens, 2001).

5) T-Time: The outcome would be measured after 2 weeks for 3months. The results will be recorded at an interval of two weeks from the onset of the study throughout the 3months

In evidenced-based clinical practice, it is imperative to standardize treatments in order to avoid skewing expected treatment outcomes. Teaching the subjects, the importance of chemotherapy treatment should be part and parcel of the planning process of the patient recruitment into the research study. More importantly, standardizing instruction to study subjects is also important in ensuring no additional interventions are inadvertently introduced during the study period. Additional intervention can be by way of extra pieces of advice to the study subjects (Stevens, 2001).

Evidence-based clinical practices, clinicians are encouraged to not only provide available cancer care choices but also undertake to provide information on quality care. In addressing challenges and complication associated with breast cancer, clinicians should provide timely, accurate information (Morley, 2009).

Keywords in Literature Review

The keywords to look for in literature review include; breast net weight, breast biopsies related history, hyperplasia prior to biopsy, radiation of the chest, breastfeeding, obesity, excessive use of alcohol, sedentary lifestyles, and chemotherapy as well as exogenous hormones. These items show the mode of progression of cancerous cells and influence the type of healthcare to be provided to patients in evidence-based clinical practices (Stevens, 2001).

Reference

Morley, P. T. (2009). Evidence evaluation worksheets: the systematic reviews for the evidence evaluation process for the 2010 International Consensus on Resuscitation Science. Resuscitation, 80(7), 719-721.

Riva, J. J., Malik, K. M., Burnie, S. J., Endicott, A. R., & Busse, J. W. (2012). What is your research question? An introduction to the PICOT format for clinicians. The Journal of the Canadian Chiropractic Association, 56(3), 167.

Stevens, K. R. (2001). Systematic reviews: The heart of evidence-based practice. AACN Clinical Issues, 12(4), 529–538.

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