NUR 439 DISCUSSION QUESTION

Discussion Questions weeks 1 to 5 Week 1 Q#1 PICOT is utilized by the health care community to identify and study a nursing or medical practice problem. Consequently, PICOT examples that may provide insight into the use of the PICOT process, may not be relevant to nursing practice as they are based on a medical practice problem. Describe the difference between a nursing practice problem and a medical practice problem. Provide one example of each. Discuss why is it important to ensure your PICOT is based on a nursing practice problem. The big difference between a nursing practice problem vs. a medical practice problem is that for nursing, the problem is usually notated during the nurse’s assessment of the patient’s condition, disease and main complaints during this time (NANDA International Knowledgebase, n.d.). Nursing practice problems usually start with the patient entering the healthcare facility where the initial intake is performed, medical diagnosis takes place and the care of the patient during their time in the healthcare facility to the aftercare of the patient with a discharge note, resources and other directed instructions that the nurse can facilitate in their scope of practice. Usually the nurse is most concerned with what can and potentially could kill a patient in addition to adding holistic measures to keep the patient comfortable in addition to being informed. For example, nurses usually focus on Maslow’s first two bottom triangles when it comes to assessing a patient (Mcleod, 2020). The first being physiological needs as in food, shelter, survival, etc. while next step is safety as in, are the bed rails up, are their potential fall risks, what are the short and long-term goals of treatment, etc. A medical practice problem is usually focused on the pathology and disease state itself in addition to standard of care treatments (NANDA International Knowledgebase, n.d., para.1). For example, if a diabetic patient were to come in for a physical exam, a physician may notate that there are ulcerations on the feet of the patient, diagnosis it, give directions and prescriptions and have the patient follow up in a few weeks to check the prognosis of the ulcerations. The reason it is important to ensure that nursing practice problems are ‘PICOT’ based is because of several reasons. The first being that as nurses we are concerned with patient’s well-being and patient-centered care, the second being that nursing encourage positive patient outcomes and the third is to ensure that this can be done in the nurse’s scope of practice. Patient-centered care is critical to patient’s well-being and overall picture to health. While the physicians may have the caring attitude want what is best for the patient, it is our job as the nurse to not only find out the individual needs and wants of the patient but to ensure that we can advocate for that patient if there is a need for it (Evidence-Based Practice, 2010). Positive patient outcomes are also important in that they can help patient’s heal faster, become more informed and help patients learn to take better care of themselves (Rosseter, 2019). In addition, patients do better with nurses that obtain a BSN due do advanced education, evidence-based practice models and better PICOT questions that ensure the patient is taken care of (Rosseter, 2019 & Helbig, 2018). The nursing scope of practice is crucial to know. What a nurse can and cannot do can mean the difference between life and death for a patient. It is also important that the nurse knows what they can and cannot do under the state and laws that govern them (Writers, 2020). For example, while a nurse may have seen a similar situation over and over again, such as chest pain, it is up to the physician to make sure that the proper labs and imaging studies are ordered. Nurses can advocate for certain testing and labs but ultimately it is up to the physician. If a nurse were to administer a ‘clot buster’ for a stroke without an order the patient could either die or be alive. Either way, the nurse never acts without an order. References: What is the difference between a medical diagnosis and a nursing diagnosis?: NANDA International Knowledgebase. (n.d.). Retrieved May 18, 2020, from Evidence-Based Practice, Step by Step: Asking the Clinical Question A Key Step in Evidence-Based Practice. (2010, March). Retrieved May 18, 2020, from Article_ID= Helbig, J. (2018). History and Process of Nursing Research, Evidence-Based Nursing Practice, and Quantitative and Qualitative Research Process. Retrieved May 18, 2020, from Mcleod, S. (2020, March 20). Maslow's Hierarchy of Needs. Retrieved May 18, 2020, from Rosseter, R. (2019). Creating a more highly qualified nursing workforce. Retrieved May 18, 2020, from