Running head: PICOT QUESTIONS 2
PICOT QUESTIONS 2
PICOT questions
PICOT questions
Background
Throughout an acute hospitalization, patient’s ambulation is frequently disregarded because of their acute ailment. A patient’s functional position post-release is correlated to their movement during hospitalization. The absence of mobility during hospitalization can result in decreased quality of life, augmented length of stay, and lead to “suboptimal” care. (Dirkes, (2019). Barriers to patient mobility in critical care involve the absence of assistive tools, the absence of inspiration amongst both the patients and staff and most importantly, fear of patient falling. These factors add to the decrease of hospital-related functions due to the presence of immobility both proximately and their days post-hospitalization. Injuries from falls are the most prevalent issue in early mobility plans, particularly in critical care. For instance, patients within the hospital on factors such as surgery, medications, and diagnostic testing conditions, which wanes the body or result in confusion can have mobility difficulties. According to Filipek, (2017), ”every year, there are hundreds of cases of falls occurring in hospitals and 45% of these cases leads to injuries and sometimes death.” Therefore, controlled mobility programs during hospitalization are imperative to prevent and reduce falling cases, lessen the necessity for post-acute care in SNF (skilled nursing facility) as well as lessen LOS.
Significance to nursing
Early mobility is important to nursing practice because of the adverse effects lack of movement causes both immediately and thirty days post-hospitalization. Moreover, recent studies have indicated the health benefits and cost savings of getting hospital patients walking as soon after their procedures. These benefits are distinct. Physical activities strengthen muscles and joints, and movement is linked with shorter hospital stays. Brief hospital stays will in turn generate considerable savings. Mobilization programs aimed at critical care patients are estimated to save a mean of $ 940 per Medicare recipient. Though rehabilitation is guaranteed to enhance functionality position, there is an assumption that lack of mobility in hospitalization accounts for several SNF releases leading to augmented healthcare expenditure.
Therefore, nurses should assist patients with mobility while keeping in mind all blockades to treatment and probable complications to lessen hospital stay and enhance patient care and wellbeing. Although nurses tend to favor EPB and regard its function in their daily practice, institution blockades might still exist leading to application difficulties. (Boehm, 2021). Thereby, nurses should be dedicated and committed to ambulating patients frequently. Through recognizing the inferences presented by immobility in the hospital and the statistical pertinent on how these adverse outcomes directly impact the patients, nurses can further engage in decision-making modifications via clinical-centered situations.
PICOT questions
The following questions focus on explicit interventions and how these interferences might result in particular outcomes. These PICOT questions focus on the topic of early mobility and fall prevention.
1. In hospitalized patients, do patients involved in early mobility plans have reduced LOS, and do these programs lead to lessened SNF releases in comparison to those patients who are not on mobility plans? (Boehm, (2021). The population (P) is the patients in hospitals, Intervention (I) is patients ordered on early mobility plan, Comparison(C) is between those in mobility plans and those not in the mobility program (standard activity). The outcome (O) will be to assess LOS of patients discharged to go home and those discharged to a SNF. Patients will be placed on a mobility plan for twenty-four hours of their admission.
2. In hospitalized patients, does ambulation cause patients to be at a greater risk for falls, or does the program decrease fall risks? Population(P) is the hospitalized patients, Intervention includes directives for early mobility plan to reduce or prevent fall, Comparison is the rate of fall in patients in mobility plans to those on standard activity directive, outcome (O) is to assess the rate of falls of patients in early mobility system with those in standard activity directives. The timeline will be twenty-four hours after admission.
3. In Hospitalized patients, do patients with a bed rest directive have a lengthier stay (LOS) in the hospital in comparison to patients with activity directives? Population(P) is the hospitalized patients, Intervention includes directives for physical activities, Comparison will be the LOS of patients with physical activity directive in comparison to those with bedrest directives. Outcome will be assessed with by the period of stay in hospital between these two groups, throughout their hospitalization
Conclusions
Dirkes, (2019) notes that early patient mobility is an essential aspect of patient care, especially in critical care. Proper mobilization of patients is crucial to lessen physical difficulties and to enhance the emotional and social wellbeing of patients. Moreover, supervised mobility programs reduce and prevent falling in patients with acute illnesses. Thus, mobility programs are crucial for decreasing hospital stay, increasing quality of care, reducing medical costs, and optimizing patient care and wellbeing.
References
Boehm, L. M., Lauderdale, J., Garrett, A. N., & Piras, S. E. (2021). A multisite study of multidisciplinary ICU team member beliefs toward early mobility. Heart & Lung: The Journal of Cardiopulmonary and Acute Care, 50(1), 214-219.
Dirkes, S. M., & Kozlowski, C. (2019). Early mobility in the intensive care unit: evidence, barriers, and future directions. Critical care nurse, 39(3), 33-42.
Filipek, C., Bennett, K. T., & Kissel, K. (2017). Lighting the Path: Fall Prevention Strategies in a Mixed Intensive Care (ICU) and Coronary Care Unit (CCU). Canadian Journal of Critical Care Nursing, 28(2).
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