NURS-FPX4030Using a PICO(T) Framework and Evidence to Develo | Lecture notes Accounting | Docsity (2024)

Download NURS-FPX4030Using a PICO(T) Framework and Evidence to Develo and more Lecture notes Accounting in PDF only on Docsity! NURS-FPX4030 Using a PICO(T) Framework and Evidence to Develop Care Practices Capella University NURS-FPX4030: Making Evidence-Based Decisions Using a PICO(T) Framework and Evidence to Develop Care Practices To create favorable outcomes for premature infants admitted to the neonatal intensive care unit (NICU), PICO(T) research framework needs to be implemented. PICO(T) is expanded to Population/Patient, Intervention, Comparison, Outcome, and Time. With the use of secondary research, this assessment will assess the effectiveness of corticosteroids given antenatally, apply the PICO(T) process, identify sources of evidence that could be potentially effective in answering a PICO(T) question, explain the findings from articles or other sources of evidence, and explain the relevance of the findings from chosen sources of evidence to making a decision related to a PICO(T) question. Use of the PICO(T) Approach when Caring for Premature Infants in the NICU The practice issue identified is the effectiveness of corticosteroids when given antenatally on the premature infant outcome. The question being asked is: Do premature infants experience better outcomes in the NICU when a full course of corticosteroids is administered antenatally? The intervention approach identified is a full course of corticosteroids given antenatally, medical intervention in anticipation of premature delivery. The population being studied are premature infants admitted to the neonatal intensive care unit. The comparison will be between those who did not receive corticosteroids at all and/or those who only received a partial course. The outcome is the neonatal outcome. The time in which this will be measure will be throughout the neonates hospitalization in the neonatal intensive care unit. Sources of Evidence for PICO(T) Questions Sources of research will include peer-reviewed articles written by experts in the field of obstetrics and neonatology. The sources used will be published within the last five years. Using the Capella library, parameters will be set for full-text articles, that are peer-reviewed, and the date range will be from 2016 to 2021. Research Results The overwhelming consensus throughout the research was that corticosteroid administration antenatally has a direct correlation with neonatal outcomes. “Corticosteroid administration in pregnant women at risk of preterm delivery is currently one of the most effective perinatal strategy known to improve neonatal outcomes” (Herrera et al., 2019, p. 1). Corticosteroids are administered to antenatal patients when preterm delivery is thought to be unavoidable. In the article Association of Neurodevelopmental Outcomes and Neonatal Morbidities of Extremely Premature Infants With Differential Exposure to Antenatal Steroids a study was conducted using the question of neonatal and childhood outcomes with no, partial, and complete courses of antenatal steroids (ANS) to preterm infants. The study was conducted using a total of 6,121 infants. Of the infants studied, 848 received no ANS, 1581 had a partial course, and 3692 received a complete course of ANS (Chawla et al., 2016). Out of the 6121 infants included in the study, 4284 survived until their 18-20 month follow up and data was collected on 3892 infants. The study shows significant differences in the three different groups. The study conducted looked at the rates of mortality, severe intracranial hemorrhage (IVH), necrotizing enterocolitis (NEC), bronchopulmonary dysplasia, and neurodevelopmental impairment. Looking at results from each category, it can be determined that even a partial dose of ANS significantly improves neonatal outcomes. In their respective orders of no, partial, and complete ANS course morality was noted to be 43.1%, 29.6%, and 25.2%, severe IVH was 23.3%, 1.91%, and 11.7%, NEC was noted to be 48.1%, 37.1%, and 32.5%, bronchopulmonary dysplasia was 74.9%, 68.9%, and