The Clinical Issue and Research Questions Developing Using PICOT
Chronic obstructive pulmonary disease (COPD) is a persistent, preventable, and treatable disease that is characterized by persistent airflow limitations (Lewis et al., 2017, p 557). It is associated with an enhanced chronic inflammatory response in the airways and the lungs, primarily caused by cigarette smoking and other noxious particles and gases (Lewis et al., 2017, p. 557). Smoking cigarettes or other noxious particles can damage the air sac and lining of the lung. COPD can cause shortness of breath, coughing, and wheezing in the patients. COPD is not diagnosed until the symptom is moderately advanced. So, exposure to chemical toxins can increase the risk of further damage. A patient with smoking is at high risk for COPD because smoking is a major cause of COPD. Risk factors of COPD also include genetic factors, age, experiencing respiratory infection during childhood, exposure to secondhand smoke, exposure to chemical irritants, dust, and air pollution. People with the age of 40 or older have higher onset of COPD symptoms (Lewis et al., 2017, p. 559). In the review literature of prior studies, it describes the correlation between active smoking and secondhand smoking on COPD, which found clear evidence that cigarette smoking, either active or secondhand smoke, can contribute to COPD (Pizzichini et al., 2018). Not only a smoking person but a secondhand smoker is also at equal risk for getting diagnosed with COPD.
A patient with COPD is very significant in nursing practice. Although COPD cannot be cured, being a nurse, it is our responsibility to care for and manage people who have been living with COPD. It is our role to minimize symptoms and improve the quality of their lives. The priority nursing intervention is to maintain the airway in any patient. Patients with COPD can increase risk for their respiratory infections (Lewis et al., 2017, p. 558). They are more likely to catch colds, pneumonia, or other respiratory infections. It can also lead to heart problems, lung cancer, depression, shortness of breath, and tissue damage. So, maintaining the lung’s function is very important because our body needs oxygen to function, and the lung is a major organ for gas exchange. So, teaching patients about smoking cessation is a very important part because quitting smoking can prevent further damage to the lungs, and we can treat the current damage in the lungs. Patients with COPD already have shortness of breath and breathing problems. As a nurse, it is our responsibility to teach patients about getting the vaccines to prevent further damage to the lungs. For example, Flu and Pneumonia can cause lungs infection, and we have to teach patients with COPD to get vaccines. There are influenza and pneumococcal vaccine available, which can help to prevent getting flu and pneumonia. There is a research study that shows a reduction in the relative risk for mortality among influenza-vaccinated COPD patients (Eagan, Hardy, Grydeland, Bakke & Cox, 2016). The research shows that patients with COPD getting the influenza vaccine decreases the mortality rate and improves the health of COPD-diagnosed patients.
Research Questions Developing Using PICOT
PICOT is an acronym that helps to develop a research question that helps to research for evidence. In PICOT, P stands for a patient population, I stand for intervention or issue of interest, C stands for comparison of interventions or comparison of interests, O stands for an outcome, and T stands for the time frame. Here are some research questions related to my topic using PICOT.
Are people the age of 40 or older (P) who have been smoking cigarettes (I) compared with those who have never smoked cigarettes (C) at increased risk for COPD (O) after 1-10 years?
For patients diagnosed with COPD disease (P), how does the use of influenza vaccine (I) compared to not receiving the vaccine (C) impact the risk of developing Pneumonia (O) during flu season (T)?
For patients with respiratory issues (P), does smoking cessation (I) reduces the risk of developing COPD (O) compared with patients with smoking (C) in 5-10 years (T)?
These are research questions mainly focused on COPD patients or patients with respiratory difficulty and smoking cessation. Smoking is a leading cause of COPD, and smoking cessation can reduce further damage to the heart. Also, the current guidelines advocate annual vaccination against influenza for all COPD patients, regardless of severity or age, with one shot (Eagan et al., 2016). It means all COPD patients are recommended for the influenza vaccine to prevent them from getting the flu. Hence, smoking cessation, getting annual vaccinations, and teaching about the risk of smoking can help to decrease the risk of COPD.
Reference:
Lewis, S. M., Dirksen PhD, R. R. S. N., Heitkemper, M. M. L., Bucher, L., Harding, M. M., Kwong, J., & Roberts, D. (2017). Medical-surgical Nursing: Assessment and Management of Clinical Problems (10th ed.). St. Louis, Missouri: Elsevier, Incorporated.
Pizzichini, E., Pizzichini, M. M. M., Caminha, G. P., Lubianca Neto, J. F., Hopkins, C., & Moreira, J. da S. (2018). Rhinosinusitis symptoms, smoking, and COPD: Prevalence and associations. Clinical Otolaryngology, 43(6), 1560–1565. https://doi- org.westcoastuniversity.idm.oclc.org/10.1111/coa.13215
Eagan, T. M., Hardie, J. A., Grydeland, T. B., Bakke, P. S., & Cox, R. J. (2016). Self-reported influenza vaccination and protective serum antibody titers in a cohort of COPD patients. Respiratory Medicine, 115, 53-59. doi: http://dx.doi.org.westcoastuniversity.idm.oclc.org/10.1016/j.rmed.2016.04.008
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Question 
Begin by selecting a topic in nursing posted below that is of interest to you. Next, use PICOT to format a research question about that topic. Provide 1 PICOT research question. Find one quantitative or qualitative peer-reviewed research article related to your nursing topic that was published within the last five years. Reminder: All peer-reviewed research articles have methods, discussion, and results sections.
The Clinical Issue and Research Questions Developing Using PICOT
* Posted below is an example of a PICOT research question. Please use it to help with the question.
Include the following:
Title page
Provide a brief description of the topic and background information. You can use your peer-reviewed journal or the Evidence-Based Practice care sheets in CINAHL or Nursing Reference Center Database.
Explain the significance of the topic to nursing practice. Background information can be found in journal articles in the introduction section. Results and conclusions will speak to the significance of the topic. The EBP care sheets posted below may have sources for you to choose from.
Provide 1 clearly-stated PICOT question.
Include 1 peer-reviewed journal source related to your topic.
*These are the nursing topics to choose from. Falls, Accidental: Resulting in Injury
Medication Errors: Distractions and Interruptions
Alarm Fatigue and Patient Safety
Pressure Injury: Prevention
Handoff: Patient Safety
Hospital Readmissions
Nursing Staffing and Patient Safety: Shiftwork
CAUTI
CLABSI
ICU Acquired Delirium
Ventilator-associated pneumonia
Venous thromboembolism
Diabetes
There will be a point deduction if a peer-reviewed research journal article within the last five years is not used and a point deduction if the article is not included with your submission.