1. Sandra Kolk Ferris State University COHP 450
PICO PRESENTATION
Sandra Kolk
Ferris State University
COHP 450

2. To begin… Types of Research Design PICO Question
Amongst hospital patients, what does the effect of support and advocacy from professional staff have on patient outcomes versus no support or advocacy?
Qualitative- descriptive and observable data including opinions
Quantitative- facts, numbers and measurable data

3. Searching…
Search Engines
Search Words
Results

4. Rationale Why Important? Advocacy in nursing Emotional support
Discharge planning
Emotional support important when the patient is in your care. Important to understand the needs of your patient and build rapport and trust
Important to communicate the needs of the patient to the next caregiver whether it be that they are being discharged to their home or to another healthcare professional.

5. Article 1: Stroke Discharge advocacy to reduce 30-day readmission rates
Evaluate
Theory
Study
Design
Method
Findings
Comparative design study titled…
Purpose- acute care settings held financially responsible for readmission rates higher than national averages under the patient protection act and affordable health care act
The thought for the study: Readmissions often associated with gaps in follow up care
Sample- 2 neuroscience units and 700 beds in an academic medical center
Compared readmission rates and ED visits before, during, and after the implementation of a revised DC process including better advocacy
Results showed 9.39%- 3.24% readmin a
16.36% % ED

6. Article 2: Mothers’ experiences of labor support: Exploration of qualitative research
Evaluate
Theory
Study
Design
Method
Findings
Qualitative review study
Look at womens perception of labor support by professional caregivers
CINAHL and Healthstar searching words: labor support, labor, delivery
Commonalities of findings sorted into 4 groups
Physical comfort
Emotional support
Informatioal support
Advocacy
Limitations: variety of cultural settings that limit generalizability

7. Ethical Considerations
What is ethics in research?
For this research
Cultural considerations
Informed consent
For the women and labor: cultural considerations as well as informed consent. Cultural sensitivities when implementing research results that may not be generalizable to an entire population
For the Stroke and advocacy article, informed consent is also an ethical consideration, althought there is no identifiying data used

8. Strength/Quality Type of research Dates Feasibility
Qualitative studies bring descriptive, observable data which is important for EBP, however it lacks facts and statistics
Stated- limited number of qualitative studies to compare results
…not as accurate
Stroke advocacy- data is recent and thorough and the Journal and publisher are well known… Lippincott is a very common publisher for nursing books

9. Credibility/Contribution
Education
References
Authors have good credientials in both articles
Including DNP and PhD
References

10. Relevance Communication of results Implications for change
Individual level
Professional level
Generalizability
Labor- communicated at individual level for quality of care, opinions used for quality improvement
Advocacy results- facts and numbers communicatd at professional level policy improvement
Generalizability- good for stroke article, results can be used for a large population
Labor- cultural barrier, not generalizable, limited research

11. Nursing Implications Advocate Follow-up
Supports Advocacy and its importance
Potential to contribute to EBP to change professional policies and require follow up care and ensure proper management after discharge to reduce readmissions and hospital costs
Labor study- qualitative information to consider when working as an OB nurse to improve your quality of care and better understand the needs of your patients

12. Potential Barriers $$$ Judgements Time Lack of credibility
In my personal experience, cost. Everything is billable so when you spend extra time with a patient for follow up care you arent able to bill for that
Need to look past that and realize the benefits it has on the patient as well as long term cost benefits- if they return and we are paid,…lose money
No time to do the extra follow up
Lack of credibility to implement these research findings

13. Additional PICO questions
Amongst the elderly, does having Medicare versus having another insurance increase hospital readmission rates?
Amongst hospitals, does nursing advocacy versus no nursing advocacy for patients increase hospital costs?

14. Conclusion
r/t PICO question and based on my results, advocacy and support from nursing staff does improve patient outcomes. However, more research may be needed to implement as EBP in the healthcare setting

15. REFERENCES Bowers, B. B. (2002, April). Mothers' Experiences of Labor
Support: Exploration of Qualitative Research. JOGNN, 31(6).
Poston, K. M., Dumas, B. P., & Edlund, B. J. (2013, December 6). Outcomes of a Quality Improvement Project Implementing Stroke Discharge Advocacy to Reduce 30-Day Readmission Rates. Journal of Nursing Care Quality, 29(3),
Thank you