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. Although nursing practice problems and medical practice problems are related in that they are used for medicine, there are differences between the two. A nursing practice problem is an issue encountered during nursing practice, such as during a patient assessment, related to the patient’s response to a health problem they are experiencing. There are numerous considerations to the nursing practice problems (Fuller, 1982). This ranges from the patient’s signs and symptoms to an illness to their difficulties in completing the activities of daily living due to a fractured extremity. This is due to nursing care involves the entire individual, family or community. Fuller, (1982) states that nursing practice problems, “…deal with modalities of patient care such as support, comfort, prevention of trauma, promotion of recovery, health screening, appraisal and/or assessment, health education, and coordination of health care.”
A medical practice problem is concerned with a medical condition or disease. It identifies a condition, searches for causes, establishes a prognosis, and prescribes a treatment for the condition (Chiffi & Zanotti, 2015).
Chiffi and Zanotti (2015) state, “In conclusion, medical and nursing diagnoses have different goals: a medical diagnosis identifies a variation from a norm, while a nursing diagnosis should judge the existence of a potential for enhancing self-care.”
Consider a patient with a fractured wrist. The physician will set the fracture and prescribe pain medication. These are examples of medical practice problems. The nurse will review the aftercare and medication instructions with the patient. The nurse will also review care of the splint and possibly arrange a visiting RN to help with activities of daily living.
The PICOT question is the first step in establishing or improving evidence-based practice with the goal of solving problems with patients. “Nurses use EBP to provide patients with safe, quality care and to improve outcomes” (Helbig, 2018). The PICOT is based on a nursing practice problem because it is designed to improve patient care. An example of using PICOT for evidence-based practice would be studying the frequency of oral care with the goal of reducing the incidence of ventilator associated pneumonias. It is not designed for disease research.
Using 200-300 words APA format with references to support discussion
Solution:
Nursing practice problems and medical practice problems are closely related but differ in focus and scope. A nursing practice problem emphasizes the patient’s response to a health condition and how nursing interventions can promote comfort, recovery, or prevention of complications. Fuller (1982) explains that nursing problems involve modalities of patient care such as health education, prevention, and coordination of care. For example, if a patient has a fractured wrist, a nursing problem might involve impaired mobility and difficulty performing activities of daily living. The nurse would address this through patient teaching, splint care, and arranging supportive resources.
In contrast, a medical practice problem focuses on diagnosing, treating, and curing disease. Chiffi and Zanotti (2015) describe medical diagnoses as identifying a deviation from normal physiology and prescribing treatment. Using the same example, the physician diagnoses the fracture, sets the bone, and prescribes pain medication—tasks centered on the disease itself.
It is essential that a PICOT question be based on a nursing practice problem because evidence-based practice (EBP) in nursing seeks to improve patient care and outcomes rather than investigate disease mechanisms. Helbig (2018) emphasizes that nurses use EBP to deliver safe, high-quality care. For instance, a PICOT question on whether regular oral care reduces ventilator-associated pneumonia addresses a nursing problem because it evaluates an intervention nurses directly provide. Basing PICOT questions on nursing issues ensures research remains patient-centered and within the scope of nursing practice.
References
Chiffi, D., & Zanotti, R. (2015). Medical and nursing diagnoses: A critical comparison. Journal of Evaluation in Clinical Practice, 21(1), 152–158. https://doi.org/10.1111/jep.12252
Fuller, F. T. (1982). Nursing diagnosis: Theory, practice, & research. Appleton-Century-Crofts.
Helbig, J. (2018). History and process of nursing research, evidence-based nursing practice, and quantitative and qualitative research process. Grand Canyon University.
