picot question

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Fatima Jinnah Women University, Rawalpindi *

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Nursing

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Nov 24, 2024

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Evidence-Based Practice Project: PICOT Paper The level and type of injury, as well as a person's responsiveness to analgesics and perception of pain, all affect how trauma sufferers feel pain. According to Brown et al. (2020), unmanaged or ineffectively controlled pain worsens the impact of trauma on hemodynamic stability, respiratory, renal, and gastrointestinal function, which increases health issues and mortality. My PICOT question is: In geriatric trauma patients, does administering scheduled analgesics compared to PRN analgesics decrease the length of hospital stay within six months? This paper will discuss the PICOT, including demographics, the evidence-based intervention, expected outcomes, implementation, and evaluation. Population\'s Demographics and Health Concerns Over 46 million older adults, or those who are 65 or older, are currently residing in the United States, according to the U.S. Census Bureau. The number of older persons is predicted to grow by about 18 million between 2020 and 2030, when the final baby boom group reaches the age of 65 (Dahlhamer et al., 2018). Healthcare, long-term care, and social services are becoming more and more necessary as the world's population ages (Dahlhamer et al., 2018). Due to many chronic health issues such heart disease, hypertension, diabetes, arthritis, and depression, geriatric people have different healthcare needs than other age groups. In addition to age-related physical changes, chronic diseases increase the risk of falls and fractures in older persons, which can result in trauma (Dahlhamer et al., 2018). By 2050, it is anticipated that over 40% of all injured patients will be individuals older than 65. Between 2007 and 2016, the proportion of patients with serious trauma who were 65 years of age or older rose from 25.1% to 36.7%. According to Jiang et al. (2020), the incidence of geriatric trauma rises by 4.3% every year. Trauma is linked to both acute and chronic pain, which, if not properly controlled, can lead to decreased mobility, respiratory problems, delirium, and a higher risk of readmission to the hospital. Proposed Evidence-Based Intervention

Giving geriatric trauma patients scheduled analgesics is the suggested EBP strategy. According to Brown et al. (2020), the optimum method for managing acute trauma pain in older individuals is to follow a regular regimen of safe analgesics for brief periods of time. Patients have improved pain control when analgesics are administered on a regular schedule. It significantly increases patient and provider satisfaction, minimizes hospital stay, and maximizes pain control (Brown et al., 2020). Reducing chronic pain and the abuse of prescription painkillers is an objective of Healthy People 2030 that is congruent with the intervention (ODPHP, 2020). The intervention will assist in achieving CP-01's goal of lowering the percentage of persons with chronic pain who frequently have their daily activities restricted (ODPHP, 2020). Additionally, it will assist in achieving goals CP-D01 and CP-D02, which are to improve self-management of chronic pain that commonly limits life or work activities and lessen the effect of chronic pain on loved ones. Previous Practice or Research Geriatric trauma patients received analgesics on a PRN basis as part of the previous standard of care for pain management. The use of improper analgesics in senior patients has been linked to the PRN practice, which worsens their pain (Vaismoradi et al., 2021). Additionally, it results in inadequate pain management, which has a detrimental impact on patients' quality of life and wellbeing, raises the risk of readmissions, and raises the expense of medical care. An increased dependence on analgesics, especially opioids, is linked to PRN (Vaismoradi et al., 2021). The PRN practice must advance by creating a personalized care strategy. The Expected Outcome for the Intervention The administration of scheduled analgesics is anticipated to lead to better patient perceptions of pain management and, as a result, higher patient satisfaction with the standard of care. Additionally, more people are anticipated to take prescribed pain relievers such acetaminophen and low-dose opioids (Brown et al., 2020). Scheduled analgesia is anticipated to enhance pain management and thus boost patients' freedom and mobility. A shorter hospital stay for senior patients will result in lower medical expenses in the long run, according to Brown et al. (2020). Additionally, it will assist in reducing the need of PRN analgesics and their related side effects, such as opioid dependence..

Time for Implementing the Intervention and Evaluating the Outcome Within six months, the evidence-based intervention will be put into practice. Reviews of geriatric trauma patients who were admitted within the previous six months will be recorded by nurses. Patients' average pain scores, whether they were taking planned or PRN analgesics, and their levels of care from pre-hospital to discharge will all be recorded by nurses. The average pain score and length of hospital stay for trauma patients who received planned versus PRN analgesics will be compared six months later for an evaluation.. Support for Population Health Management for Selected Population Through health promotion, nursing science is used to support the management of senior patients' health. It focuses on informing senior citizens on how to stop or delay the onset of chronic illnesses and injuries that could result in trauma (Dahlhamer et al., 2018). The quality of care is impacted by social determinants of health such unemployment, low household income per capita, and low levels of education. In order to save healthcare expenditures, they should be combined in the treatment of geriatric trauma patients by offering effective pain management measures. According to Gioffrè-Florio et al. (2018), women experience falls and injuries in older populations more often than males do. The information can be used to target specific patients for teaching on preventing slips, trips, and falls as well as the best care strategies to take into account when lowering trauma-related mortality and morbidity. Conclusion Pain management is an essential component of trauma care because trauma is uncomfortable. Geriatrics are at risk for falls, which are the main cause of trauma in this population due to a number of chronic health issues. To provide geriatric trauma patients with scheduled analgesics is my suggested evidence-based solution. In order to effectively and appropriately manage pain in geriatric trauma patients, a planned analgesic regimen is necessary. The intervention is anticipated to enhance pain management, boost independence and mobility, and shorten hospital stays.

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References Brown, L. R., Ferre, A. C., & Ho, V. P. (2020). Aches and Pain in the Geriatric Trauma Patient. Current Trauma Reports , 6 , 174-182. Dahlhamer, J., Lucas, J., Zelaya, C., Nahin, R., Mackey, S., DeBar, L., ... & Helmick, C. (2018). Prevalence of chronic pain and high-impact chronic pain among adults—United States, 2016. Morbidity and Mortality Weekly Report , 67 (36), 1001. Gioffrè-Florio, M., Murabito, L. M., Visalli, C., Pergolizzi, F. P., & Famà, F. (2018). Trauma in elderly patients: a study of prevalence, comorbidities and gender differences. Il Giornale di chirurgia , 39 (1), 35. Jiang, L., Zheng, Z., & Zhang, M. (2020). The incidence of geriatric trauma is increasing and comparison of different scoring tools for the prediction of in-hospital mortality in geriatric trauma patients. World journal of emergency surgery , 15 (1), 1-8. Vaismoradi, M., Jamshed, S., Lorenzl, S., & Paal, P. (2021). PRN medicines management for older people with long-term mental health disorders in home care. Risk management and healthcare policy , 2841-2849.

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