Medical-Surgical/Telemetry unit

Medical-Surgical/Telemetry unit

Medical-Surgical/Telemetry unit

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I have worked in the Medical-Surgical/Telemetry unit for a few years now, and one of the most common cardiac diseases that I have seen in patients is Congestive Heart Failure (CHF). In fact, CHF affects about 26 million people worldwide, and 800,000 new cases are diagnosed every year (Wang & Li, 2021). Furthermore, the incidence rate is expected to increase every year due to the rising number of people with risk factors for CHF, such as hypertension and diabetes (Wang & Li, 2021). CHF is very debilitating; not only can the disease lower the quality of life for patients, but it can be very costly to public health due to the poor outcomes and high cost of treatment (Wang & Li, 2021). Therefore, prevention of CHF and better management of the disease are beneficial to individual patients and for society as a whole. Medical-Surgical/Telemetry unit

I would like to utilize this information regarding CHF to devise a clinical question in the PICOT format. According to Melnyk and Fineout-Overholt (2019), a PICOT question consists of Patient population, Intervention or Issue, Comparison intervention, Outcome, and Time. My PICOT question is as follows: “In CHF patients (P), how does follow-up education after discharge (I) compared with CHF education during hospitalization (C) affect the rate of re-hospitalization due to CHF exacerbation (O) within six months?”

This PICOT question is relevant and important because of how prevalent CHF is. As stated earlier, CHF affects many people worldwide. As nurses and advanced practice nurses, we are likely to come across many patients who suffer from CHF. Furthermore, some studies have shown that the provision of individualized education to CHF patients after discharge can lead to decreased re-admission due to CHF (Wang & Li, 2021). As educators, nurses can empower patients by providing them with the knowledge and means to maintain optimal health and minimize the negative effects of the disease.



PICOT questions are important for focusing the search for evidence in the introductory process of evidence-based practice. Without properly constructed PICOT questions, research pertinent to the issue at hand may be difficult to locate, or results found may be lacking the necessary evidentiary support to provide the best clinical outcomes (Melnyk & Fineout-Overholt, 2019). According to Dr. Fineout-Overholt, “the purpose of PICOT questions is to guide the systematic search of healthcare databases to find the best available evidence to answer the question” (Melnyk & Fineout-Overholt, 2019, p.72). Therefore, PICOT questions must be properly constructed with all the essential elements to maximize the search for evidence in the literature.

The PICOT question I have constructed is: How does the incorporation of testosterone in bioidentical hormone replacement for perimenopausal and postmenopausal women affect the symptoms of hormone deficiency (e.g. sleeplessness, fatigue, lack of energy, decreased libido, weight gain) compared to the use of estrogen and/or progesterone alone? I came up with this question dealing with my health journey and struggle to find adequate and reliable information on the subject. There is a significant amount of bioidentical hormone replacement options on the market, but some are not recognized by the general medical community, specifically the use of testosterone replacement in women. However, there a many doctors that tout its positive benefits for women and promote its use. I am searching for evidence in the literature that either confirms or contradicts this claim. The journey through perimenopause and menopause can be a difficult process for women and include horrible symptoms that affect a woman’s sleep, energy, exercise, sexual relationship, temperature control, and weight gain for several years. If there is a better way to counteract these symptoms and provide improved patient outcomes then they need to be recognized by the medical community as a whole and incorporated into practice guidelines. My one fear in selecting this question is that there will not be a significant amount of research in which to write my paper or qualify the outcome.

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