Writing thePICOT Question
|What is your burning clinical question? This is a general question about the topic area you are considering for your DNP Project and why this is important to you and your practice.|
|Depression is anticipated to be the leading causal for the disability, and the second contributor to global disease burden by 2020 (Glasziou, 2007). The devastation resulting from depression is based on the number of years lost to death as well as disability, which will be exceeded only by heart disease. Therefore, screening or managing depression is significant to reduce the occurrence of the associated risks and mortality.It is essential to base my project on depression screening tools for adults’ primary care treatment.The project will focus on the primary care diagnosis of the depressive disorders.
Arethe primary care screening toolseffectiveforadults’depression diagnosis as compared to thetraditional standard care? Scores above 15 will warrant treatment for the depression, using psychotherapy, antidepressants orcombination treatment. The Patient Health Questionnaire (PHQ-9) will be used as the main literature search for the project. The chosen articles were relevant to primary health care, as well as the use of depression screening tools, and biases related to the screening tools (Raina, 2013). It is evident that the chosen PHQ-9 is an efficient and effective screening method that provides rapid depression diagnosis eliminating about a half of the patients by the first two questions, and if these two questions obtain a positive response, then I proceed to the next seven questions.Thus, depression screening is an important initiative that facilitates a full diagnostic interview (Schulberg & Scott, 2016). For the realization of the reduced cases of depression by 2020, there is a need for good nursing practice as stipulated by the IOM for the advanced nursing practice. The regular screening is advised to be part of the nursing routine.
|Type of PICOT and Rationale for Choice of this Type of PICOT|
|The model of choice is diagnosis PICOT because there was a need to determine whether screening in primary care is useful or not.|
|P||Depression diagnosis in adults|
|C||Usual standard care|
|O||Effective depression management|
|Written PICOT– use the format as identified in Melnyk & Fineout-Overholt for the specific type of PICOT|
|In adult depression diagnosis, (P)are screening tools (I) effective for primary care patients compared to the usual standard care (C) for depression management in five months (T)?|
|Write a paragraph about the significance of the question to advanced nursing practice. Cite one source**from the literature that also establishes that this is a priority (maybe a national research priority) or why it would be significant for nurses in practice beyond your opinion.|
Concerning the proposed disease cost and depression prevalence, depression in primary care remained underdiagnosed and undertreated partially because of low confidence in the identification and treatment of mental health diseases. Much research proposes re-engineering of primary health care to monitor adherence to treatment and symptom over time besides screening patients for depression (Dreskin, 2018). Diagnosis and treatment for mental health illnesses require a clinical awareness of the significance of the problem, understanding of the available tools for screening, and a systematic approach for the application of patient-centered evidence-based treatment (Melnyk & Fineout-Overholt, 2018).Although there are an increased number of advanced practice nurses in primary care, it is significant to identify the possible reasons that lead to under-diagnosis and under-treatment of depression within their work environment. Therefore, this project will a professional development required for effective screening for nursing practice through a systematicPHQ-9. An EBP through a comprehensive and formative approach guides the development of a plan for practice change.
Dreskin, M. (2018). Depression Care Management—an Evidence-Based, Collaborative Care Approach to Treating Depression in a Primary Care Setting. The Permanente Journal, 89(5), 78-92.
Glasziou, P., Del Mar, C. & Salisbury, J. (2007). Evidence-based practice workbook (2nd ed.). Malden, MA; Blackwell. ISBN: 9781405167284
Melnyk, B., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing and healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Lippincott Williams & Wilkins. ISBN: 978-1496384539 New Edition
Raina, S. (2013). Healthcare technician delivered screening of adults with diabetes to improve primary care provider recognition of depression. Journal of Family Medicine and Primary Care, 2(2), 209.
Schulberg, H. C., & Scott, C. P. (2016). Depression in primary care: Treating depression with interpersonal psychotherapy. Psychotherapy in managed health care: The optimal use of time & resources, 7(1), 153-170. doi:10.1037/10098-012
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