Hence, we saw an unprecedented surge in telehealth. Policies, HHS Digital What study types are most likely to have the information you seek? The intervention was the classification of a CT scan as either positive or negative for COVID-19. 2 0 obj Provide answers to the following: Identify and describe one practice-related issue or concern. endobj This has included several provisions related to the use of telehealth, including the expansion of what services may be provided virtually.8Private insurers are also taking steps to support the use of telehealth, such as expanding lists of eligible services, waiving cost sharing, and providing monitoring devices to patients.9 Through necessity and as a result of these emergency provisions, the use of telehealth technologies, and broader application of telehealth concepts outside of CMS technical standards, has rapidly increased. withtheleadinvestigators.Thisformatenabled usto question theinvestigatorsaboutcore projectdesignelements,keychallenges, lessonslearned, andfuturedirections.Thestoriesof theseprojectsarepresentedbelow. endobj Running head: EBP TELEHEALTH Evidence Based Practice: Use of Telehealth to Reduce Rehospitalizations in the CHF Population Chadwick Boberg, RN, BSN . Is the presentation clear and easy to follow? As such, it is often necessary to ask background questions, which ask for more general, foundational knowledge about a disorder, disease, patient population, policy issue, etc. 0000034911 00000 n endobj <> [44 0 R 47 0 R 48 0 R 49 0 R 50 0 R 52 0 R 53 0 R 55 0 R 56 0 R 57 0 R 58 0 R 59 0 R 60 0 R] Scenario: Your patient has a history of blood clots and after they came in to your clinic with right calf discomfort and tightness,you're concerned about DVT. uuid:0d82ba4f-b276-11b2-0a00-90a288020000 Use and impact of virtual primary care on quality and safety: The public's perspectives during the COVID-19 pandemic. Missed acute coronary syndrome during telephone triage at out-of-hours primary care: lessons from acase-control study. endstream 15 0 obj The evidence to support the role of telehealth is strong. Published March 2019. over the past 14 years (see About page; opens in new window). In _________ (P), how does _________ (I) compared to _________(C) affect _______(O) within _______ (T)? Is there a control or alternative management strategy you would like to compare to the intervention or indicator? In general, telehealth is the delivery of health care through technology such as mobile phones or computers. Although telehealth was originally developed for rural and underserved patients, telehealth has now emerged in a wide array of healthcare specialties in both the rural and urban setting (Orlando et al., 2019). endobj Dr. Sikka is the Founder and Chief Medical Officer of SonoStik, LLC and advises Emergency Medical Innovations, LLC. Research has demonstrated that it promotes continuity of care, decreases costs, and improves patient self-management and overall outcomes, particularly in the management of discrete disease states. %PDF-1.7 % <> Washington, DC, Eleanor Fitall, MPH Eligible services typically required that the beneficiary live in a rural area and receive services from a clinician at a distant location. PICO Question: Samples with different Specialties; Search this Guide Search. Must be double spaced and and written in Times New Roman 12 Font as per APA guidelines. endobj 2. Escalation protocols should be identified, developed, and applied in the context of a given practice and should cover the range of scenarios that a practice may encounter, including the need for a higher level of care, such as an emergency visit, or the need for diagnostic studies. endobj As a master's prepared nurse in an advanced practice role, discuss how you would evaluate the quality and effectiveness of a telehealth tool. 0000017236 00000 n Centers for Medicare & Medicaid Services. <> 91 42 uuid:0d82ba50-b276-11b2-0a00-9093c99cfe7f Use of proper English spelling is a MUST! 206 0 obj Patient-safety incidents during COVID-19 health crisis in France: An exploratory sequential multi-method study in primary care. endobj PICO (alternately known as PICOT) is a mnemonic used to describe the four elements of a good clinical question. Does dietary carbohydrate intake influence healthy weight maintenance (BMI <25) in patients who have family history of obesity (BMI >30). <>/MediaBox[0 0 612 792]/Parent 11 0 R/Resources<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI]>>/StructParents 25/Tabs/S/Type/Page>> A guide for conducting nursing research at KUMC. Institutions should establish escalation protocols that dictate when a patient receiving telehealth services should be transitioned to urgent in-person follow-up care, or even to receiving emergency services. below. Telehealth, Telemedicine and Telecare: What's What? A good PICOT question should have a measurable outcome and specific interventions. into text boxes that reflect each of the five PICOT components. . 6 0 obj 10.6% of patients are homeless. Across most frameworks, youll often be considering: PICO is the most common framework for developing a clinical research question, but multiple question frameworks exist. https://www.cms.gov/files/document/covid-19-physicians-and-practitioners.pdf. attitudes, experiences and reflections on learning, qualitative, quantitative or mixed methods, What is the context for the question? Eight research . Evidence Based Practice Question (PICO Question) Do weekly telehealth visits in adults over the age of 65 improve loneliness and depression as measured by UCLA loneliness, PHQ-2, and PHQ-9 scales over a 3-month period? <> (Where?). You will be prompted below to choose one of four potential statistical objectives for 2021-10-15T10:45:49-07:00 P- female non smokers w/ daily second hand smoke exposure, C- female non smokers w/o daily smoke exposure. Federal Communications Commission. 37 0 obj Coronavirus Disease 2019 (COVID-19) and Safety of Older Adults Residing in Nursing Homes. <>stream In middle-aged men with suspected myocardial infarction (P), are serial 12-lead ECGs (I) compared with one initial 12-lead ECG (C) more accurate in diagnosing an acute myocardial infarction (O)? Rosswurm and Larrabee (1999) EBP model was used as a guiding framework for the pilot study. Who is the group of people being studied? 132 0 obj <>stream What time periods should be considered? What counts as a reduction in joint pain? Its expanded use has served as a means of ensuring the safety of both patients and frontline providers, as well as conserving use of critical personal protective equipment (PPE) supplied. Accessed May 6, 2020. Associate Professor, Attending Physician (independent variable). Construct your PICOT question in the standard PICOT question format (narrative) and define each letter separately, such as: o P = Native American Diabetic Communities in NM o I = Use Tele-med for monthly follow-up care o C = In comparison to 6 month MD office visits o O = To reduce hospitalizations caused by diabetic complications o T = Over the If implemented appropriately, telehealth can be an incredibly effective approach to ensuring patient and provider safety during this unprecedented outbreak. 0000001136 00000 n Questions addressing the prediction of the course of a disease. Utilizing Telehealth Technology to Reduce Social Isolation and Depression in Seniors <>19]/P 27 0 R/Pg 45 0 R/S/Link>> What is a good PICO(T) questions regarding telehealth during the COVID pandemic? Secondary Research Articles ; (KKc ]ROSU6Mpk45xr^MzFKOg{K/-i}>?\=oJQq,- Questions addressing the prediction of the course of a disease. 8. endobj endobj 9. In _______(P), what is the effect of _______(I) on ______(O) compared with _______(C) within ________ (T)? please use the PICOT question examples All rights reserved. Patient Satisfaction with Telehealth Services Compared to In-Office Visits: A Systematic Literature Review I have taught the PICOT You may choose to build on the practice issue you identified in NR500NP/NR501NP. clinical placements in prison healthcare settings. Appropriate for: questions of experience or perspectives (questions that may be addressed by qualitative or mixed methods research). A Virtual Hospitalist Program to Address a Hospitals Challenges at the Start of the COVID-19 Pandemic. <><>7 8]/P 6 0 R/Pg 45 0 R/S/Link>> application/pdf TheirBMI is within a normal range, but they have a family history of obesity, and are concerned aboutthe impact carbsmay have onmaintaining a healthy weight. In _______(P), what is the effect of _______(I) on ______(O) compared with _______(C) within ________ (T)? 5 0 obj While telehealth is providing powerful approaches for protecting patients and providers during the COVID-19 outbreak, its increased and evolving use raises other potential patient safety concerns. AppendPDF Pro 6.3 Linux 64 bit Aug 30 2019 Library 15.0.4 using the PICOT framework. Nam lacinia p, s ante, dapibus a molestie consequat, ultrices ac magna. . As this suggests, deficient safeguarding in regards to confidential information is a very real danger in telemedicine practice (Thompson, Koumanakos and Hadjri, 2012). <>3]/P 6 0 R/Pg 196 0 R/S/Link>> Clinic design for safety during the pandemic: safety or teamwork, can we only pick one? <> endobj Please read the assignment guidelines and rubric. Ensuring primary care diagnostic quality in the era of telemedicine. Accessed April 26, 2020. The George Washington University The use of telehealth has been growing steadily as a patient-centered complement to care provided face-to-face, particularly among private insurers. Issues that can "Over six month period.." or "In three years"). https://www.ahip.org/health-insurance-providers-respond-to-coronavirus-covid-19. Obtain consent for telehealth visits and explain the process thoroughly and answer any questions. Using these remote and virtual capabilities can reduce the number of providers that need to come into direct contact with a patient in the hospital and can conserve single-use PPE. application/pdf in new window). Introduction; Research Toggle Dropdown. "The question needs to identify the patient or population we intend to study, the . Use this worksheet to break down the parts of your PICO question. Medical Faculty Associates Identifying barriers to and opportunities for telehealth implementation amidst the COVID-19 pandemic by using a human factors approach: a leap into the future of health care delivery? This allows patients to receive care from the safety of their homes and avoid exposure to the virus during transit or at in-person appointments. These solutions include "encryption technologies, anonymizers, and opt-in functions" (Thompson, Koumanakos and Hadjri, 2012, p. 149). endobj Health Affairs Blog. 5-8. xWN@}z}-I$RS_:\U Fwv=38{e5Q;;^U%i:+'.7NHd2jVpy[Qrw_$$p5$isng?vo!'q, Utilizing Telehealth Technology to Reduce Social Isolation and Depression in Seniors. A good PICOT question has five elements and is most applicable in evidence based cases. Short(Definitions(of(Different(Types(of(Questions( First, providers need to understand the limitations of delivering care remotely and the implications on their diagnostic capabilities, particularly among providers who have limited prior telehealth experience. What are the qualitative differences in patient experience in telehealth versus in-person interactions with healthcare providers. Your PICOT question looks good but it is too broad. Patient Safety Events and the Role of Patient Safety Organizations During the COVID-19 Pandemic. your PICOT question. The definitions and frames below may be helpful for organizing your question: Questions addressing how a clinical issue, illness, or disability is treated. Questions addressing how one experiences a phenomenon or why we need to approach practice differently. |I 2012). endobj All clinical staff within a given institution should be aware of these guidance documents and of when to use them. My name is Eric Heidel, PhD, PStat, and I am an Associate Professor of Biostatistics at Questions addressing the act or process of identifying or determining the nature and cause of a disease or injury through evaluation. q6&}h8"@*5Mx-";WS,7uG?E|J(#%tR)uYfh#=\XF##;\Iiuxr4!eJtIB |$={vbw468&E(?Q~? Example: For adolescents with type II diabetes (P) does the use of telehealth consultations (I) compared to in-person consultations(C)improve blood sugar control(O)? trailer It can help reduce barriers to care for people who live far away from specialists or who have transportation or mobility issues. long term transition support programs (residency/mentorship), no or limited transition support / orientation. MEDPAC. Columbia, MD. 0000049147 00000 n endobj Management and patient safety of complex elderly patients in primary care during the COVID-19 pandemic in the UK-Qualitative assessment. Telehealth Nursing Essay. 0000003917 00000 n Telehealth typically involves the delivery of long-distance or remote healthcare via electronic communication and information technologies. Safeguards are required, such as password protection, in order to ensure that issues of confidentiality of patient data are enforced (Lateff, 2011). In order to most appropriately choose an information resource and craft a search strategy, it is necessary to consider whatkindof question you are asking: aspecific, narrow "foreground" question, or a broader background question that will help give context to your research? First, providers need to understand the limitations of delivering care remotely and the implications on their diagnostic capabilities, particularly among providers who have limited prior telehealth experience. endobj IMPAQ International T- Time period(ie. Many people find that it helps them clarify their question, which in turn makes it easier to find an answer. With this unprecedented surge in use of telehealth, there is matter of delivering quality care. Understanding how the design and implementation of online consultations affect primary care quality: systematic review of evidence with recommendations for designers, providers, and researchers. Also consider: Appropriate for: describing association between particular exposures/risk factors and outcomes. 37 0 obj This worksheet will help you build a PICOT question and identify keywords for your searchable question. ing real world practice, based on the research question and type of intervention.17 Table 1 gives a classication of the major types of comparisons in telehealth research. (I) Intervention, treatment, or issue of interest. All sources and references must not be older than 5 years old. statistical tests by visiting the PICOT question and statistics page (opens in new window). Published March 30, 2020. Policy, U.S. Department of Health & Human Services. Sites, Contact a who (who was studied - a population or sample), a what (what was done or examined - an intervention, an exposure, a policy, a program, a phenomenon). The extensive uptake of telehealth has considerably transformed health care delivery since the beginning of the COVID-19 pandemic and has imposed tremendous challenges to its large-scale implementation and adaptation. endobj endobj PICO is a abbreviation that has elements of a good clinical question. Example: What are the experiences and perspectives ofundergraduate nursing studentsin clinical placements within prison healthcare settings? Such virtual triage processes can protect other patients by directing potentially infected individuals to the most appropriate location to seek care or testing and keep them out of primary care waiting rooms. https://s3.amazonaws.com/media2.fairhealth.org/whitepaper/asset/A%20Multilayered%20Analysis%20of%20Telehealth%20-%20A%20FAIR%20Health%20White%20Paper.pdf. Click "Next" below to start your research. What is the outcome that may be affected by the exposure (dependent variable)? In OR nurses doing a five minute scrub (P) what are the differences in the presence and types of microbes (O) found on natural polished nails and nail beds (I) and artificial nails (C) at the time of surgery (T)? the University of Tennessee Graduate School of Medicine (UTGSM) as well as an PICOT is an acronym that is used to represent the clinical question: (P) Patient population, or group of patients of interest. Understanding such fundamentals, like regulating speech pattern or positioning the video camera, lighting, and location can make the experience more user-friendly for the patient and facilitate a smooth and effective visit. 0000008905 00000 n HW]%7}_Q,u%)LC2! t ,rV%K:,SB+ufoh!eO$Cz3-T1b4$r6{}L{-SgC'\~JKXv))p:F.-w4Eots\o[Lwq41! A&\D;5)eiXHaP@@6b6w_lliq|"("2:WcF+axOSFz.>W]!IfAn?YZ &k+k:LgiHh> U1r(V zjCT^{6),9M~[fL]cElf [S|i>T OQ0)=N|_WC\3HOK[ERj=#=jQd The increased use of telehealth during the COVID-19 pandemic has not been without challenges. Adapted from: Melnyk, B. M., & Fineout-Overholt, E. (2011). 5600 Fishers Lane <>17]/P 20 0 R/Pg 196 0 R/S/Link>> In ________ (P) are/is ________(I) compared with ________(C) more accurate in diagnosing ________(O)? 214 0 obj 41 0 obj Research Associate, IMPAQ Health :&VLp~3H Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins. Adapted from the PICOT Questions Template; Ellen Fineout-Overholt, 2006. % <> xU]o@|\l(TU P`klqgD5P$w=XmeWp3^4uUm^&`Fp 0J3N?kzn~`~s@$RSzdr_UMV/`6IG*,f%R!,q1zub:1f)tO|qSPq5L#(gs]K,WL?3y8kTJG:YzI0)R!fw^,,i [)/h Ra hn&0IM,B))\|(,Ucq~vNS~J0%2 G%~sH$u". -dJia,V?w*ky$k9:%~ Mandated report: Telehealth services and the Medicare program. 0000031290 00000 n 26 0 obj Accredited Professional Statistician. Washington, DC, Joel Willis, DO, PA, MA, MPhiL Accessed April 26, 2020. endobj PICOT: The PICOT question that guided this project was among patients with a recent diagnosis of stroke (P), what is the effect of a telehealth appointment with a nurse practitioner (NP) for post discharge follow-up (I), compared to a standard face-to-face clinic appointment (C), on 30-day readmissions rates (O), within two months (T)? Questions addressing the act or process of identifying or determining the nature and cause of a disease or injury through evaluation.