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Asking the Relevant Clinical Questions Evidence-based nursing is a process founded on the collection, interpretation, appraisal, and integration of valid, clinically significant, and applicable research. It is not about developing new knowledge or validating existing knowledge, but rather translating existing evidence so that it can be applied to clinical decision making. This process starts with formulating a sound PICO question. PICO is a format for developing a good clinical research question prior to starting a review or research. It is a mnemonic used to describe the four elements of a sound clinical foreground question. Scenarios: #1 A nurse in the PACU is interested in ways to decrease the use of pain medication in post-op patients. She’s wondering if classical music or guided imagery might be efficacious. #2 A 17-year-old African American woman, just diagnosed with hepatitis B, has been taking acetaminophen for headaches. Her mother has heard that acetaminophen can cause liver problems, and she asks you if her daughter should continue taking the drug for her headaches, considering her hep-b diagnosis. #3 You are on a hospital committee exploring best practices in inpatient oncology nursing. The first question to come before the committee is, “how can we improve patients’ sleep quality and quantity without resorting to sleep medication?” The committee decides to explore relaxation techniques (e.g., massage; music), noise reduction, bed/pillow comfort, and ambient temperature changes. Your assignment is to find the best practices to reduce noise levels on the unit. #4 A 53-year-old woman with rheumatoid arthritis wants to possibly change her medication to short-term low-dose corticosteroids instead of NSAIDS, which are upsetting her stomach. Will the corticosteroids be as effective? #5 Jeff, a smoker of more than 30 years, has tried to quit unsuccessfully in the past. A friend of his recently quit with acupuncture. He wonders if he should try it. Instructions: Choose one (1) clinical scenario above, and answer the following questions: -What is evidence-based nursing practice and why is it important? -What is the PICO process? -Formulate a well defined clinical question that will yield the most relevant and best evidence. -Describe the background of the question -Present the question using PICOT format Indicate what will be the best study to answer the clinical question.

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