NURS FPX 4025 Assessment 3 Applying the PICO (T) Process

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Assessment

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NHS FPX 4000:
Developing a Health Care Perspective

NHS FPX 4000 Assessment 2

Applying Research Skills

NHS FPX 4000 Assessment 2

Applying Research Skills

NHS FPX 4000 Assessment 2

Applying Research Skills

NHS FPX 4000:
Developing a Health Care Perspective

NHS FPX 4000 Assessment 2

Applying Research Skills

NHS FPX 4000 Assessment 2

Applying Research Skills

NHS FPX 4000 Assessment 2

Applying Research Skills

NHS FPX 4000:
Developing a Health Care Perspective

NHS FPX 4000 Assessment 2

Applying Research Skills

NHS FPX 4000 Assessment 2

Applying Research Skills

NHS FPX 4000 Assessment 2

Applying Research Skills

NHS FPX 4000:
Developing a Health Care Perspective

NHS FPX 4000 Assessment 2

Applying Research Skills

NHS FPX 4000 Assessment 2

Applying Research Skills

NHS FPX 4000 Assessment 2

Applying Research Skills

NHS FPX 4000:
Developing a Health Care Perspective

NHS FPX 4000 Assessment 2

Applying Research Skills

NHS FPX 4000 Assessment 2

Applying Research Skills

NHS FPX 4000 Assessment 2

Applying Research Skills

NHS FPX 4000:
Developing a Health Care Perspective

NHS FPX 4000 Assessment 2

Applying Research Skills

NHS FPX 4000 Assessment 2

Applying Research Skills

NHS FPX 4000 Assessment 2

Applying Research Skills

NHS FPX 4000:
Developing a Health Care Perspective

NHS FPX 4000 Assessment 2

Applying Research Skills

NHS FPX 4000 Assessment 2

Applying Research Skills

NHS FPX 4000 Assessment 2

Applying Research Skills

NURS FPX 4025 Assessment 3

[Student Name]

Capella University

[Prof. Name]

August 2025

NURS FPX 4025 Assessment 3: Heart Failure and the PICO(T) Process

One of the research methodologies is PICO(T), which leads to precise, applicable, and evidence-based solutions to clinical questions. It aids the realization of evidence-based practice (EBP) by doctors. Even though not every case is a concern, P in the PICO(T) case represents patients, population, or problem, I represent the intervention, C means comparison or control, O-outcome, and T- time. PICO(T) procedure may serve as a buffer to refine search findings and reduce the list of available evidence that can be reached in clinical cases. In NURS FPX 4025 Assessment 3, the PICO(T) methodology will design a research question on the issue of heart failure and then use the research to answer the question.

Heart Failure

Heart failure is the persistent disease that concerns a big number of individuals globally. This condition can be investigated by the use of PICO(T) in clinical decision making. Overall, the quality of life in HF has been linked with poor quality of life, elevated hospitalization, and negative mortality. There are nearly 6 million citizens with heart failure in the United States alone (Roger & Clinic, 2021). When the body functional needs overpower the cardiac output, acute illness advances to heart failure (HF). According to the findings of the American Heart Association (AHA) using the PICO(T) framework in nursing, the previous use of tobacco, high blood pressure, obesity, increased cholesterol, and a deficiency of physical exercise are some of the factors that raise the risk of having heart failure (AHA, 2025). Although most of these risk factors are being believed to be changeable, there are still risk factors, such as history of

myocardial infarction, birth abnormalities and cardiomyopathy, which may also be hereditary (AHA, 2025). They are discussed in NURS FPX 4025 Assessment 3.

The negative outcomes of heart failure (HF) include decreased quality of life, cardiaccachexia, arrhythmia, acute lethal cardiovascular events, increased numbers of hospitalizations, and thrombosis (Malik & Chhabra, 2023). Moreover, although the disease is not new and medical community shows its great interest, HF patients still die with a high rate. PICO model for research can apply in the case of a five-year survival of patients with newly diagnosed heart failure which is estimated to be at approximately 50 percent (Roger & Clinic, 2021). These effects and consequences can be much more serious in the case of populations that have become historically marginalized. These populations often do not have quality healthcare, so it affects their general health adversely. This problem can be resolved with the help of nursing research PICO questions. The most exposed to heart failure (HF) are the Black people and then Hispanic people (Bozkurt et al., 2023). They could be attributed to the presence of institutional racism and health inequity in the social determinants of health, and these groups have a greater risk of developing the cardiac risk factor of heart failure as compared to whites (Bozkurt et al., 2023). As a consequence of the above-mentioned healthcare disparities, the Black and Hispanic individuals tend to develop heart failure issues and unsatisfactory outcomes in general. This was raised in NURS FPX 4025 Assessment 3.

PICOT Question

Patients with heart failure have very frequent readmissions. During a 30-day interval after recovery, roughly a quarter of patients with HF in a healthcare facility were

readmitted (Oskouie et al., 2024). According to the discussion mentioned in NURS FPX 4025 Assessment 3, hospitalization in patients with HF negatively affects the quality of life of the patients and overloads the health system, costing the US economy more than 11 billion dollars annually (Bozkurt et al., 2023). Evidence-based practice PICO example that was used to guide HF patients who are making heavy returns to hospital includes the following. In comparison to a standard care regime, with what does the inclusion of telehealth visits show an effect on readmission rate among HF patients in a one-year period? Some HF sufferers cut across this age bracket. Based on the PICO model for research, in the intervention type, telehealth visits once the patient is released and compare it with no intervention. The result is readmission rates of HF patients who were given the intervention. Lastly there is the one-year period within which the information will be collected

Research Process

The technique of searching into the evidence involved numerous databases and search terms to answer the PICO(T) question. The databases which were utilised were Pub-Med Central, Proquest Nursing Databases, and CINAHL Complete. As the search continued, criteria were employed, so that only results that are peer-reviewed and in English language of the past five years could be utilized. The key words used were; heart failure, readmissions and telehealth. To narrow the results further, even the keywords telemedicine and e-health were mentioned to search. The type of the study was also taken into consideration in order to select the most appropriate evidence that could be used in PICO(T) in clinical decision making.

The main interest of the study was the systematic reviews as well as the meta-analyses. The certainty and relevance of every evidence source in reducing readmission rates of HF patients was evaluated as discussed in NURS FPX 4025 Assessment 3. The article on the implementation of remote monitoring in a systematic review of randomized controlled trials (RCTs) as the method of reducing the number of readmissions related to heart failure and/or chronic obstructive pulmonary disease (Stergiopoulos et al., 2024) was also one of the sources used as evidence-based practice PICO example. As the procedure of the telemonitoring included, the following were remotely measured: blood pressure, oxygen saturation, weight, and heart rate (Stergiopoulos et al., 2024). In the reviewed studies by Stergiopoulos and colleagues, telemonitoring has had no remarkable effects on the readmission rate according to 67 percent of the RCTs of patients with HF (Stergiopoulos et al., 2024). The article was published in the peer-reviewed, cross-disciplinary journal Frontiers in Digital Health and it was posted in PubMed Central during 2024. As medical practitioners, working either at Johns Hopkins or in the Mayo Clinic, they are authors (and experts) in their own right. NURS FPX 4025 Assessment 3 discusses the implementation of intervention telemedicine as a measure to reduce readmission of HF patients, and the present systematic review also attends to the same patient group, outcome, and intervention as part of the proposed PICO(T) question.

A systematic review and meta-analysis research study that aimed to determine the impact of mobile health applications on the outcomes of patients with heart failure (Ni et al., 2024) was the other piece of evidence selected. This study can be used in PICO(T) in clinical decision making. One of the outcomes we covered in this review was

hospitalization rates. Reminders recorded vital sign and symptom reporting, educational materials, patient-based suggestions, telehealth visits, and social support were all included in the mobile application (Ni et al., 2024). The study’s findings, which demonstrate the application of the PICO model for research, show that the use of mobile apps can enhance patient-provider interaction and self-management of the disease, lead to a reduction in hospitalizations, and ultimately improve the quality of life of patients with HF (Ni et al., 2024). In 2024, the paper appeared in the peer-reviewed academic journal Journal of Nursing Management. The CINAHL Complete database has information on it. Ni and the writers are affiliated with the West China Hospital’s Cardiology department. As an evidence-based practice PICO example, Ramtin and colleagues’ review, meta-analysis, and systematic analysis from 2023 were carried out to evaluate and synthesize data in order to determine whether the use of distance education was linked to the readmission of patients with heart failure (HF). As discussed in NURS FPX 4025 Assessment 3, remote education in this work refers to instruction via phone calls or video calls, text messages, telemonitoring with an individual education plan, mobile applications, and print booklets with physical copies (Ramtin et al., 2023). Through this systematic review and meta-analysis, the authors concluded that telehealth and other remote learning techniques and systems probably reduce readmissions among patients with heart failure (Ramtin et al., 2023). To find this study, the ProQuest ion Nursing Databases were utilized. The study was initially published by John Wiley & Sons, Inc., a well-known publisher of academic publications, in Nursing Open, an open-access, peer-reviewed journal. Furthermore, because the 2023 study only looked at the readmission rates of HF patients, it can be deemed pertinent to the

diagnosis and issue being examined, which can be used in PICO(T) in clinical decision making.

The following PICO(T) question can be addressed with the help of the evidence: How do telehealth visits affect hospital readmission rates for HF patients over a 12-month period when compared to standard care? The telehealth logic of telemonitoring was not statistically significant when used to lower the rehospitalization rate in patients with heart failure (Stergiopoulos et al., 2024), which can be investigated using the PICO(T) framework in nursing. This is one of the sources of evidence. NURS FPX 4025 Assessment 3 noted that while telemonitoring was found to be insignificant in lowering readmission rates, other telehealth interventions might have comparable effects. According to a systematic review and meta-analysis by Ni and colleagues (2024), hospitalization rates for heart failure patients generally decreased after the introduction of a mobile health application that allows patients to track their symptoms, report vital signs, schedule telehealth visits with providers, and access educational materials. Ramtin and colleagues’ other systematic review and meta-analysis from 2023 showed how the PICO model for research and showed that distance education had a favorable impact on HF patients’ readmission rates. Since both studies found that distance education, including the use of mobile applications and access to telehealth phone calls and video visits reduced rehospitalization among patients with heart failure, the paper by Ni and colleagues (2024) supports the study by Ramtin and colleagues (2023). As discussed in NURS FPX 4025 Assessment 3, telemedicine seems to be able to lower hospital readmissions as compared to not employing telehealth modalities, according to the research that has been presented. For the most part, telemonitoring

was found to be inconsequential (Stergiopoulos et al., 2024). However, the total hospitalization readmission rate for individuals with HF may be reduced with the use of remote learning tools and mobile health apps (Ni et al., 2024; Ramtin et al., 2023).

References

American Heart Association (AHA). (2023, March). What is heart failure? heart.org. Retrieved March 20, 2025, from https://www.heart.org/en/health-topics/heart-failure/what-is-heart- failure

Bozkurt, B., Ahmad, T., Alexander, K. M., Baker, W. L., Bosak, K., Breathett, K., Fonarow, G. C., Heidenreich, P., Ho, J. E., Hsich, E., Ibrahim, N. E., Jones, L. M., Khan, S. S., Khazanie, P., Koelling, T., Krumholz, H. M., Khush, K. K., Lee, C., Morris, A. A., Page, R. L., 2nd, … Writing Committee Members (2023). Heart failure epidemiology

and outcomes statistics: A report of the heart failure society of America. Journal of cardiac failure, 29(10), 1412–1451.

https://doi-org.library.capella.edu/10.1016/j.cardfail.2023.07.006

Malik A, Chhabra L. (2023). Congestive heart failure. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan. https://www.ncbi.nlm.nih.gov/books/NBK430873/

Ni, Y.-X., Liu, X.-H., He, L., Wen, Y., You, G.-Y., & Igarashi, Y. (2024). Mobile application‐ based interventions for people with heart failure: A systematic review and meta‐ analysis. Journal of Nursing Management, 2024, 1–14. https://doiorg.library.capella.edu/10.1155/2024/6859795

Oskouie, S., Pandey, A., Sauer, A. J., Greene, S. J., Mullens, W., Khan, M. S., Quinn, K. L., Ho, J. E., Albert, N. M., & Van Spall, H. G. (2024). From hospital to home: Evidence-based care for worsening heart failure. JACC. Advances, 3(9), 101131. https://doiorg.library.capella.edu/10.1016/j.jacadv.2024.101131

Ramtin, S., Yazdani, Z., Tanha, K., & Negarandeh, R. (2023). The impact of distance education on readmission of patients with heart failure: A systematic review and meta-analysis. Nursing Open, 10(7), 4205-4215. https://doi.org/10.1002/nop2.1698

Roger, V. L., & Clinic, M. (2021). Epidemiology of heart failure. Circulation Research, 128(10), 1421. https://10.1161/circresaha.121.318172

Stergiopoulos, G. M., Elayadi, A. N., Chen, E. S., & Galiatsatos, P. (2024). The effect of telemedicine employing telemonitoring instruments on readmissions of patients with heart failure and/or COPD: A systematic review. Frontiers in digital health, 6, 1441334. https://doi-org.library.capella.edu/10.3389/fdgth.2024.1441334

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NURS FPX 4025 Assessment 3 Applying the PICO (T) Process

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NURS FPX 4025 Assessment 3: Heart Failure and the PICO(T) Process

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Research Process

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