Benchmark – Evidence-Based Practice Project: PICOT Paper
Benchmark
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Assessment Description
Refer to the PICOT you developed for your evidence-based practice project proposal in the Evidence-Based Practice Project Proposal: PICOT assignment in Topic 3. If your PICOT required revision, include those revisions in this assignment. You will use your PICOT paper for all subsequent assignments you develop as part of your evidence-based practice project proposal in this course and in NUR-590, during which you will synthesize all of the sections into a final written paper detailing your evidence-based practice project proposal.
Write a 750-1,000-word paper that describes your PICOT. Include the following:
Describe the population’s demographics and health concerns.
Describe the proposed evidence-based intervention and explain how your proposed intervention incorporates health policies and goals that support health care equity for the population of focus.
Compare your intervention to previous practice or research.
Explain what the expected outcome is for the intervention.
Describe the time for implementing the intervention and evaluating the outcome.
Explain how nursing science, social determinants of health, and epidemiologic, genomic, and genetic data are applied or synthesized to support population health management for the selected population.
Create an appendix for your paper and attach the PICOT. Be sure to review feedback from your previous submission and revise your PICOT accordingly.
Complete the “APA Writing Checklist,” located in Class Resources, to ensure that your paper adheres to APA style and formatting criteria and general guidelines for academic writing. Include the completed checklist as the final appendix at the end of your paper.
Refer to “Evidence-Based Practice Project Proposal – Assignment Overview,” located in Class Resources, for an overview of the evidence-based practice project proposal assignments.
You are required to cite four to six peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.
Benchmark Information
This benchmark assignment assesses the following programmatic competencies:
MBA-MSN; MSN
PICOT Final
Name__Shaune Anderson___________________________________
Complete your PICOT using your approved proposed nursing practice problem. If they were approved, you may use the population and intervention developed in your Topic 1 assignment. Include any necessary revisions in this submission. Refer to the “Example PICOT” below as needed for guidance on how to complete the PICOT.
PICOT Question
P Population Substance abuse in antepartum, intrapartum, and postpartum women of childbearing age
I Intervention Support and treatment of the addicted patient
C Comparison Non-opioid addicted pregnant and postpartum patient
O Outcome Decrease maternal mortality rate in the addicted patient
T Timeframe 5 years
PICOT
Create a complete PICOT statement. In pregnant women who are opioid addicted (P), does providing a comprehensive set of services delivered in a coordinated and integrated approach (I), when compared to non-opioid addicted pregnant women (C), lead to decrease in maternal deaths (o) in ante/intra/postpartum patients from day 43- 365 days (T)
Problem Statement
Create a problem statement for your PICOT. You will use this problem statement throughout your final written paper.
Opioid Use Disorder (OUD) is at epidemic levels globally and in the United States (Center for Drug Evaluation and Research, 2019). Studies showed that between 2017-2022 pregnancy associated overdose mortality rates increased by 81%, compared to a 38% increase among non-drug dependent reproductive-aged women (Emilie Bruzelius, 2022). Lack of access to comprehensive services before, during, and after pregnancy. Specifically shortage of maternity care and substance use treatment providers/health centers. Lack of individual and family support within the community and social services(Petersen et al., 2019). Improvement of quality of care and supportive care has the potential to decrease addiction, leading to a decreased maternal mortality rate (Rizk et al., 2019).
References
Center for Drug Evaluation and Research. (2019, September 11). (irbs) and protection of human subjects. U.S. Food and Drug Administration. https://www.fda.gov/about-fda/center-drug-evaluation-and-researchcder/institutional-review-boards-irbs-and-protection-human-subjects-clinical-trials
Emilie Bruzelius, M. (2022, December 6). US trends in drug overdose mortality among pregnant and postpartum persons, 2017-2020. JAMA. https://jamanetwork.com/journals/jama/fullarticle/2799164
Petersen, E. E., Davis, N. L., Goodman, D., Cox, S., Mayes, N., Johnston, E., Syverson, C., Seed, K., ShapiroMendoza, C. K., Callaghan, W. M., & Barfield, W. (2019). vital signs: pregnancy-related deaths, United
States, 2011–2015, and strategies for Prevention, 13 states, 2013–2017. MMWR. Morbidity and Mortality Weekly Report, 68(18). https://doi.org/10.15585/mmwr.mm6818e1
Rizk, A. H., Simonsen, S. E., Roberts, L., Taylor‐Swanson, L., Lemoine, J. B., & Smid, M. (2019). Maternity care for pregnant women with opioid use disorder: A Review. Journal of Midwifery & Women’s Health, 64(5), 532–544. https://doi.org/10.1111/jmwh.13019
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Benchmark: Evidence-based Practice Project- PICOT Description
The paper presents a detailed description of a PICOT developed previously for an evidence-based practice project. The PICOT states, “In pregnant women who are opioid addicted (P), does providing a comprehensive set of services delivered in a coordinated and integrated approach (I), when compared to opioid-addicted pregnant women receiving standard care (C), lead to decrease in maternal deaths (o) in ante/intra/postpartum patients from day 43- 365 days (T) (See Appendix 1). Each aspect of the PICOT is addressed in the subsequent sections. The discussion also draws from relevant and current literature.
Population Demographics and Health Concerns
Women of childbearing age (15 to 49 years) are at risk of mental health issues during the antepartum, intrapartum, and postpartum periods. Mental health problems during pregnancy and postpartum in women in the reproductive age bracket are a global public health problem. Among one of the prevalent mental health issues in this population is opioid use disorder. The Center for Drug Evaluation and Research (2019) reported that opioid use across all age groups and populations is an epidemic worldwide and in the U.S. In women of childbearing age, studies have indicated a rise in overdose-related fatalities. A study by Bruzelius and Martins (2022) on trends of drug overdose deaths in pregnant and postpartum women addicted to opioids showed mortality rates rose by 81% between 2017 and 2020 compared with a 38% increase in non-drug dependent women. Petersen et al. (2019) noted that lack of access to comprehensive care before, during, and after pregnancy heightens the risk of mortality. Inadequate maternity care and substance use management due to a lack of providers or healthcare facilities worsen the women’s outcomes. Besides, not having family support and ancillary social and community services also aggravates the substance use disorder. Rizk et al. (2019) recommended improving the quality of care and behavioral health support for women in antepartum, intrapartum, and postpartum to reduce opioid dependency and addiction, reducing maternal mortality rate. Overall, opioid use disorder (OUD) is a significant issue in childbearing-age women leading to poor maternal health outcomes and mortality.
Proposed Evidence-Based Intervention
The proposed evidence-based intervention is a comprehensive care for pregnant women to address opioid use disorder. It comprises multiple services, including screening and assessing substance use disorder (SUD) as part of prenatal care. The Substance Abuse and Mental Health Services Administration (SAMHSA) recommends universal screening and assessment as primary care clinical guidelines for pregnant women at risk of SUD. Healthcare providers should provide universal screening to expectant women during the first prenatal visit. They should also follow up on the patients to determine problematic SUD. The goal of screening is to ensure timely assessment of SUD or opioid use disorder to enable access to treatment. The other service involves providing pharmacological treatment to patients who screen positive for OUD. SAMHSA proposes prescribing buprenorphine for patients with opioid use disorder to lessen addiction and prevent maternal death based on drug prescription policies, such as the Consolidated Appropriations Act of 2023, section 1262. They can also refer the patients to life-saving drugs to reduce harm and prevent death from overdose. The agency also urges healthcare practitioners to refer patients to psychotherapists depending on the OUD’s severity. SAMHSA also calls healthcare providers to offer patient-and family-centered care. Patients with OUD should receive personalized and coordinated care. The healthcare providers should engage the patients to improve treatment outcomes. It is also crucial to include family to act as patients’ social support (SAMHSA, 2023). These clinical recommendations from SAMHSA are also supported by research literature. Ecker et al. (2019) recommended screening and follow-up treatment for women with opioid use disorder. The bundled intervention will reduce the mortality rate in women before, during, and after childbirth.
The proposed intervention incorporates health goals and policies. The intervention contributes to Healthy People 2030 goals on maternal deaths and drug and alcohol use. The Healthy People 2030 goal is to reduce maternal deaths by providing quality clinical care to women during pregnancy and postpartum, including preventing illicit and addictive drug use. Relevant objectives include screening for mental health disorders, including depression and OUD (Office of Disease Prevention and Health Promotion, n. d.). The recommended intervention seeks to decrease the mortality rate and improve maternal health outcomes for women before, during, and after child delivery. The intervention also enhances equity by proposing universal screening and follow-up treatment for all women in antepartum, intrapartum, and postpartum. Turienzo et al. (2021) recommended comprehensive care for pregnant women that addresses inequalities and disparities. The authors urged healthcare providers to develop accessible and long-term public health interventions.
Comparing the Intervention to Previous Practice or Research
To examine the effectiveness of the proposed intervention, it will be compared with previous practice or standard care. The standard care for pregnant care entails providing antenatal care, delivery, and maternal and child healthcare services during postpartum. Usually, healthcare providers do not include behavioral health support in antepartum, intrapartum, and postpartum periods. Lack of comprehensive care increases the risk of death in women with opioid use disorder. It also results in unmet mental health needs because most women with SUD have underlying psychiatric disorders, such as depression and anxiety. Therefore, it is expected that the intervention group will have a lower death rate than the control group, which will include opioid-addicted pregnant and postpartum women receiving standard care.
Expected Outcome and Timeframe for The Intervention
The expected outcome is a decrease in mortality rate among pregnant and postpartum women, who are addicted to opioids within 43 to 365 days of the intervention. The rate of deaths among women with opioid use disorder in the intervention arm will be determined and compared with that of the comparison group over the project timeline (43-365 days) (Rizk et al., 2019; Turienzo et al., 2021). A decrease in mortality rate in the treatment group that is higher than in the control arm will indicate the intervention’s effectiveness.
Application of Nursing Science, Social Determinants of Health, and Epidemiologic, Genomic, and Genetic Data Are Applied to Support Population Health Management for The Population
Nursing practice, epidemiologic, social determinants of health, and genetic, and genomic data have been applied to facilitate population health management for opioid-addicted pregnant and postpartum women. The interventions, including primary care, behavioral health support, and patient and family engagement are drawn from nursing science and practice. Also, the intervention assesses mortality rate, which is an epidemiologic measure. It also considers the vulnerability of pregnant women and addresses social determinants of health by improving access to treatment. It also emphasizes screening to identify genomic and genetic data that influence opioid use disorder. Overall, the intervention will promote population health because it adopts a holistic approach.
References
Bruzelius, E., & Martins, S. S. (2022). US trends in drug overdose mortality among pregnant and postpartum persons, 2017-2020. JAMA, 328(21), 2159-2161. https://doi.org/10.1001/jama.2022.17045.
Center for Drug Evaluation and Research. (2019, September 11). (IRBS) and protection of human subjects. U.S. Food and Drug Administration. https://www.fda.gov/about-fda/center-drug-evaluation-and-researchcder/institutional-review-boards-irbs-and-protection-human-subjects-clinical-trials
Ecker, J., Abuhamad, A., Hill, W., Bailit, J., Bateman, B. T., Berghella, V., Blake-Lamb, T., Guille, C., Landau, R., Minkoff, H., Prabhu, M., Rosenthal, E., Terplan, M., Wright, T. E., & Yonkers, K. A. (2019). Substance use disorders in pregnancy: Clinical, ethical, and research imperatives of the opioid epidemic: A report of a joint workshop of the Society for Maternal-Fetal Medicine, American College of Obstetricians and Gynecologists, and American Society of Addiction Medicine. American Journal of Obstetrics and Gynecology, 221(1), 5-28. https://doi.org/10.1016/j.ajog.2019.03.022.
Office of Disease Prevention and Health Promotion (n. d.). Pregnancy and childbirth. Office of Disease Prevention and Health Promotion, U.S. Department of Health and Human Services. https://health.gov/healthypeople/objectives-and-data/browse-objectives/pregnancy-and-childbirth.
Petersen, E. E., Davis, N. L., Goodman, D., Cox, S., Mayes, N., Johnston, E., Syverson, C., Seed, K., ShapiroMendoza, C. K., Callaghan, W. M., & Barfield, W. (2019). Vital signs: Pregnancy-related deaths, United States, 2011–2015, and strategies for Prevention, 13 states, 2013–2017. MMWR. Morbidity and Mortality Weekly Report, 68(18), 423-429. https://doi.org/10.15585/mmwr.mm6818e1.
Rizk, A. H., Simonsen, S. E., Roberts, L., Taylor‐Swanson, L., Lemoine, J. B., & Smid, M. (2019). Maternity care for pregnant women with opioid use disorder: A Review. Journal of Midwifery & Women’s Health, 64(5), 532–544. https://doi.org/10.1111/jmwh.13019.
SAMHSA (2023). Evidence-based, whole-person care for pregnant people who have opioid use disorder: SAMHSA Advisory, May 2023. Substance Abuse and Mental Health Services Administration. https://store.samhsa.gov/sites/default/files/pep23-02-01-002.pdf.
Turienzo, C. F., Newburn, M., Agyepong, A., Buabeng, R., Dignam, A., Abe, C., Bedward, L., Rayment-Jones, H., Silverio, S. A., Easter, A., Carson, L. E., Howard, L. M., & Sandall, J. (2021). Addressing inequities in maternal health among women living in communities of social disadvantage and ethnic diversity. BMC Public Health, 21(176), 1-5. https://doi.org/10.1186/s12889-021-10182-4.
Appendices
Appendix 1: PICOT Final
PICOT Final
Name__Shaune Anderson___________________________________
PICOT Question
P Population Substance abuse in antepartum, intrapartum, and postpartum women of childbearing age
I Intervention Support and treatment of the addicted patient
C Comparison Opioid-addicted pregnant and postpartum patients receiving standard care
O Outcome Decrease maternal mortality rate in the addicted patient
T Timeframe 43 days to 365 days
PICOT
Create a complete PICOT statement. In pregnant women who are opioid addicted (P), does providing a comprehensive set of services delivered in a coordinated and integrated approach (I), when compared to opioid-addicted pregnant women receiving standard care (C), leads to a decrease in maternal deaths (o) in ante/intra/postpartum patients from day 43- 365 days (T)
Problem Statement
Create a problem statement for your PICOT. You will use this problem statement throughout your final written paper.
Opioid Use Disorder (OUD) is at epidemic levels globally and in the United States (Center for Drug Evaluation and Research, 2019). Studies showed that between 2017-2022 pregnancy associated overdose mortality rates increased by 81%, compared to a 38% increase among non-drug dependent reproductive-aged women (Emilie Bruzelius, 2022). Lack of access to comprehensive services before, during, and after pregnancy. Specifically, shortage of maternity care and substance use treatment providers/health centers. Lack of individual and family support within the community and social services (Petersen et al., 2019). Improvement in quality of care and supportive care has the potential to decrease addiction, leading to a decreased maternal mortality rate (Rizk et al., 2019).
Appendix 2: APA Writing Checklist