Description
The purpose of this assignment is to provide the student the opportunity demonstrate competency in performing the role of the psychiatric mental health nurse practitioner in a safe environment.
PICO Question “How have the dynamics of fentanyl use correlated with fentanyl-related deaths changed in children (aged zero to eighteen years) compared to adults (aged nineteen and above years) in the last three years?”
Submission Instructions:
To complete this assignment, address the following criteria:
Posters should include the following content:
A Project title. This should be placed towards the top of the poster, including the names of the authors and university affiliation
An Introduction section. This should highlight the problem addressed in a brief literature review with citations and your hypothesis or hypotheses.
The Purpose section: The poster states the objectives of this inquiry relative to the overall evidence-based literature review on this topic.
The Methods/Search Strategy section. An overview of how you studied your primary source(s): Describes the evidence-based solution. How was it developed? Include the theoretical framework (if applicable). Identify databases searched and inclusion/exclusion criteria.
The Results The poster describes the search, the number of studies included, and the level of evidence.
The Synthesis of Evidence The poster briefly describes the synthesis of the evidence that includes major trends and notable gaps.
The Implications for Practice section. The poster includes recommendations for practice, education, or future research based on the review and synthesis of the evidence.
A References section. Make sure your references include at least four references with three primary research articles. Primary articles describe studies in which the authors collected the data themselves. References must be in APA format. If you cannot fit four or more references into your poster, you should provide the references separately as an attached Word document. For assistance with APA formatting, please contact BrainFuse Online link in Canvas or visit the STU library at https://www.stu.edu/library/Links to an external site.
Academic Poster Format
Present your poster in electronic formatLinks to an external site.. Use the linked video as a guide for your assignment.
Students may use PowerPoint Poster template.
Video for creating poster
Grading Rubric
Your assignment will be graded according to the grading rubric.
NUR 670 Poster Presentation Rubric
Criteria Ratings
Points
Project Title Exemplary – 4-5 points
Thoroughly, accurately, and clearly reflect the content of the presentation. Distinguished – 2-3 points
Reflects content very well but not thoroughly. Novice – 0-1 points
Does not reflect content of the presentation. 5 points
Introduction: The abstract states the objectives of this inquiry relative to the overall evidence-based literature review on this topic Exemplary – 4-5 points
Identifies a creative, focused, and manageable topic that addresses potentially significant and previously less explored aspects of the topic, problem, and/or project. Distinguished – 2-3 points
Project and/or research question moderately described. Moderately clear rationale. Purpose was somewhat focused and clear. Novice – 0-1 points
Vaguely described project and/or research question. Weak rationale. Purpose was poorly focused and not sufficiently clear. 5 points
Purpose: States the purpose of the study and why it is important to practice and/or patient care Exemplary – 4-5 points
Background information is engaging and leads to a clear purpose statement. Relevance to advanced practice nursing and the field of psychiatry is articulated well. Distinguished – 2-3 points
Background information is at times unclear or uninteresting. Relevance to advanced practice nursing or psychiatry could be more clearly articulated. Novice – 0-1 points
Background information is illogical or unrelated to the topic. There is no relevance to advanced practice nursing or the field of psychiatry. 5 points
Search Strategy: The poster identifies databases searched, inclusion/exclusion criteria, number of studies included and level of evidence. Exemplary – 7-10 points
Methods are appropriate to address aim/question and connected to the purpose of the research; Identifies method used to support thesis or answer the research question. Distinguished – 3-6 points
Methods are inappropriate to address research aim or question. Methods are unclear or not connected to purpose of research Novice – 0-2 points
Research strategy was not clearly mentioned but implied; or, not appropriate for purpose of the research. 10 points
Synthesis of Evidence: The poster briefly describes the synthesis of the evidence that includes major trends and notable gaps in the research. Exemplary – 14-20 points
Thorough comparison and contrast of findings are provided and relate to the main discussion points in the order of their appearance in the purpose statement. Focus is on research findings rather than research methods. Study limitations that might have led to different findings are discussed. Gaps and controversies that exist in the literature are clearly discussed. Distinguished – 7-13 points
Comparison and contrast of findings are provided but lack thoroughness. Discussion of findings could relate better to the main discussion points in the purpose statement. Study limitations are discussed, but possible connections to differences in findings are not clearly identified. Gaps and controversies in the literature are discussed, but clarity could be enhanced. Novice – 0-6 points
Comparison and contrast of findings are lacking. Discussion of findings does not relate well to the main discussion points in the purpose statement. Study limitations are not mentioned. Gaps (what is unknown and needs to be researched) and controversies that exist in the literature are not discussed. 20 points
Implications for Practice: Does the poster present significance to psychiatry and is it relevant to the advanced practice nurse role? Does it include recommendations for practice, education, or future research based on the review and synthesis of the evidence? Exemplary – 7-10 points
Thorough comparison and contrast of findings are provided and relate to the main discussion points in the order of their appearance in the purpose statement. Focus is on research findings rather than research methods. Distinguished – 3-6 points
Comparison and contrast of findings are provided but lack thoroughness. Discussion of findings could relate better to the main discussion points in the purpose statement. Study limitations are discussed, but possible connections to differences in findings are not clearly identified. Gaps and controversies in the literature are discussed, but clarity could be enhanced. Novice – 0-2 points
Comparison and contrast of findings are lacking. Discussion of findings does not relate well to the main discussion points in the purpose statement. Study limitations are not mentioned. Gaps (what is unknown and needs to be researched) and controversies that exist in the literature are not discussed. 10 points
Writing and Scholarly Voice: Identifies a creative, focused, and manageable
topic that addresses potentially significant and
previously less explored aspects of the topic,
problem, and/or project Exemplary – 4-5 points
Writing is fluid, precise, and clear; lexicon of the field is clearly explained and defined; the tone is professional; vocabulary and syntax are mature; scholarly style and format are accurately used; the candidate’s ‘voice’ is heard and yields a definitive presence, authority, and understanding of the issues being discussed. Distinguished – 2-3 points
Writing is somewhat developed and professional; spelling, punctuation, grammar, in general, meet program and institutional standards; dissertation formatting is adequate; the lexicon of the respective field is understood and used properly. Novice – 0-1 points
More work developing academic writing skills necessary; syntax or vocabulary may not be well developed; a reliance on jargon may be a weakness, writing may be difficult to read or understand; tone may not exhibit an understanding of the academic writing genre; errors of spelling, punctuation or formatting may be present; document may have formatting problems, the candidate may not have a command of the field’s lexicon. 5 points
Oral Presentation: The abstract is concise and coherent. Exemplary – 13-20 points
Narration and/or answering of questions is engaging, thorough, and adds greatly to the presentation. Presentation is well-rehearsed. Voice, eye contact and pacing hold interest and attention of the audience; introduced self and project. Distinguished – 4-12 points
Narration and/or answering of questions is somewhat lacking. Audio-Video presentation does not support the content of the presentation. Some difficulty communicating ideas. Poor voice projections; some eye contact; no introduction; mispronounced a few words; long pauses; appears somewhat confused. Novice – 0-3 points
Narration and/or answering of questions is lacking, Audio-Video presentation was not submitted or the video was not created using the audio or video platform required in the instructions. Great difficulty communicating ideas. Poor voice projection; no eye contact; no introduction; mispronounced words; stopped or had long pauses; read entirely from notes. 20 points
Overall Appearance: The abstract presents significance to psychiatry and is it relevant to the advanced practice nurse role? Exemplary – 7-10 points
Prominently positions title/authors of paper thoroughly but concisely presents main points of introduction, hypotheses/ propositions, research methods, results, and conclusions in a well-organized manner. Overall visually appealing; not cluttered; colors and patterns enhance readability; Uses font sizes/variations which facilitate the organization, presentation, and readability of the research Graphics (e.g., tables, figures, etc.) are engaging and enhance the text content is clearly arranged so that the viewer can understand order without narration. Distinguished – 3-6 points
Visual appeal is adequate; somewhat cluttered; colors and patterns detract from readability Use of font sizes/variations to facilitate the organization, presentation, and readability of the research is somewhat inconsistent/distractions Graphics (e.g., tables, figures, etc.) adequately enhance the text Content arrangement is somewhat confusing and does not adequately assist the viewer in understanding order without narration. Novice – 0-2 points
Not very visually appealing; cluttered; colors and patterns hinder readability Use of font sizes/variations to facilitate the organization, presentation, and readability of the research is inconsistent/distracting Graphics (e.g., tables, figures, etc.) do not enhance the text Content arrangement is somewhat confusing and does not adequately assist the viewer in understanding order without narration. 10 points
APA Formatting: The poster, including all citations, level headings and the references, and follows the 7th Edition APA format. Exemplary – 7-10 points
Follows APA guidelines of components: double space, 12 pt. font, abstract, level headings, hanging indent and in-text citations. The references contain at least the 6-8 required current scholarly academic reference and text reference. Distinguished – 3-6 points
References page contains one current or outdated scholarly academic resource. Many errors of APA 7th guidelines: double space, 12 pt. font, abstract, level headings, hanging indent, and in-text citations. Novice – 0-2 points
References page contains no current scholarly academic resources, only internet webpages or no reference page. Lack of APA guidelines for references provided or in-text citations. 10 points
Total Points
100
Attached are word docs from previous discussions in course based on PICO question. I just cut and pasted it. The comments in yellow are the corrections the professor suggests. Please let me know if you have any questions. I will need to put a pic on poster, according to video. But I guess you will send me poster which is editable and I will be able to add that on my own?double space, 12 pt. font, abstract, level headings, hanging indent and in-text citations. The references contain at least the 6-8 required current scholarly academic reference and text reference.
NUR 670 Poster Presentation Rubric
NUR 670 Poster Presentation Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeProject Title
5 to >3.0 pts
Exemplary
Thoroughly, accurately, and clearly reflect the content of the presentation.
3 to >1.0 pts
Distinguished
Reflects content very well but not thoroughly.
1 to >0 pts
Novice
Does not reflect content of the presentation.
5 pts
This criterion is linked to a Learning OutcomeIntroduction:The abstract states the objectives of this inquiry relative to the overall evidence-based literature review on this topic
5 to >3.0 pts
Exemplary
Identifies a creative, focused, and manageable topic that addresses potentially significant and previously less explored aspects of the topic, problem, and/or project
3 to >1.0 pts
Distinguished
Project and/or research question moderately described. Moderately clear rationale. Purpose was somewhat focused and clear.
1 to >0 pts
Novice
Vaguely described project and/or research question. Weak rationale. Purpose was poorly focused and not sufficiently clear.
5 pts
This criterion is linked to a Learning OutcomePurpose:States the purpose of the study and why it is important to practice and/or patient care
5 to >3.0 pts
Exemplary
Background information is engaging and leads to a clear purpose statement. Relevance to advanced practice nursing and the field of psychiatry is articulated well.
3 to >1.0 pts
Distinguished
Background information is at times unclear or uninteresting. Relevance to advanced practice nursing or psychiatry could be more clearly articulated.
1 to >0 pts
Novice
Background information is illogical or unrelated to the topic. There is no relevance to advanced practice nursing or the field of psychiatry.
5 pts
This criterion is linked to a Learning OutcomeSearch StrategyThe poster identifies databases searched, inclusion/exclusion criteria, number of studies included and level of evidence.
10 to >6.0 pts
Exemplary
Methods are appropriate to address aim/question and connected to the purpose of the research; Identifies method used to support thesis or answer the research question.
6 to >2.0 pts
Distinguished
Methods are inappropriate to address research aim or question. Methods are unclear or not connected to purpose of research
2 to >0 pts
Novice
Research strategy was not clearly mentioned but implied; or, not appropriate for purpose of the research
10 pts
This criterion is linked to a Learning OutcomeSynthesis of Evidence:The poster briefly describes the synthesis of the evidence that includes major trends and notable gaps in the research.
20 to >13.0 pts
Exemplary
Thorough comparison and contrast of findings are provided and relate to the main discussion points in the order of their appearance in the purpose statement. Focus is on research findings rather than research methods. Study limitations that might have led to different findings are discussed. Gaps and controversies that exist in the literature are clearly discussed.
13 to >6.0 pts
Distinguished
Comparison and contrast of findings are provided but lack thoroughness. Discussion of findings could relate better to the main discussion points in the purpose statement. Study limitations are discussed, but possible connections to differences in findings are not clearly identified. Gaps and controversies in the literature are discussed, but clarity could be enhanced.
6 to >0 pts
Novice
Comparison and contrast of findings are lacking. Discussion of findings does not relate well to the main discussion points in the purpose statement. Study limitations are not mentioned. Gaps (what is unknown and needs to be researched) and controversies that exist in the literature are not discussed.
20 pts
This criterion is linked to a Learning OutcomeImplications for Practice:Does the poster present significance to psychiatry and is it relevant to the advanced practice nurse role? Does it include recommendations for practice, education, or future research based on the review and synthesis of the evidence?
10 to >6.0 pts
Exemplary
Thorough comparison and contrast of findings are provided and relate to the main discussion points in the order of their appearance in the purpose statement. Focus is on research findings rather than research methods.
6 to >2.0 pts
Distinguished
Comparison and contrast of findings are provided but lack thoroughness. Discussion of findings could relate better to the main discussion points in the purpose statement. Study limitations are discussed, but possible connections to differences in findings are not clearly identified. Gaps and controversies in the literature are discussed, but clarity could be enhanced.
2 to >0 pts
Novice
Comparison and contrast of findings are lacking. Discussion of findings does not relate well to the main discussion points in the purpose statement. Study limitations are not mentioned. Gaps (what is unknown and needs to be researched) and controversies that exist in the literature are not discussed.
10 pts
This criterion is linked to a Learning OutcomeWriting and Scholarly Voice:Identifies a creative, focused, and manageable
topic that addresses potentially significant and
previously less explored aspects of the topic,
problem, and/or project
5 to >3.0 pts
Exemplary
Writing is fluid, precise, and clear; lexicon of the field is clearly explained and defined; the tone is professional; vocabulary and syntax are mature; scholarly style and format are accurately used; the candidate’s ‘voice’ is heard and yields a definitive presence, authority, and understanding of the issues being discussed.
3 to >1.0 pts
Distinguished
Writing is somewhat developed and professional; spelling, punctuation, grammar, in general, meet program and institutional standards; dissertation formatting is adequate; the lexicon of the respective field is understood and used properly.
1 to >0 pts
Novice
More work developing academic writing skills necessary; syntax or vocabulary may not be well developed; a reliance on jargon may be a weakness, writing may be difficult to read or understand; tone may not exhibit an understanding of the academic writing genre; errors of spelling, punctuation or formatting may be present; document may have formatting problems, the candidate may not have a command of the field’s lexicon.
5 pts
This criterion is linked to a Learning OutcomeOral PresentationThe abstract is concise and coherent.
20 to >12.0 pts
Exemplary
Narration and/or answering of questions is engaging, thorough, and adds greatly to the presentation. Presentation is well-rehearsed. Voice, eye contact and pacing hold interest and attention of the audience; introduced self and project.
12 to >3.0 pts
Distinguished
Narration and/or answering of questions is somewhat lacking. Audio-Video presentation does not support the content of the presentation. Some difficulty communicating ideas. Poor voice projections; some eye contact; no introduction; mispronounced a few words; long pauses; appears somewhat confused.
3 to >0 pts
Novice
Narration and/or answering of questions is lacking, Audio-Video presentation was not submitted or the video was not created using the audio or video platform required in the instructions. Great difficulty communicating ideas. Poor voice projection; no eye contact; no introduction; mispronounced words; stopped or had long pauses; read entirely from notes
20 pts
This criterion is linked to a Learning OutcomeOverall AppearanceThe abstract presents significance to psychiatry and is it relevant to the advanced practice nurse role?
10 to >6.0 pts
Exemplary
Prominently positions title/authors of paper thoroughly but concisely presents main points of introduction, hypotheses/ propositions, research methods, results, and conclusions in a well-organized manner. Overall visually appealing; not cluttered; colors and patterns enhance readability; Uses font sizes/variations which facilitate the organization, presentation, and readability of the research Graphics (e.g., tables, figures, etc.) are engaging and enhance the text content is clearly arranged so that the viewer can understand order without narration
6 to >2.0 pts
Distinguished
Visual appeal is adequate; somewhat cluttered; colors and patterns detract from readability Use of font sizes/variations to facilitate the organization, presentation, and readability of the research is somewhat inconsistent/distractions Graphics (e.g., tables, figures, etc.) adequately enhance the text Content arrangement is somewhat confusing and does not adequately assist the viewer in understanding order without narration
2 to >0 pts
Novice
Not very visually appealing; cluttered; colors and patterns hinder readability Use of font sizes/variations to facilitate the organization, presentation, and readability of the research is inconsistent/distracting Graphics (e.g., tables, figures, etc.) do not enhance the text Content arrangement is somewhat confusing and does not adequately assist the viewer in understanding order without narration
10 pts
This criterion is linked to a Learning OutcomeAPA FormattingThe poster, including all citations, level headings and the references, and follows the 7th Edition APA format.
10 to >6.0 pts
Exemplary
Follows APA guidelines of components: double space, 12 pt. font, abstract, level headings, hanging indent and in-text citations. The references contain at least the 6-8 required current scholarly academic reference and text reference.
6 to >2.0 pts
Distinguished
References page contains one current or outdated scholarly academic resource. Many errors of APA 7th guidelines: double space, 12 pt. font, abstract, level headings, hanging indent, and in-text citations
2 to >0 pts
Novice
References page contains no current scholarly academic resources, only internet webpages or no reference page. Lack of APA guidelines for references provided or in-text citations.
10 pts
Total Points: 100
Unformatted Attachment Preview
Creating a Search Strategy (PICO Question)
not graded yet
Rosalind Lopez
St Thomas University
NUR 670: Psychiatric Integration Practicum
Dr Linda Mays
September 14, 2023
The Importance of an Effective Search Strategy
Search strategies are crucial in determining the quality, authenticity, and credibility of the
literature review undertaken. An effective search strategy involves searching for materials from
reliable sources relevant to the study topic. An efficient search strategy, which focuses on
reviewing existing literature, helps retrieve the right articles from a database, which is crucial in
answering the study question (Walden University, 2023). A search strategy helps outline the
parameters and dimensions of the study, such as the population sample to be used, the sampling
methods, the study design, the methodology, and the methods of analysis. It is also helpful in
filtering the research materials to be used by eliminating older materials that are no longer
relevant to the study topic (Walden University, 2023). An efficient and well-executed review can
thoroughly answer research questions and establish a solid platform for advancing knowledge
(Snyder, 2019). My PICO question seeks to address “How have the dynamics of fentanyl use
correlated with fentanyl-related deaths changed in children (aged zero to eighteen years)
compared to adults (aged nineteen and above years) in the last three years?” My search was
limited to research articles not older than three years, as the question addressed Fentanyl use
dynamics in the US among both adults and children within the last three years. This discussion
emphasizes the importance of an effective search strategy when conducting a literature review,
compares the reliability of evidence-based research using an evidence pyramid, and provides
detail on the search strategy used to conduct the literature review for my PICO question.
Reliability of Evidence-Based Research
The evidence pyramid has seven levels, which visualize the different types of research
evidences based on the quality and amount of evidence presented in a study. The various levels
are presented in a pyramid, with the top having the highest quality of evidence for the study
topic. In contrast, the bottom of the pyramid presents the least reliable evidence (Walden
University, 2023). The different types of pieces of evidence, from the top of the pyramid to the
bottom, include systematic reviews, critically appraised topics, article synopses (critically
appraised individual researches), randomized controlled trials, cohort studies, case series/casecontrolled studies, and lastly, background information, also known as expert opinions.
Systematic reviews provide the highest quality of evidence as they target a specific clinical
question and comprehensively review it (Walden University, 2023). Critically appraised topics
and critically appraised individual articles, which are below systematic reviews, also provide
quality literature reviews on specific topics. However, in literature reviews, randomized
controlled trials, cohort studies, and case series are less reliable as they contain unfiltered
information. Therefore, their reliability is limited. Background information, also known as expert
opinions, is at the bottom of the pyramid and is the least reliable since the information may not
be based on research.
Search Strategy
My PICO question revolves around establishing the correlation between fentanyl use and
fentanyl-related deaths in children compared to adults. An in-depth research was necessary to
establish the evidence related to this question. The first phase entailed choosing databases that
provided research-based evidence relevant to the PICO question. I used Google Scholar, Pub
Med, and Jstor, three online libraries, and databases for peer-reviewed articles. Using a
combination of the key terms, a preliminary search was carried out. The PICO question served as
the basis for the development of keywords and phrases. To ensure a thorough search, synonyms
and phrases that were closely similar were also used. I combined Boolean operators with key
words and used inclusion and exclusion criteria to narrow search. Articles that were not peer
reviewed or outside of the United States were excluded. Only articles within the last three years
were included. Each study that met the above criteria were subject to a full review. At first, I
aimed to find systematic reviews, critically appraised topics, and critically appraised individual
articles on the PICO question. However, such materials are limited, and I could barely find any
related to the topic. I managed to find some critically appraised individual articles on the topic.
One such article was by D’Orsogna et al. (2023), which discusses the role of fentanyl in
accelerating deaths in the US across different genders, races, and other demographics. I then
sought randomized controlled trials and cohort studies, which I found numerous. Such studies
include Warren et al.’s (2023) study, which reviews data on opioid misuse among US youths
aged 12 to 21. Another helpful study was by Arredondo (2023), a report in the Los Angeles
Times focusing on fentanyl-related deaths among youths. A study by Friedman et al. (2023) was
found relevant to the study question as it reviews the trends in deaths due to drug overdose
among US youths. Another study by Gaither (2023), shows the trend of pediatric deaths from
fentanyl, with more than a 30-fold increase in fentanyl-related deaths occurring between 2013
and 2021. Despite the many research articles found through research, the search criteria were
narrowed down by eliminating materials with information from the last three years.
References
Arredondo, V. (2023). “No child should be dying”: Fentanyl-related deaths among kids rising, Yale
study says. Los Angeles Times. https://www.latimes.com/world-nation/story/2023-0511/fentanyl-deaths-children-teens-opioids-yale-school-of-medicine-study-jama-juliegaitherLinks to an external site.
D’Orsogna, M.R. (2023). Fentanyl-driven acceleration of racial, gender, and geographical disparities
in drug overdose deaths in the United States. PLOS Glob Public
Health, 3(3). https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.00007
69Links to an external site.
Friedman, J., Godvin, M., Shover, C., Gone, J., Hansen, H., & Schriger, D. (2022). Trends in Drug
overdose deaths among US adolescents, January 2010 to June 2021. JAMA Network, 327(14),
pp. 1398-1400. https://doi.org/10.1001/jama.2022.2847
Gaither, J. (2023). National Trends in Pediatric Deaths From Fentanyl, 1999-2021. JAMA Pediatr.
2023 Jul 1, 177(7), pp.733-735.
https://doi.org/10.1001/jamapediatrics.2023.0793.
Snyder, H. (2019). Literature review as a research methodology: An overview and guidelines. Journal
of Business Research, 104, pp.333-339. https://doi.org/10.1016/j.jbusres.2019.07.039.
Walden University. (2023). Evidence-based research: Levels of evidence
pyramid. https://academicguides.waldenu.edu/library/healthevidence/evidencepyramidLinks to
an external site.
Warren, K.L, Adams, J., & Bobashev, G. (2023). Trends in opioid misuse among individuals aged 12
to 21 years in the US. JAMA Netw Open. 6(6).
https://doi.org/10.1001/jamanetworkopen.2023.16276
The Purpose of the PICO Question
You must fine-tune your PICO question, it is not structured correctly. You will not earn the highest score on the
academic poster if this is not revised.
You must use scholarly references only. Please visit Brainfuse for more information.
Rosalind Lopez
St Thomas University
NUR 670: Psychiatric Integration Practicum
Dr Linda Mays
August 31, 2023
The Purpose of the PICO Question
The PICO question refers to a structured scientific approach used for framing and
formulating a research question. It is a mnemonic that assists clinicians in developing a
foreground question in an evidence-based practice. PICO stands for Population/Problem,
Intervention, Comparison, and Outcome (NYU, 2023). The population defines the group or issue
under the study, including demographics and characteristics of individuals. The intervention
component outlines various diagnostic tests and treatments used in addressing the problem being
investigated. The comparison element of the PICO question contrasts the selected intervention to
another approach (NYU, 2023). On the other hand, the outcome states the dependent variable,
including the desired result of the research.
Purpose
The primary aim of the PICO question is to investigate and provide an answer to a serious
clinical issue. According to Ford and Melnyk (2019), PICO is a searching strategy that leads to
unbiased evidence. Ideally, evidence-based research focuses only on relevant studies to uncover
the answer to the clinical question. This implies that the PICO question offers an effective
literature search involving keywords and inclusion criteria. It also enables the research to focus
on a specific clinician issue and outcome (Eriksen & Frandsen, 2018). Notably, the PICO
question entails a narrow scope of investigation, which enhances focus and clarity. Another
purpose of this strategy is that it allows the researcher to identify specific care for the patient
(Eriksen & Frandsen, 2018). This is because the PICO question facilitates evidence appraisal
through comparison with other treatments. In addition, the framework promotes collaboration
among clinicians and patient-centered care since it supports evidence-based practice.
Selected PICO Question
The PICO question chosen for this week focuses on the impact of fentanyl use on children
compared with adults. It states, “How have the dynamics of fentanyl use correlated with fentanyl
related deaths changed in children (aged zero to eighteen years) compared to adults (aged
nineteen and above years) in the last three years?” Deaths related to fentanyl use have increased
among children under 18 years in the recent past. According to Jenco (2023), fentanyl deaths in
children in the United States reached 94 percent in 2021. Significantly, teenagers between 15 and
19 years were disproportionately affected by the problem. As such, fentanyl use is a serious
clinical issue that warrants investigation.
The PICO question helps in identifying individuals and groups affected by fentanyl use. In
this case, the population under interrogation is children between zero and eighteen years. The
intervention in the question involves observing the changes in fentanyl deaths over the last three
years. Research shows a significant rise in opioid and fentanyl deaths among children between
2020 and 2022 due to the Covid-19 pandemic (Jenco, 2023). The PICO question also provides a
comparison between the changes in fentanyl deaths in children and adults. Spencer et al. (2022)
indicate that deaths from drug overdose were 62 per 100,000 population among individuals
within 35-44 years in 2021. This shows the outcome of the research issue under investigation. It
demonstrates that there is a general increase in fentanyl deaths in children and adults. In this
case, the PICO question provides a structured strategy for obtaining evidence regarding fentanyl
use and deaths among children versus adults. The systematic approach ensures clarity in how the
clinical problem is addressed.
References
Eriksen, M. B. & Frandsen, T. F. (2018). The impact of patient, intervention, comparison, outcome
(PICO) as a search strategy tool on literature search quality: a systematic review. Journal of the
Medical Library Association, 106(4), 420–431. https://doi.org/10.5195/jmla.2018.345
Ford, L. G. & Melnyk, B. M. (2019). The underappreciated and misunderstood PICOT question: A
critical step in the EBP process. Worldviews on Evidence-Based Nursing, 16(6), 422-423.
https://doi.org/10.1111/wvn.12408
Jenco, M. (2023). Study: Fentanyl involved in 94% of pediatric opioid deaths in 2021. American
Academy of Pediatrics, https://publications.aap.org/aapnews/news/24370/Study-Fentanylinvolved-in-94-of-pediatric-opioid?autologincheck=redirected
NYU. (2023). Capstone and PICO project toolkit. https://guides.nyu.edu/pico/question
Spencer, M. R., Miniño, A. M., & Warner, M. (2022). Drug overdose deaths in the United States,
2001–2021. NCHS Data brief, 457, 1-8.
https://www.cdc.gov/nchs/products/databriefs/db457.html
Psychiatry Issues in the United States Public Health Domain: Fentanyl-Related Deaths
PICO Question and Emerging Psychiatric Problem
Rosalind Lopez
St Thomas University
NUR 670: Psychiatric Integration Practicum
Dr Linda Mays
August 24, 2023
Real-world current problem in US psychiatric care
Treatment-resistant depression is a major real-world issue currently emerging in the US
psychiatric care system. According to Weissman et al. (2023), treatment-resistant depression is a
form of depression where standard pharmacotherapy and psychotherapy do not work to ease the
patient’s symptoms, requiring them to seek alternative therapies or modify medical dosages. The
issue of treatment-resistant depression is cross-cutting, affecting the psychological and
sociological dynamics of the patients’ lives. As it continues to become a formidable issue in the
United States psychiatric system, it cross-cuts the various areas through which it can be
addressed. As indicated by Schreiber et al. (2023), there is a strong significant association
between the emergence of high opioid use, including fentanyl use, among adolescents and adults
in America and the growing incidence of treatment-resistant depression among the same
population. Thus, the changes in the incidence of fentanyl use, and depression, in turn, may be
interconnected as important facets of nursing and psychiatric care practice in the United States.
Yet, this interconnection and the specific issues remain underexplored, despite their importance
in shaping the trajectory of healthcare in the United States in recent years.
PICO Question
The PICO question, “How have the dynamics of fentanyl use correlated with fentanyl
related deaths changed in children (aged zero to eighteen years) compared to adults (aged
nineteen and above years) in the last three years?, ” is an important area of interest for advanced
practice nursing. P (Population): Children aged zero to eighteen years, I (Intervention):
Dynamics of fentanyl use, C (Comparison): Comparison of children (aged zero to eighteen
years) to adults (aged nineteen and above years), O (Outcome): Pattern of fentanyl-related deaths
in the last three years.
Importance of the selected PICO question
According to Opsahl et al. (2020), patient-based care is the premise of any professional
healthcare practice, including nursing. As such, the focus of the selected PICO question on
specific patient groups is imperative to this. For instance, the focus on the impact of fentanyl
deaths on children is an interesting area of nursing practice. Similarly, fentanyl is a commonly
used and abused opioid among adolescents and adults and a leading cause of depression among
abusers (Nguyen et al., 2020; Oliva et al., 2020). Due to the severity of its impact on dopamine
levels and other chemicals in the brain, fentanyl is believed to exacerbate or contribute to
depression. During active addiction and during withdrawal, depression symptoms can be caused
by fentanyl. Due to this, the focus of the question on children and adults alike introduces a new
dynamic to understanding how mortalities and depression related to fentanyl use can be
mitigated. Moreover, this question influences evidence-based practice in nursing. Advanced
nursing practice emphasizes utilizing the latest medical research in decision-making related to
patient care (Opsahl et al., 2020). As such, addressing this PICO question will inform the
creation of a body of evidence that focuses on the possible protocols and interventions that can
be utilized to reduce mortalities related to fentanyl in adults and children.
Overall, this PICO question is of significant public health impact. According to Nguyen et
al. (2020), fentanyl related deaths are a major concern in the American public health domain.
Research informed by this question will be crucial in forming reference points for health
campaigns, workshops, and educational conferences on preventing fentanyl deaths among all
people across the United States. Further, this question is important in resolving the emerging
public health issue of drug-resistant depression as a public health concern in America since the
pandemic. Fentanyl is a widely used narcotic in the hospital environment. However, with recent
concerns about opiate overdose and toxicity, all healthcare providers should be familiar with the
drug’s adverse effects and how to reverse them (Ramos-Matos et al., 2023). Ultimately, the PICO
question is a reference point for nurses in advanced practice to improve their patient care
outcomes and public health initiatives significantly. Further, this question is imperative in
improving healthcare quality across healthcare centers in the United States.
References
Nguyen, A. P., Glanz, J. M., Narwaney, K. J. & Binswanger, I. A. (2020). Association of opioids
prescribed to family members with opioid overdose among adolescents and young adults. JAMA
Network Open, 3(3), e201018e201018. https://doi.org/10.1001/jamanetworkopen.2020.1018Links to an external site.
Oliva, E. M., Bowe, T., Manhapra, A., Kertesz, S., Hah, J. M., Henderson, P. & Trafton, J. A. (2020).
Associations between stopping prescriptions for opioids, length of opioid treatment, and
overdose or suicide deaths in US veterans: observational
evaluation. BMJ, 368. https://doi.org/10.1136/bmj.m283Links to an external site.
Opsahl, A., Nelson, T., Madeira, J. & Wonder, A. H. (2020). Evidence‐based, ethical decision‐
making: using simulation to teach the application of evidence and ethics in practice. Worldviews
on Evidence‐Based Nursing, 17(6), 412-417. https://doi.org/10.1111/wvn.12465Links to an
external site.
Ramos-Matos, C., Bistas, K. & Lopez-Ojeda, W. (2023). Fentanyl. In: StatPearls [Internet]. Treasure
Island (FL): StatPearls Publishing; 2023 Jan-. https://www.ncbi.nlm.nih.gov/books/NBK459275/
Schreiber, S., Keidan, L. & Pick, C. G. (2023). Treatment-Resistant Depression (TRD): Is the Opioid
System Involved?. International Journal of Molecular Sciences, 24(13),
11142. https://doi.org/10.3390/ijms241311142Links to an external site.
Weissman, C. R., Bermudes, R. A., Voigt, J., Liston, C., Williams, N., Blumberger, D. M., … &
Daskalakis, Z. J. (2023). Repetitive Transcranial Magnetic Stimulation for Treatment-Resistant
Depression: Mismatch of Evidence and Insurance Coverage Policies in the United States. The
Journal of Clinical Psychiatry, 84(3), 46813. https://doi.org/10.4088/JCP.22com14575Links to
an external site.
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