picot response

Peer Post Number 1

PICOT Question
A PICOT question consists of five elements – P for patient or population, I for intervention, C for comparison, O for outcome, and T for time frame for intervention to achieve the outcome (Melnyk & Fineout-Overholt, 2019). Using the PICOT process helps formulate a thoughtful and specific question to resolve a clinical problem using research that are evidence-based.  
PICOT Question: 
In adult patients presenting to the emergency department (ED) with clinical indications of sepsis, does the implementation of sepsis bundles and protocols for early identification and treatment for sepsis, compared to routine clinical care, decrease ICU admission and improve mortality in sepsis patients? 
Population: Adult ED patients with suspected sepsis 
Intervention: Implementation of sepsis bundles/protocols 
Comparison: Routine clinical care 
Outcome: Decreased ICU admissions and improved mortality in sepsis patients 
Time: 1 day to 1 month 
I arrived at this topic and question because of my role as a sepsis nurse at our hospital. In addition of being a part of our sepsis team, I am also an ICU nurse and we deal with septic shock patients very often. Sepsis has been my primary interest since my fourth semester in nursing school back in 2011. I think this topic is important because sepsis, severe sepsis, and septic shock has been a serious major global health care problem and has an estimated number of deaths between 15-19 million per year worldwide (Tiru, et al., 2015). This topic will definitely help everyone to see and understand how early identification of sepsis and early initiation of treatments improve patient overall outcomes and decrease overall mortality.   

Peer Post Number 2
Is smoking e-cigarettes more addictive than smoking tobacco that educating teenagers,
in the out-patient department, of its adverse effects will reduce lung injury? I find the question
relevant as I observed more teenagers using e-cigarettes or vape products and impacting their
health. Teenagers are these 13 to 19 years of age that get into the habit of using e-cigarettes.
These electronic cigarettes, introduced primarily to help cigarette smokers get off smoking,
are considered a less harmful alternative to smoking cigarettes. However, the supposed benefit
outweighed the risk as it was initially presented as a non-nicotine product, thus enticing
teenagers.
            “Instead of inhaling the cancer-causing smoke of burning tobacco, adults would get theirnicotine fix by breathing in the aerosol of a flavoured liquid, heated in a stick or pen just enough to become vapour” (Mitchell, Nov2019). Unfortunately, aggressive marketing of these e-cigarettes influenced the vulnerable youth population to experiment and use the product. Aftercaring for a patient who never smoked a cigarette as a teenager, developed pneumonia and progressive lung disease from vaping, and eventually died, it was a wake-up call to learn about the topic.
            The importance of knowing how addictive these e-cigarettes, especially to teenagers, and educating them of the harmful effects of inhaling this product may reduce lung injury and
subsequent morbidity and mortality. “Citing studies that have found that young people who
never smoked a cigarette at all, once they started vaping, were five times more likely to smoke the next year compared to youth who did not vape” (Knopf, Feb2019). Therefore, preventing or reducing teenagers’ use of e-cigarettes through education is the primary goal of the inquiry. The timeframe of the study is for a period of 6-months. And the teaching is done during the teenagers’ visit to the out-patient clinic. Thus, evaluating teaching outcomes through follow-up phone calls and mail-in questioners are next.