Medical practice problems concern a medical condition and provide information about the patients pathophysiology. Whereas a nursing practice problem concerns the human response to an actual or potential health problems and life processes. An example of a medical problem would be a CVA or stroke and the physiological conditions that accompany that. In contrast the nursing practice problems for this situation can include impaired verbal communication, risk for falls, interrupted family process, or powerlessness. In addition the nursing practice problem can include multiple problems for one medical problem (Herdman, 2016.) An example of how medical and nursing practice problems differentiate is pneumonia and the physiological symptoms that accompany it vs the nursing practice problem associated would be knowledge deficit and potential for injury (Henry, 1995.)
It is important that nurses recognize the difference between the two and are able to focus their research on nursing specific problems, because that is what can be brought to the bedside and implemented. As the textbook describes, The nursing profession has always sought to improve care provided to patients to improve patient outcomes (GCU, 2018. This is supported by the realization by hospitals within recent years that investing into nursing can improve patient outcomes and supporting nursing research results in EBP coming to the bedside in a faster manner. (GCU, 2018.)
Grand Canyon University (Ed). (2018). Nursing research: Understanding methods for best practice. Retrieved from https://lc.gcumedia.com/nrs433v/nursing-research-understanding-methods-for-best-practice/v1.1
Henry, S. B., & Holzemer, W. L. (1995). A comparison of problem lists generated by physicians, nurses, and patients: implications for CPR systems. Retrieved May 4, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2579119/
Herdman, H. (2016). What is the difference between a medical diagnosis and a nursing diagnosis?: NANDA International Knowledgebase. Retrieved May 4, 2020, from https://kb.nanda.org/article/AA-00266/0/What-is-the-difference-between-a-medical-diagnosis-and-a-nursing-diagnosis-.html
Through Evidence-Based Practice we find ways to deliver safe patient care and improve patient outcomes. (Helbig, 2018). PICOT is A system for formulating a clear research question; P is for problem or population, I is for intervention, C is for comparison, O is for outcome of interest, and T is for time of study (Helbig, 2018). When the PICOT is established the nurse will research what is needed to answer the question. (Helbig, 2018). PICOT is used to identify nursing and medical practice problems. A nursing practice problem deals with the response to the patient in contrast to the medical practice problem which deals with the actual medical condition.
Nurses use the nursing process within their scope of practice to deal with health problems. An example of a PICOT nursing practice problem would be, decreasing central line infections in a hemodialysis clinic. P: Patients in clinic, I: using sterile technique when accessing CVC lines, C: in comparison to using aseptic technique, O: no infections in the clinic T: 3 months
A medical practice deals with the medical condition and finding solutions to prevent or cure illness. For example, the physician may compare 2 iron medications to treat iron deficiency anemia. With efforts to see which medication works better. P: Patients in clinic I: using Venofer iron for patients in clinic, C: in comparison to using Ferrlecit iron, O: Venofer Iron will increase Iron percentages in blood by 5% in patients, T: 3 months
It is important for the nurse to practice PICOT within their scope of practice. Through nursing diagnosis, assessment, planning, implementation and evaluation. The nurse reports issues to the physician and carries out orders within their scope.
References
Helbig, J. (2018). History and process of nursing research, evidence-based nursing practice, and quantitative and qualitative research process. In Nursing research: Understanding methods for best practice. Retrieved from: https://lc.gcumedia.com/nrs433v/nursing-research-understanding-methods-for-best-practice/v1.1/#/chapter/1