NURS FPX 4025 Assignment 4 Presenting Your PICO(T) Process Findings to Your Professional Peers

NURS FPX 4025 Assignment 4 Presenting Your PICO(T) Process Findings to Your Professional Peers

Student Name

Capella University

NURS-FPX4025 Research and Evidence-Based Decision Making

Prof. Name

Date

Presenting Your PICO(T) Process Findings to Your Professional Peers

Dehydration is a prevalent concern among older adults, affecting up to 60% of those living independently and between 28% to 38.4% in long-term care settings. Hospital admission rates due to dehydration are also significant, with 37% of elderly patients arriving at the hospital already dehydrated, and many remain in that condition even after 48 hours of care (Li et al., 2023). This analysis centers on the effectiveness of nurse-led interventions in managing and preventing dehydration, highlighting the importance of proactive, evidence-based nursing strategies in improving outcomes.

Diagnosis: Prognosis, Potential Risks, and Associated Complications

Dehydration arises from an inadequate amount of water in the body, typically leading to electrolyte imbalances. Its presentation often includes symptoms such as dry mouth, fatigue, dizziness, and decreased urine output. The condition can trigger systemic complications, including acute kidney injury (AKI), electrolyte disturbances, and even sepsis if left untreated. In pediatric populations, dehydration caused by diarrheal diseases contributes to 14% to 30% of mortality rates globally (Daley & Avva, 2024).

Among older adults, comorbidities often complicate dehydration management. A cross-sectional study involving 1,377 older individuals found that those diagnosed with Major Neurocognitive Disorder (MND) had a higher prevalence of dehydration (58%) compared to those without MND (53%). After adjusting for age and gender, the link between MND and dehydration remained statistically significant (Kirazoglu et al., 2024). Additional conditions such as hypertension, hyperglycemia, and chronic kidney disease (CKD) were more common in dehydrated patients, especially those with cognitive impairments.

In the U.S., dehydration accounts for 1% to 3% of hospital admissions among the elderly, with mortality ranging from 5% to 15% in severe cases (Taylor et al., 2022). The elderly are particularly susceptible due to reduced thirst perception, multiple medications, and existing chronic illnesses. Healthcare professionals must be vigilant in identifying early signs such as confusion and physical weakness, which, if undiagnosed, may quickly escalate to critical complications. A targeted nursing approach—emphasizing personalized care, hydration education, and fluid intake monitoring—can substantially reduce these risks and enhance patient safety.

Table 1. Risk Factors and Consequences of Dehydration in Adults

Category	Details
Common Symptoms	Dry mouth, dizziness, fatigue, low urine output
Complications	AKI, sepsis, electrolyte imbalances, hospital readmission
High-Risk Groups	Elderly, cognitively impaired, polypharmacy patients
Associated Illnesses	MND, hypertension, CKD, hyperglycemia
Hospital Impact	1–3% of admissions; mortality 5–15% in severe dehydration

Formulating the Research Question

To systematically address dehydration in adults, a targeted PICO(T) research question was formulated:

PICO(T) Question: In adult patients diagnosed with dehydration (P), how does the implementation of nurse-led hydration strategies and patient education (I), compared to standard care (C), improve hydration status (O) over 12 weeks (T)?

This inquiry aims to evaluate the effect of structured nursing interventions on improving hydration levels and decreasing associated risks.

Table 2. Breakdown of the PICO(T) Framework

Element	Description
Population (P)	Adults with dehydration
Intervention (I)	Nurse-led strategies: hydration education, intake monitoring, individualized plans
Comparison (C)	Standard care without structured hydration intervention
Outcome (O)	Improved hydration levels, fewer complications, reduced hospitalizations
Time (T)	12 weeks

Nurse-led interventions involve proactive monitoring, personalized hydration protocols, and structured patient education. Compared to standard care—which typically reacts to dehydration after symptoms appear—these strategies are preventative in nature. Evidence supports that such interventions improve hydration status and reduce complications like urinary tract infections and kidney injuries (Li et al., 2023).

Peer-Reviewed Sources

To support the PICO(T) query, a review of scholarly databases—PubMed, CINAHL, Cochrane Library, and Google Scholar—was conducted. Articles were evaluated using the CRAAP method, ensuring content met standards of Currency, Relevance, Authority, Accuracy, and Purpose (Shah et al., 2024).

One quasi-experimental study by Uyanık and Dağhan (2021) found that nurse-led hydration management significantly improved fluid intake and reduced dehydration symptoms in older adults. Their approach included structured protocols, reinforcing the effectiveness of planned interventions.

Bruno et al. (2021) reviewed 19 studies with 978 participants and concluded that nurse-led behavioral strategies improved daily fluid consumption by an average of 300.93 mL. Their meta-analysis revealed statistically significant improvements in hydration and a decrease in falls and UTIs, underscoring the role of nurses in hydration management.

Additionally, the CDC (2024) outlines best practices for hydration during emergencies and health crises, focusing on community education and hydration planning for vulnerable groups. Simone et al. (2023) conducted qualitative research with healthcare professionals and caregivers, highlighting the importance of interprofessional collaboration. They identified areas for improvement, including individualized assessment, monitoring systems, and caregiver education. These findings reinforce the importance of coordinated, nurse-led care approaches in addressing dehydration.

Table 3. Summary of Peer-Reviewed Evidence Supporting Nurse-Led Hydration Strategies

Study/Source	Main Findings
Uyanık & Dağhan (2021)	Structured protocols improved hydration and reduced dehydration symptoms
Bruno et al. (2021)	Interventions led to 300.93 mL increase in fluid intake and reduced UTI incidence
CDC (2024)	Emphasizes nurse-led monitoring during public health emergencies
Simone et al. (2023)	Identified gaps in interprofessional roles and suggested care improvements

Evidence-Based Response to the PICO(T) Question

The findings collectively confirm that structured, nurse-led hydration interventions enhance fluid intake and reduce dehydration-associated risks. Uyanık and Dağhan (2021) demonstrated tangible improvements in hydration status in care settings. Bruno et al. (2021) validated this with meta-analytical data. CDC guidance (2024) affirms that such strategies are especially vital during emergencies. Simone et al. (2023) noted that nurses and caregivers must collaborate and be equipped with clear role definitions and educational resources.

However, successful implementation depends on several contextual factors. These include patient health literacy, mental health conditions, socioeconomic constraints, and access to healthcare services. Future investigations should explore how individualized and culturally sensitive interventions can address these barriers to optimize outcomes across diverse populations.

Essential Care Steps Guided by Evidence-Based Recommendations

Effective management of dehydration begins with a comprehensive clinical evaluation. This includes assessing the patient’s hydration status, identifying risk factors such as cognitive decline, mobility limitations, and comorbidities. This step allows for tailored intervention planning.

Next, structured nurse-led care is implemented. Key components include fluid intake reminders, regular hydration status monitoring, and patient-centered education programs. Simone et al. (2023) found that these steps significantly reduce the recurrence of dehydration.

Finally, empowering patients through education plays a crucial role. Teaching individuals to identify early dehydration signs and maintain daily fluid intake fosters autonomy and adherence to care plans. This approach also alleviates the healthcare system burden by minimizing avoidable admissions and complications (CDC, 2024).

Conclusion

Addressing dehydration through nurse-led, evidence-based strategies is essential in reducing complications, hospital readmissions, and emergency visits among adults. This approach empowers both patients and nurses by fostering proactive hydration practices. Structured interventions, including patient education, individualized plans, and routine monitoring, significantly enhance hydration outcomes—particularly in high-risk groups with chronic illnesses.

References

Bruno, C., Collier, A., Holyday, M., & Lambert, K. (2021). Interventions to improve hydration in older adults: A systematic review and meta-analysis. Nutrients, 13(10), 3640. https://doi.org/10.3390/nu13103640

CDC. (2024, May 10). About water and healthier drinks. Centers for Disease Control and Prevention. https://www.cdc.gov/healthy-weight-growth/water-healthy-drinks/index.html

Daley, S. F., & Avva, U. (2024, June 8). Pediatric dehydration. National Library of Medicine; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK436022/

NURS FPX 4025 Assignment 4 Presenting Your PICO(T) Process Findings to Your Professional Peers

Kirazoglu, Heybeli, Atcıyurt, Yigitalp, Smith, L., Veronese, N., Rahmati, M., & Soysal, P. (2024). The relationship between dehydration and etiologic subtypes of major neurocognitive disorder in older patients. European Geriatric Medicine, 15(4), 1159–1168. https://doi.org/10.1007/s41999-024-00986-z

Li, S., Xiao, X., & Zhang, X. (2023). Hydration status in older adults: Current knowledge and future challenges. Nutrients, 15(11), 1–15. https://doi.org/10.3390/nu15112609

Shah, V., Lava, C. X., Hakimi, A. A., & Hoa, M. (2024). Evaluating quality, credibility, and readability of online over‐the‐counter hearing aid information. The Laryngoscope, 134(7). https://doi.org/10.1002/lary.31278

Simone, I., Huppertz, & Lohrmann, C. (2023). Roles, mutual expectations and needs for improvement in the care of residents with (a risk of) dehydration: A qualitative study. Journal of Advanced Nursing, 80(1), 150–160. https://doi.org/10.1111/jan.15777

Taylor, K., Jones, E., & Tripathi, A. (2022). Adult dehydration. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK555956/

NURS FPX 4025 Assignment 4 Presenting Your PICO(T) Process Findings to Your Professional Peers

Uyanık, G., & Dağhan, S. (2021). Effect of a hydration management program on older adults’ fluid consumption and dehydration parameters: A quasi-experimental study. Journal of Gerontological Nursing, 47(9), 40–48. https://doi.org/10.3928/00989134-20210803-04