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1. NURS FPX 4025 Assessment 3 Developing a PICO(T)
Student Name
Capella University
NURS-FPX4025
Professor’s Name
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NURS FPX 4025 Assessment 3

2. Developing a PICO(T)
Acute appendicitis remains one of the most urgent surgical emergencies among adults, requiring
timely and precise intervention to prevent life-threatening complications. Contemporary
literature increasingly supports the use of antibiotics, in combination with supportive care, as an
effective nonoperative treatment for uncomplicated appendicitis. This shift challenges traditional
surgical dominance, suggesting that conservative management may enhance recovery outcomes,
minimize postoperative risks, and shorten hospitalization periods (Bass et al., 2023). Current
research aims to determine whether nursing-led antibiotic management improves treatment
efficacy, reduces complications, and accelerates recovery within six months in adults diagnosed
with uncomplicated acute appendicitis.
Acute appendicitis affects approximately 250,000 individuals annually in the United States and
is a leading cause of acute abdominal pain requiring emergency intervention (Beckermann et al.,
2024). The condition often arises from luminal obstruction due to fecal material or infectious
processes, resulting in bacterial proliferation and inflammation. If untreated, appendicitis can
rapidly progress to perforation, peritonitis, or sepsis. Individuals from lower socioeconomic
backgrounds are disproportionately affected, experiencing delayed diagnosis, higher rates of
perforation, and prolonged hospitalizations (Estrella et al., 2021). These disparities underscore
the importance of equitable access to diagnostic resources, evidence-based nursing practices, and
timely interventions that reduce healthcare burden and enhance patient outcomes.
Developing a PICOT Question
To address the issue systematically, a PICOT framework is used to formulate an evidence-based
clinical inquiry: In adult patients with acute appendicitis (P), does a combination of nursing-led
antibiotic treatment and supportive care (I), compared to surgical appendectomy (C), improve
treatment outcomes, reduce complications, and promote faster recovery (O) over a six-month
period (T)? The population (P) includes adults suffering from acute appendicitis. The
intervention (I) involves a nursing-managed antibiotic and supportive care regimen. The
comparison (C) is surgical management via appendectomy. The outcome (O) targets improved
recovery, fewer complications, and shorter healing times, while the timeframe (T) is six months.
This PICOT question provides a structured foundation for investigating evidence-based
nonoperative approaches to managing uncomplicated appendicitis.
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3. Benefits of Using the PICOT Approach
The PICOT framework enables nurses to develop precise, evidence-based, and patient-centered
clinical questions that guide decision-making and care planning. In cases of acute appendicitis, it
helps evaluate nursing interventions such as pain management, fluid resuscitation, patient
education, and antibiotic therapy within a measurable timeframe (Maqbali, 2024). This approach
allows nurses to identify the most effective care strategies, integrate scientific evidence into
clinical practice, and compare outcomes between nonoperative and surgical management.
Moreover, systematic reviews confirm that nurses play a vital role in nonoperative care delivery
by ensuring consistent antibiotic administration, monitoring recovery, and providing
comprehensive patient education. Evidence-based nursing practice not only improves patient
safety and recovery outcomes but also enhances healthcare efficiency, reduces the risk of
unnecessary surgical interventions, and alleviates the overall healthcare system burden.
Identifying Evidence Sources for a PICO(T) Question
A systematic literature search was conducted using premier databases including Scopus,
PubMed, CINAHL, and the Cochrane Library to identify reliable evidence supporting antibiotic-
based nursing interventions in acute appendicitis management (Li et al., 2024). Search terms
included “antibiotic therapy nursing management,” “acute appendicitis non-surgical treatment,”
“supportive nursing care,” and “appendicitis complications.” Boolean operators (AND, OR,
NOT) were applied to refine the search and ensure comprehensive coverage. Evidence was
selected from systematic reviews, meta-analyses, randomized controlled trials (RCTs), and
clinical guidelines published within the last decade. Additionally, authoritative sources such as
the American Nurses Association (ANA) and the Centers for Disease Control and Prevention
(CDC) provided valuable guidance for establishing nursing-led antibiotic protocols (Cramm et
al., 2024). This rigorous evidence search equips nurses with the knowledge to deliver patient-
centered, effective, and evidence-informed antibiotic care for acute appendicitis.
Systematic Reviews and Meta-Analyses
Systematic reviews and meta-analyses offer high-quality evidence for comparing antibiotic
therapy with surgical appendectomy in adults with acute appendicitis. By synthesizing data from
multiple studies, these reviews determine whether nonoperative interventions yield outcomes
comparable to surgery regarding recurrence, complication rates, and patient satisfaction (Li et al.,
2024). The insights gained from such analyses enable clinicians to make well-informed,
evidence-based decisions that improve recovery rates and reduce healthcare costs while
maintaining patient safety.
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4. Randomized Controlled Trials (RCTs)
Randomized controlled trials provide empirical evidence for assessing the safety and efficacy of
antibiotics versus surgical intervention. These trials measure key outcomes such as recovery
time, recurrence, and complication rates. The findings reveal that antibiotic therapy, when
appropriately administered and monitored by nursing professionals, can be as effective as
surgical treatment for uncomplicated appendicitis (Li et al., 2024). RCTs further validate the role
of nurses in managing nonoperative cases, demonstrating improved recovery times and reduced
postoperative risks through structured patient education and symptom monitoring.
Clinical Practice Guidelines
Clinical practice guidelines provide standardized recommendations based on robust evidence,
guiding clinicians and nurses in the management of acute appendicitis. Guidelines emphasize the
importance of proper diagnosis, timely initiation of antibiotic therapy, and continuous
assessment of patient response to treatment (Li et al., 2024). The integration of nursing-led
antibiotic protocols within these guidelines strengthens the clinical framework, ensuring
consistency in care delivery, reducing complications, and enhancing recovery outcomes.
Peer-Reviewed Journal Articles
Peer-reviewed literature supports the growing role of nurses in administering and managing
antibiotic therapy for uncomplicated appendicitis. These studies highlight the impact of nursing
interventions on patient education, treatment adherence, and post-treatment monitoring (Bom et
al., 2021). Evidence from scholarly journals reinforces the necessity for nurses to remain current
with evolving nonoperative management practices, thereby promoting patient-centered,
evidence-based care.
Evaluating Acute Appendicitis Evidence
The CRAAP criteria—Currency, Relevance, Authority, Accuracy, and Purpose—serve as an
essential tool for evaluating research quality and applicability in evidence-based practice. For
this study, all sources were published within the last decade, ensuring currency and reliability.
The selected research aligns closely with the PICOT framework and directly addresses the
efficacy of antibiotic versus surgical interventions. Peer-reviewed sources from reputable
journals enhance accuracy and credibility, while objective presentation of findings minimizes
bias and supports evidence-driven nursing decisions (Kington et al., 2021).
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5. Findings from Relevant Sources on Healthcare Issues
Evidence from Bom et al. (2021) supports nursing-administered antibiotic therapy as a viable
alternative to surgery for uncomplicated appendicitis. The study emphasizes that nurses are
integral to accurate diagnosis, antibiotic administration, and patient monitoring. Similarly, Leite
et al. (2022) found that nurse-supervised antibiotic therapy reduces postoperative complications,
shortens hospital stays, and improves patient satisfaction compared to surgery. Moris et al.
(2021) further highlight that individualized nursing care plans—encompassing education,
monitoring, and symptom management—enhance patient recovery and reduce recurrence.
Together, these studies reinforce the PICOT inquiry by validating the safety, effectiveness, and
practicality of nurse-led nonoperative management for uncomplicated appendicitis.
Relevance of Findings to PICOT
All reviewed studies converge on the conclusion that nurse-managed antibiotic therapy provides
safe and effective outcomes for patients with uncomplicated appendicitis. Bom et al. (2021)
demonstrate the importance of differentiating between uncomplicated and complicated cases,
while Leite et al. (2022) confirm the success of antibiotic regimens under nursing supervision.
Moris et al. (2021) advocate for individualized patient-centered care to optimize recovery
outcomes. Collectively, this evidence supports the feasibility and value of nursing-led
interventions, which align with the PICOT framework’s focus on evidence-based, patient-
specific, and time-bound care.
Conclusion
The integration of nursing-led antibiotic therapy presents a promising, evidence-based approach
to managing uncomplicated acute appendicitis. While appendectomy remains the traditional
standard, nurse-directed nonoperative treatment demonstrates comparable safety and efficacy in
well-selected patients. By emphasizing patient education, continuous assessment, and
collaborative care, nurses play a transformative role in improving recovery outcomes and
reducing healthcare burden. Sustained implementation of evidence-based nursing practices will
strengthen clinical decision-making, enhance patient satisfaction, and support long-term
healthcare improvement through safe and effective nonoperative management strategies.
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6. References
Bass, G. A., et al. (2023). Journal of Surgical Studies. https://doi.org/10.1016/j.jss.2021.04.031
Beckermann, J., et al. (2024). National Academy of Medicine. https://doi.org/10.31478/202107a
Estrella, R., et al. (2021). JAMA Surgery. https://doi.org/10.1001/jamasurg.2022.2937
Maqbali, M. (2024). International Nursing Review. https://doi.org/10.1111/inr.13075
Li, X., et al. (2024). Advances in Surgical Science. https://doi.org/10.1007/978-3-031-78298-5_6
Leite, C. F., et al. (2022). JAMA Network Open. https://doi.org/10.1001/jama.2021.20502
Bom, W., et al. (2021). Clinical Nursing Practice.
Moris, D., et al. (2021). World Journal of Surgery.
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