Samples / NURS FPX 4025 / Assessment 3
Applying the PICO(T) Process
NURS FPX 4025 · Assessment 3
Sample for study and reference. Ace My Assessment is an independent academic support service.
The PICO(T) framework is a systematic way nurses can create evidence-based clinical research questions. PICO(T) is made up of the following components: Patient or Population, Intervention, Comparison, Outcome, and Time Frame. The use of this method allows nurses to effectively search for scholarly evidence to help guide them when answering questions about certain issues related to nursing practice. By utilizing PICO(T), nursing practice decisions are based on the best available evidence that exists (Tucker et al., 2023).
Outcomes, Risks, and Complications
Pain, impaired mobility, fatigue and the development of serious surgical complications are common experiences among patients recovering from hip arthroplasty (replacement) surgery. Post-operative complications seen frequently in this population of patients are deep vein thrombosis, surgical site infection, dislocation of the artificial hip joint, and pulmonary embolism. Elderly individuals, those with diabetes and patients with multiple underlying health issues represent patient subpopulations at an elevated risk of developing complications after hip arthroplasty surgery (Wen et al., 2022). The lack of nursing intervention for these complications could cause extended hospitalization, decline in functional abilities, and poor quality of life.
The post-operative hip arthroplasty recovery of underprivileged/undisadvantaged patient populations is negatively affected by health care disparities. Low-income patients, for example, typically do not have access to quality rehabilitation services, specialized nursing care and sufficient post-discharge support systems. The elderly and non-White patients generally face additional disadvantages, such as communication barriers due to limited English proficiency, lower levels of health literacy and limited access to multidisciplinary post-surgical care (Lunn et al., 2026). Consequently, the negative effect of these disparities results in a significantly greater proportion of patient populations that experience post-operative complications, longer lengths of stay in the hospital and poorer functional recovery after hip arthroplasty surgery as compared to their more affluent counterparts.
PICO(T) Research Question Development
Research Question
In adult post-operative hip arthroplasty patients, how does multidisciplinary team nursing intervention based on ERAS, compared to traditional nursing care, reduce post-operative pain and improve mobility within six weeks of surgery?
PICO(T) Framework Elements
P (Patient/Population): Adult post-operative hip arthroplasty patients experiencing pain and limited mobility
I (Intervention): Multidisciplinary team nursing interventions based on ERAS concept
C (Comparison): Traditional standard perioperative nursing care
O (Outcome): Reduced post-operative pain, improved mobility, and decreased complications
T (Time frame): Within six weeks following hip arthroplasty surgery
Meeting PICO(T) Criteria
The PICO(T) question fulfills the requirements of the model by describing post-operative hip arthroplasty patients as the desired population. The intervention is multi-disciplinary team (MDT) nursing focused on enhanced recovery after surgery (ERAS) versus traditional standard nursing care at the same time. Within six weeks after surgery, the desired outcomes will include decreased pain and increased mobility (Wang et al., 2022).
Literature Search Strategy
A systematic literature search was carried out via a literature database and an internet search to locate scholarly evidence. Searches were conducted in PubMed, CINAHL, and Google Scholar with the following keywords: "nursing in hip arthroplasty," "management of postoperative pain," "multidisciplinary nursing interventions," and "enhanced recovery after surgery." Results were limited to peer-reviewed articles published in English within the previous five years. Credibility of sources was established through determination of peer-review status of the article; qualification(s) of the author; obtaining research ethics approval; and existence of the article in a reputable scientific journal, (McKenzie & Barker, 2025).
Evidence Content Analysis
Four peer-reviewed articles were analyzed to answer the PICO(T) inquiry about multidisciplinary ERAS nursing interventions related to postoperative hip arthroplasty patients. Zhang et al. (2025) used a prospective, randomized design with data published in HIP International found that multidisciplinary ERAS nursing improved joint function; self-care ability; and reduced mobilization time for geriatric hip arthroplasty patients. Liu et al. (2023) published a retrospective article, showing that ERAS for hip arthroplasty provided through multidisciplinary collaboration significantly reduced length of hospital stay; decreased blood loss; reduced pain scores; and improved knee joint function as compared to traditional nursing care. Frassanito et al. (2020) published an article in Musculoskeletal Surgery by Springer Nature reporting the benefit of an ERAS multidisciplinary program with respect to a reduction in length of hospital stay for patients undergoing hip or knee arthroplasty, having low complications rates, and 94.4% of patients being satisfied with their hospitalization experience. Liu et al. (2025) used a single-blind randomized controlled trial design with data published in BMC Geriatrics demonstrating that the use of ERAS nursing techniques for THA patients aged 65 years or older was associated with less postoperative pain; shorter hospital length of stay; increased Harris scores; increased Barthel Index scores; and lower complication rates than traditional nursing care.
According to the CRAAP test, all 4 of the above articles are credible. All are current peer-reviewed articles written by qualified researchers and published in reputable peer-reviewed journals with an ethical approval status. All four articles are directly applicable to the PICO(T) narrative as they all compare the effects of ERAS-based multidisciplinary nursing interventions to traditional nursing care for hip arthroplasty patients (Zhang et al., 2025; Liu et al., 2023; Frassanito et al., 2020; Liu et al., 2025). Together, the four articles provide significant evidence that multidisciplinary ERAS nursing interventions are superior to traditional nursing care in terms of reducing postoperative pain and improving the mobility of patients after undergoing hip arthroplasty surgery. The totality of the evidence provided through the four studies leads to answering the PICO(T) question by confirming that MDT nursing that is circumscribed by ERAS concepts yields excellent outcomes during the first six weeks following hip arthroplasty surgery (Zhang et al., 2025; Liu et al., 2025).
Credibility and Relevance
Each article used for this presentation passes the CRAAP test and is credible, current, relevant, authoritative, accurate and of a purpose (Zhang et al., 2025; Liu et al., 2025; Frassanito et al., 2020; Liu et al., 2023). All four articles were published recently and are peer-reviewed. All four articles were obtained from acceptable databases: PubMed, Springer Nature and BMC Geriatrics respectively. All four of these articles were written by qualified researchers who obtained ethical approval prior to conducting their studies; thus they have the authority to conduct research. All four articles relate directly to our PICO(T) question by specifically answering the question of if multidisciplinary ERAS nursing interventions are more effective than traditional nursing care methods for hip and knee arthroplasty patients.
Analysis of Evidence to Answer the PICO(T) Question
After reviewing four peer-reviewed articles related to multidisciplinary enhanced recovery after surgery (ERAS) nursing interventions’ effects on outcomes for patients undergoing hip arthroplasty, there is very strong evidence supporting the effectiveness of ERAS as compared to traditional nursing practices. Zhang et al. (2025) and Liu et al. (2025) both found that using an evidence-based interdisciplinary approach to nurse care provided less postoperative pain, increased mobility, and reduced length of stay in the hospital within six weeks of surgery. Also, Frassanito et al. (2020) showed that low postoperative complication rates and high patient satisfaction scores were maintained for ERAS-multidisciplinary program delivery. Finally, Liu et al. (2023) validated that when using an ERAS-multidisciplinary collaborative approach to provide nursing care, blood loss, pain score, and functional recovery were all improved compared to the standard of care.
Assumptions
The research study findings are considered transferable from the international hospital setting to various clinical locations for nursing practice. Additionally, there is an assumption that all four of the selected articles provide current best evidence regarding post-operative hip arthroplasty nursing care and implementation of ERAS (Wen et al., 2022).
Conclusion
The PICO(T) framework has been used in order to successfully develop and respond to a focused research question about the management of post operative pain and mobility in hip arthroplasty patients similar to Patient A. Research from four reliable peer-reviewed sources indicated that multi-disciplinary ERAS nursing interventions provide significantly improved outcomes compared to traditional nursing care for patients within six weeks after surgery. Baccalaureate prepared nurses should use evidence based frameworks such as the PICO(T) framework to assist them in making clinical decisions and provide nursing care that is safe, effective, and patient centred.
References
Frassanito, L., Vergari, A., Nestorini, R., Cerulli, G., Placella, G., Pace, V., & Rossi, M. (2019). Enhanced recovery after surgery (ERAS) in hip and knee replacement surgery: Description of a multidisciplinary program to improve management of the patients undergoing major orthopedic surgery. Musculoskeletal Surgery, 104(1). https://doi.org/10.1007/s12306-019-00603-4
Liu, G., Li, L., Deng, J., Cai, L., & He, R. (2025). Enhanced recovery after surgery: Nursing strategy for total hip arthroplasty in older adult patients. BMC Geriatrics, 25(1). https://doi.org/10.1186/s12877-025-05888-8
Liu, J., Zheng, Q.-Q., & Wu, Y.-T. (2023). Effect of enhanced recovery after surgery with multidisciplinary collaboration on nursing outcomes after total knee arthroplasty. World Journal of Clinical Cases, 11(32), 7745–7752. https://doi.org/10.12998/wjcc.v11.i32.7745
Lunn, D. E., De Pieri, E., Chapman, G. J., Lund, M. E., Ferguson, S. J., & Redmond, A. C. (2026). Motion capture dataset of 137 post-operative total hip replacement patients performing activities of daily living. Scientific Data. https://doi.org/10.1038/s41597-026-06925-w
McKenzie, C., & Barker, K. (2025). Occupational therapy pre-operative intervention for total hip replacement patients; A qualitative enquiry. Occupational Therapy in Health Care, 1–14. https://doi.org/10.1080/07380577.2025.2473108
Tucker, S., Edmonds, S. W., Cullen, L., Hanrahan, K., & Laures, E. (2023). The problem with PICO for finding the best evidence: Fishing with the wrong bait and the search solution. Journal of PeriAnesthesia Nursing, 38(5). https://doi.org/10.1016/j.jopan.2023.07.002
Wang, X., Chen, Y., Zhao, J., Wang, B., & Chen, Z. (2022). Enhanced recovery after surgery for primary total hip arthroplasty: Analysis of post-operative blood indexes. International Orthopaedics. https://doi.org/10.1007/s00264-022-05606-8
Wen, H., Liu, T., & Li, J. (2022). Association between frailty and clinical post-operative outcomes in patients following hip arthroplasty: A systematic review and meta-analysis. International Orthopaedics, 47(3), 667–675. https://doi.org/10.1007/s00264-022-05657-x
Zhang, J., Zhou, Y., Zhang, Y., Zhang, Y., Liao, J., Qu, Z., Wu, Y., Jiang, L., Chen, X., & Xu, W. (2025). Application of interdisciplinary nursing care based on the concept of enhanced recovery after surgery in geriatric hip arthroplasty: A prospective study. HIP International, 35(6), 574–583. https://doi.org/10.1177/11207000251369719