Although nursing practice problems and medical practice problems are related in that they are used for medicine, there are differences between the two. A nursing practice problem is an issue encountered during nursing practice, such as during a patient assessment, related to the patient’s response to a health problem they are experiencing. There are numerous considerations to the nursing practice problems (Fuller, 1982). This ranges from the patient’s signs and symptoms to an illness to their difficulties in completing the activities of daily living due to a fractured extremity. This is due to nursing care involves the entire individual, family or community. Fuller, (1982) states that nursing practice problems, “…deal with modalities of patient care such as support, comfort, prevention of trauma, promotion of recovery, health screening, appraisal and/or assessment, health education, and coordination of health care.”
A medical practice problem is concerned with a medical condition or disease. It identifies a condition, searches for causes, establishes a prognosis, and prescribes a treatment for the condition (Chiffi & Zanotti, 2015).
Chiffi and Zanotti (2015) state, “In conclusion, medical and nursing diagnoses have different goals: a medical diagnosis identifies a variation from a norm, while a nursing diagnosis should judge the existence of a potential for enhancing self-care.”
Consider a patient with a fractured wrist. The physician will set the fracture and prescribe pain medication. These are examples of medical practice problems. The nurse will review the aftercare and medication instructions with the patient. The nurse will also review care of the splint and possibly arrange a visiting RN to help with activities of daily living.
The PICOT question is the first step in establishing or improving evidence-based practice with the goal of solving problems with patients. “Nurses use EBP to provide patients with safe, quality care and to improve outcomes” (Helbig, 2018). The PICOT is based on a nursing practice problem because it is designed to improve patient care. An example of using PICOT for evidence-based practice would be studying the frequency of oral care with the goal of reducing the incidence of ventilator associated pneumonias. It is not designed for disease research.