To Comment:

When reviewing the case study there are a many key points that are discussed in regards recovering from a pediatric cardiac surgery and the risk for a cardiac tamponade after the removal of a pulmonary artery catheter. There are a few pieces of information in this case study that are critical in determining how one would find the evidence, that is most appropriate, to determine how a complication, such as a cardiac tamponade, could occur in an infant only four days after an operative procedure.

The key clues include: an infant who is four days postoperative after a cardiac surgery, abnormal clotting profile, removal of a pulmonary artery catheter with drainage and ooze, followed by a deterioration in the patient's status, which ultimately leads to a diagnosis of a cardiac tamponade (Melnyk&Fineout-Overholt, 2015).

To enhance the likelihood of the most reliable evidence and helpful research, one would use a PICOT formation, to formulate a research question. The P in PICOT stands for the population at interest (Melnyk&Fineout-Overholt, 2015). In this case study, the population the study is aiming toward is an infant four days postoperative (Melnyk&Fineout-Overholt, 2015).

The next searchable topic would be the I, C, and O, which would indicate the issue at hand, the comparison of that issue, and the affect this event would have on the outcome; this would include questioning the frequency of removing a pulmonary artery catheter, or not removing the catheter, and the affects this procedure has on influencing a cardiac tamponade (Melnyk&Fineout-Overholt, 2015). The next, and final step would be to determine the T, which delivers a timeline for an event to occur (Melnyk&Fineout-Overholt, 2015).

In this case study, the timeline would be four days after surgery, which one would possibly be able to broaden to a week, to better serve research results. In a study conducted in 2012, the authors described the importance of formulating a comprehensive PICOT when researching a topic at hand (Riva et al.). This study discovered that the more detailed and specific a PICOT was, the more evidence and research was exposed to better enhance the topic of understanding (Riva et al., 2012).

This study also concluded, the more likely the researchers used the PICOT formation, the more likely one would develop a more appropriate and specific research yield (Riva et al., 2012).

With all this information, the most suitable PICOT formulated question, to determine the likelihood of an event similar to this would be: In an infant who recently had cardiac surgery, what is the frequency of cases regarding the removal of a pulmonary artery catheter, versus not removing the catheter within a week, have on the affect of developing a cardiac tamponade within the first week of surgery? This formation of questions and information would best suit the research topic at hand.

References

Melnyk, B. M., &Fineout-Overholt, E. (2015). Evidence-based practice in nursing & healthcare: A guide to best practice (3rd edition). Philadelphia, PA: Wolters Kluwer Health.

Riva, J. J., Malik, K. M., Burnie, S. J., Endicott, A. R., &Busse, J. W. (2012). What is your research question? An introduction to the PICOT formation for clinicians. Journal of the Canadian Chiropractic Association, 56(3), 167-171.