Presenting the PICO(T) Process Findings to Peers: Video Transcript

Hello. My name is Henry Ayumba, and today, I present the findings of the PICO(T) process I conducted in my clinical study concerning postoperative ventral hernia.

Let me begin by explaining the diagnosis.

Postoperative ventral hernia surgery is a standard surgical procedure that consists of the repair of a hernia by implantation of a mesh to strengthen the abdominal wall. Although this procedure increases mechanical support, it is associated with significant risks, with surgical site infection (SSI) and hernia recurrence being the most serious among them. SSIs may delay healing and induce significant discomfort and readmission to the hospital. Hernia recurrence is usually associated with infection, poor fixation, or poor healing of tissue, as noted by Smith and Parmely (2023): Presenting the PICO(T) Process Findings to Peers: Video Transcript.

Such complications are especially harmful to patients with diabetes, obesity, or an immunosuppressed state because they are more likely to experience delayed wound healing and systemic infection. I have observed the emotional and physical toll of these complications and how they negatively influence patient outcomes. Therefore, my focus is on finding prevention strategies that would not only increase recovery rates but also improve healthcare expenditures.

Let’s now delve into the research question I developed using the PICO(T) process.

In an attempt to tackle these complications, I formulated a research question based on the PICO(T) framework. The question reads, “In adult patients who undergo a procedure of ventral hernia repair with mesh implantation (P), does antibiotic prophylaxis (I) compared to no antibiotic prophylaxis (C) help in reducing surgical site infection and hernia recurrence (O) within 30 days of the surgery (T)?” This inquiry addresses every element of the PICO(T) model.

The population consists of adults who have undergone ventral hernia repair; the intervention is the use of prophylactic antibiotics; the comparison is no antibiotic use; the outcomes are SSIs and hernia recurrence rate, and the time within 30 days of surgery. This framework helped limit my literature search and gave clinical significance to guide the protocols of surgical care.

I will now present a summary of three articles yielded from the search process.

Notably, the three articles are high-quality, credible sources that directly address the use of antibiotic prophylaxis in hernia repair. To begin with, the first article is a Cochrane review conducted by Orelio et al. (2020). The review was based on the information of more than 8,000 participants who underwent inguinal and femoral hernia surgeries.

It was categorical that antibiotics are likely to decrease SSIs in high-risk surgical environments. This review is credible and relevant to my research since it is systematic and peer-reviewed.

The second study, by Emovon et al. (2025), analyzed 57 patients who received ventral hernia repair with T-line mesh. The analysis revealed a complication rate of 12.3%, of which the majority were infections, and emphasized the role of adjunct measures such as antibiotic prophylaxis. This study and its reflection on patient-level outcomes made it especially relevant to my clinical question.

Finally, the third article, authored by Daly et al. (2024), presents the SAGES guidelines on hernia surgery. These guidelines are disease-centered and involve hiatal hernias. However, they still pay extensive attention to infection prevention and the usage of antibiotics based on evidence, so they can be considered relevant and authoritative in the best practices of surgery.

Subsequently, let me now explain the answer to the PICO(T) question based on evidence analysis.

The overall evidence draws conclusions that prove the effectiveness of antibiotic prophylaxis in reducing the risk of SSIs and possibly inducing hernia recurrence indirectly. The Cochrane review gives moderate certainty evidence of effectiveness with regard to preventing superficial infections. Secondly, the results of Emovon et al. (2025) highlight the clinical implications of post-surgery infections even with modern mesh in practice. Thirdly, Daly et al.’s (2024) guidelines support that infection prevention measures, such as prophylactic usage of drugs such as antibiotics, are considered a constituent of routine surgical care.

Nonetheless, some of the assumptions that are common in all the studies are the timely and adequate selection of antibiotics, which does not necessarily apply to the real situation. Regardless, they show that the use of antibiotics is an effective approach that can improve patient outcomes.

As I conclude, let me describe key steps of care based on the evidence.

According to the literature, I recommend the use of a single antibiotic at the correct dose unit, for instance, cefazolin, within one hour before an incision of surgery. This is timed so that the tissue can have an optimum level during the operation, as evident in the CDC guidelines and Daly et al.’s (2024) study. Surgeons must observe the sterile technique, particularly during the mesh placement. Patients must be followed up during the first 30 days following surgery until evidence of infection or relapse is noted.

Also, patients with a high risk may need more observation. The education of wound care and timely identification of symptoms is imperative to avoid complications. Such measures correspond to the best practice recommendations and should facilitate quicker recovery and fewer readmission cases.

Thank you.

References

Daly, S., Kumar, S. S., Collings, A. T., Hanna, N. M., Pandya, Y. K., Kurtz, J., Kooragayala, K., Barber, M. W., Paranyak, M., Kurian, M., Chiu, J., Ansari, M. T., Slater, B. J., & Kohn, G. P. (2024). SAGES guidelines for the surgical treatment of hiatal hernias. Surgical Endoscopy, 38(9), 4765–4775. https://doi.org/10.1007/s00464-024-11092-3

Emovon, E. O., Oyola, A. M., Arias-Espinosa, L., Naga, H. I., Volk, A. S., Hope, W., Malcher, F., Levine, J. P., Harris, H. W., Yoo, J., & Patel, A. (2025). Ventral hernia repair with T-line hernia mesh: A multi-institutional experience. Surgery in Practice and Science, 21, 100285. https://doi.org/10.1016/j.sipas.2025.100285

Orelio, C. C., van Hessen, C., Sanchez-Manuel, F. J., Aufenacker, T. J., & Scholten, R. J. (2020). Antibiotic prophylaxis for prevention of postoperative wound infection in adults undergoing open elective inguinal or femoral hernia repair. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.cd003769.pub5

Smith, J., & Parmely, J. D. (2023, August 8). Ventral hernia. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK499927/

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Assessment 4 Presenting Your PICO(T) Process Findings to Your Professional Peers

Create a 5–10 minute video of yourself, as a presenter, in which you propose an evidence-based plan to improve the outcomes for your diagnosis.

Introduction
As part of the critical role that EBP plays in nursing, professional nurses share their findings with their peers and others. A big part of research is sharing knowledge so that others can also learn. Professional nurses attend seminars and read journals specific to their practice, and they also publish and present what they have learned. This assessment prepares you to share your knowledge with others.

Instructions
For this assessment, you are a presenter! You will create a 5–10 minute video using Kaltura or similar software. In the video and written narrative:

• Review your findings from Assessment 3.
• Create a poster presentation based on your findings from Assessment 3 (see the samples in the Assessment 4: Poster Template Examples reading list). Include:
  • An explanation of the diagnosis.
  • The research question you developed using PICO(T).
  • A summary of your sources.
  • The answer to your PICO(T) question based on your analysis of evidence.
• Describe the key steps of care you are recommending based on your evidence.
• Give a professional presentation to your peers, showing your poster with your voice narration using Kaltura or similar software.
• Include your written narrative/script of the presentation in a Word document. Add the link to your video at the end of your written narrative.
• Refer to Using Kaltura Campus resource as needed to record and upload your video.

Note: If you require the use of assistive technology or alternative communication methods to participate in this activity, please contact DisabilityServices@Capella.edu to request accommodations. If, for some reason, you are unable to record a video, please contact your faculty as soon as possible to explore options for completing the assessment.

Presenting the PICO(T) Process Findings to Peers: Video Transcript

Additional Requirements
Your assessment should also meet the following requirements:

• Length of video: 5–10 minutes.
• References: Cite at least three professional or scholarly sources of evidence to support the assertions you make in your video. Include additional properly cited references as necessary to support your statements.
• APA reference page: Submit a correctly formatted APA reference page that shows all the sources you used to create and deliver your video. Be sure to format the reference page according to current APA style.
• Video and narrative: You must submit a written narrative of all of your video content. Add the link to your video at the end of your written narrative.

Competencies Measured
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:

• Competency 2: Analyze the relevance and potential effectiveness of evidence when making a decision.
  • Explain a diagnosis in terms of outcomes, risks, and complications.
  • Summarize the content of at least three sources of evidence, including the credibility and relevance of the articles to a specific diagnosis issue.
• Competency 4: Plan care based on the best available evidence.
  • Describe a research question developed using the PICO(T) process to address a chosen issue related to a diagnosis.
  • Explain the answer to a PICO(T) question based on an analysis of the evidence.
  • Describe key steps of care based on the evidence.
• Competency 5: Apply professional, scholarly communication strategies to lead practice changes based on evidence.
  • Organize content in a poster presentation and written narrative so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.
  • Communicate effectively in a professional audiovisual presentation with clear light and sound.
  • Apply APA formatting to in-text citations and references, exhibiting adherence to most aspects of APA format.

Scoring Guide

• Use the scoring guide to understand how your assessment will be evaluated.

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