Evidence-Based Practice Proposal

Evidence-Based Practice Proposal

Problem description

American jails and prisons are filled by more than two million men and women at any one time and the number is likely to increase in the next two years (Mounsey, Murray, King& Oprescu, 2016). All sorts of challenges will never lack in such a populated place. Health care practitioners, in particular nurses, who work in these correctional facilities, must ensure that the places are inhabitable. They can do this by eliminating parasites that have been known to exist in cells as well as encouraging healthy living standards of inmates. For this reason, this paper will tackle the problem of scabies that is caused by the mite Sarcoptes scabiei.

A large number of inmates in the US cells have been diagnosed with the condition either from being bitten by the parasitic organism or prolonged contact with someone that has been infected (Sen, Ali, Mostofa, Sarkar, Sorcar & Begum, 2016). Research has indicated that the mere act of sharing clothes, towels and beddings can cause one to get the contagious disease, although this is to a lesser extent.

Background of the problem

Scabies, also known as seven-year itch is a highly contagious disease that is caused by Sarcoptes scabies. Patients with scabies present with itching mostly at night, rashes at the infested parts and sometimes superficial burrows. Symptoms take between four to six weeks to manifest. Inmates with scabies are usually made uncomfortable, necessitating the need of eradication of the parasites (Armand, 2014). It should be noted that symptoms will often persist for several weeks after the mites have been eradicated. It is the role of nurses who are working in jails to ensure that inmates are free of scabies and any other illnesses so that they may lead illness-free lives and are able to perform routine tasks on a daily basis. For them to effectively handle this problem, it is essential to understand signs and symptoms as well as the pathophysiologyy of the disease (Schmidt & Brown, 2014). The condition is treatable and nurses must ensure that it does not spread to other inmates, owing to its contagious nature.

Stakeholders and Change Agents

According to Goldstein & Goldstein (2013), correctional centers are endowed with a variety of change agents despite the misconception that has been held by people for a long time. The stakeholders include but not limited to the head of the nursing department of the facility, director of the facility’s medical services, wardens at the jail in addition to their assistants. Elimination of scabies would not be effective without active involvement of the inmates themselves. Therefore, they form a pivotal stakeholder and change agent role. They are the ones that are being affected by the illness and must demonstrate that they are willing to change certain habits that are known to increase the disease process and their attitudes on the same (Melnyk & Fineout-Overholt, 2011). To achieve a scabies free region, all the stakeholders must set objectives upon which they will work towards. Each member should purpose to play their roles; otherwise the condition may not be eliminated easily.

PICOT Formulation

In its contextual meaning, the PICOT question format refers to a consistent formula for coming up with questions that are researchable and answerable and aid in the elimination of the problem at hand. The acronym is known to assist a healthcare worker in formulation of clinical questions and guide them in looking for evidence. Formulation of the PICOT question involves answering some crucial issues which include: the population that is being dealt with, indicators or interventions put forward to handle the disease and comparing measures that are being used with a population that is not infected by the scabies. Besides, assessment of the outcomes is a crucial component and should be done within a timeframe that has been set. A careful formulation of this format has been found to result in improved patient outcomes. Each question must be addressed adequately so that all aspects of patient care may be handled.

The PICOT Question

P- Which population has been infected by scabies?

I- what are some of the measures that have been put forward to tackle the problem?

C- How do the population that is infected by the disease in the facility compare with the one that is not infected in terms of numbers?

O- What are the outcomes of the interventions after a specific period of time?

T- How much time has been allocated for the inmates to be free of the disease?

The population that is being tackled in this case is the jailed one and has been diagnosed with scabies.  According to Swenty & Rowser (2014), the measures that have been put forward to address the problem include health education, screening and treatment. Permethrin cream has been identified as the treatment of choice. The nurse should consider alternative management plans that would eradicate the illness. Similarly, the nurse should endeavor to decrease spread of the disease from 36% to 2% or even lesser. A time frame of three to six months can be set to ensure that inmates are free of the illness.

Purposes of the Project

The project is aimed at reducing the number of new and existing case of scabies among inmates in the facility. Alternatively, the project would intend to remind stakeholders of their roles in ensuring jails and prisons are disease-free. A healthy jail requires that stakeholders work as a team with the sole purpose of eradicating any actual or potential deviation from health. Jails are corrective facilities where inmates are entitled to healthy life as they learn of newer and better ways of living with other members of the society.

Objective of the Project

The primary objective is to eliminate scabies among inmates in jails and other corrective facilities. Other objectives include but not limited to:

  • To ensure quality and hygienic practices among the people in the jail
  • To ensure full stakeholder participation in the prevention and elimination of scabies

Relevance of the Project to Nurses

Nurses play a crucial role in ensuring that the health of the given population. Hackney & McBride (2014) reiterated the importance of collaborating with other professions to help improve patient outcomes. Working among inmates has been branded by the society to be among the most risky jobs that one can undertake. However, nurses working in detention centers have come to understand that inmates are the best people to ever work with. They are friendly and would like to be handled in a much respectable manner just like other human beings. A holistic care should be the priority of all practitioners towards a disease free society.


The PICOT questions enable nurses to make critical decisions that influence care for inmates. By asking the questions, the nurse puts themselves at an advanced position to handle the inmate. The questions act as a guide and an experienced nurse will find it easier to alleviate symptoms in collaboration with the rest of the health care team.




Armand, K. E. (2014). International Journal of Clinical Dermatology & Research (IJCDR) ISSN 2332-2977.

Goldstein, I. F., & Goldstein, M. (2013). The experience of science: An interdisciplinary approach. Springer Science & Business Media.

Melnyk, B. M., & Fineout-Overholt, E. (Eds.). (2011). Evidence-based practice in nursing & healthcare: A guide to best practice. Lippincott Williams & Wilkins.

Schmidt, N. A., & Brown, J. M. (2014). Evidence-based practice for nurses. Jones & Bartlett Publishers.

Hackney, R., & McBride, N. (2014).UK Primary Healthcare Groups.Managing Healthcare

Information Systems with Web-Enabled Technologies.4(1). pp. 123-134.

Mounsey, K. E., Murray, H. C., King, M., & Oprescu, F. (2016). Retrospective analysis of institutional scabies outbreaks from 1984 to 2013: lessons learned and moving forward. Epidemiology and infection144(11), 2462-2471.

Sen, K. G., Ali, A., Mostofa, M. K., Sarkar, S. K., Sorcar, C., & Begum, K. (2016). Prevalence of Scabies in Skin and VD OPD of Faridpur Medical College Hospital. Faridpur Medical College Journal10(1), 17-19.

Swenty, C. F., & Rowser, M. (2014). An Education Intervention in an Incarcerated Population to Reduce the Occurrence of Infectious Skin Diseases. Journal of Correctional Health Care20(4), 343-352.



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