identify a problem or concern that nursing can change and develop a PICO
question to guide the change project.
the form below to complete the PICO assignment in Milestone #1. This includes
filling in the table with information about your research question and your
Step 1: Select
the key PICO terms for searching the evidence. Clearly define your PICO
question. List each element P (problem, population, or problem), I
(intervention), C (Comparison with other treatment/current practice), and O
(Desired outcome). Is the potential solution something for which you (as nurse
or student) can find a solution through evidence research? Look in your book
for guidelines to developing your PICO question.
Step 2: Identify
the problem.What have you noticed in your work or school environment that isn’t
achieving the desired patient or learning outcomes? What needs to change in
nursing, what can you change with the support of evidence in the literature? Describe
the problem or practice issue that you want to research. What is your practice
area; clinical, education, or administration? (This is NOT where you will list
your PICO question)
Step 3: How was
the practice issues identified?How did you come to know this was a problem in
your clinical practice? Review the listed concerns and check all that apply.
Step 4: What
evidence must be gathered? Everyone should have a literature search. However,
what other sources of reliable information will be helpful for your particular
Step 5: What
terms will you use in order to make sure that your search is wide enough to
obtain required information but narrow enough to keep it focused? What
databases will you search? How will you narrow your search if needed?
What is the PICO question?____________________________________________________________
Define each element of the
P– (Patient, population, or
C– (Comparison with other
O– (Desired outcome):
What is the practice issue/problem?
What is the practice area?
How was the practice issue
identified? (check all that apply)
___ Safety/risk management concerns
___ Unsatisfactory patient outcomes
___ Wide variations in practice
___ Significant financial concerns
___ Difference between hospital and community practice
___ Clinical practice issue is a concern
___ Procedure or process is a time waster
___ Clinical practice issue has no scientific base
What evidence must be gathered?
(check all that apply)
___ Literature search
___ Expert Opinion
___ Patient Preferences
___ Clinical Expertise
___ Financial Analysis
___ Standards (Regulatory, professional, community)
Databases to search:
Evidence Appraisal Worksheet
Purpose: To find
evidence to support an intervention that will change the outcomes.
your search question below. Find AT LEAST FOUR sources to support the need for
change and the potential intervention you have selected to solve the problem.
At least three of your sources must be peer-reviewed articles. The fourth
source could be another peer-reviewed article or a reliable, credible source. Look
in your text for ideas of other sources that can be used. Using the table
below, insert and describe your four chosen resources.
Step 1: APA
Reference for the article. You will need to list the reference for the source
in APA format. Be careful when using built-in APA formats and library
citations. They may not be in APA format. Refer to Chapter 7 of your APA
Step 2: Type of
Source. If your source is a research article, you will need to ensure that it is
a peer review article. You need at least three peer-reviewed articles for your
project. If your article is a non–research source, then you will need to list
what type of source it is; systematic review, clinical practice guidelines,
organizational experience, or individual expert opinion/case study/literature
review. You may only use ONE non-research source.
Step 3: Strength
of Research. Refer to page 238-240 for research evidence and page 242-244 for
non-research evidence. While you do not need to assign a level for each study,
you will assign a quality of evidence (high, good, or low/major flaw) and
should discuss the study using some of the elements that are discussed in the
appraisal forms. For example, Research evidence: was the sample size adequate?
Was there a controlled group? Was it a randomized study? Were results clearly
stated? Was the conclusion based on the results? Were study limitations
discussed? Not all of these elements need to be discussed, but you should
discuss this information to determine if the strength of the evidence is HIGH,
GOOD, or LOW/MAJOR FLAW.
Step 4: Brief
Description of the Research. In this section, you will summarize the source in
your own words. How does this information apply to your project? What are the
results of the source? What are their recommendations?
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