MY PROBLEM IS PREVENTING HYPOTHERMIA IN SURGICAL PATIENT
Capstone Project Milestone #1:
PICO and Evidence Appraisal Worksheets
Your Instructor’s Name:
Purpose: To identify a problem or concern that nursing can change and develop a PICO question to guide the change project.
Directions: Use 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 PICO elements.
Step 1: 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? Briefly describe the problem or practice issue that you want to research. What is your practice area; clinical, education, or administration?
Step 2: 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 3: What is the scope of the problem? Does this problem affect an individual, population, or an entire institution?
Step 4: 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 5: What evidence must be gathered? Everyone should have a literature search. However, what other sources of reliable information will be helpful for your particular question?
Step 6: State the search question in narrow, manageable terms. 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? How will you narrow your search if needed?
|What is the practice issue/problem?|
|What is the practice area?___ Clinical
|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 is the scope of the problem?___ Individual
|What is the PICO question?___ P– (Patient, population, or problem):
___ I– (Intervention):
___ C– (Comparison with other treatment/current practice):
___ O– (Desired outcome):
|What evidence must be gathered? (check all that apply)|
|___ Literature search___ Guidelines
___ Expert Opinion
___ Patient Preferences
|___ Clinical Expertise___ Financial Analysis
___ Standards (Regulatory, professional, community)
|State the search question in narrow, manageable terms:|
Evidence Appraisal Worksheet
Your Instructor’s Name:
Purpose: To find evidence to support an intervention that will change the outcomes.
Directions: Type 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 forth 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 manual.
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?
|Evidence Appraisal Worksheet|
|APA Reference for ArticleGive the APA-formatted reference for the article.||Type of Source*Research: Peer-reviewed article
*Non-research systematic review, clinical practice guidelines, organizational experience, or expert opinion/case study/literature review
|Strength of ResearchDiscuss the strength of the sources.
Report if evidence is High, Good, or Low/Major Flaw. Use the tools on page 238-244 of your text and discuss the reasons why you have assigned a particular level of quality.
|Brief Description of ResearchAddress the questions.
*How does the information in the article apply to the project problem or proposed intervention?
*Summarize in your own words.
* Include results of the study and how these results are applicable to your project.
* What is the recommendation of the source for clinical practice?
Capstone Project Milestone #1:
PICO and Evidence Appraisal Guidelines
Clear identification of the problem or opportunity is the first step in evidence-based nursing. This first milestone offers two tools to assist in the identification and gathering of evidence to link the problem, proposed intervention, and desired outcomes. Completion of the milestone will include identification of the problem or concern using the PICO format and an evidence appraisal to find evidence to support an intervention that will change the outcomes.
This assignment enables the student to meet the following Course Outcomes.
CO4: Develops and outlines a scientific, systematic decision-making process to integrate critical thinking with clinical judgment to assure safe and effective outcomes. (PO #4)
CO8: Selects evidence for best practice when planning professional nursing care for individuals, families, aggregates, and communities. (PO #8)
Milestone #1 consists of the completion of one worksheet that contains two parts (i.e., the PICO worksheet and the evidence appraisal worksheet). Submit the file with the two worksheets completed to the Dropbox by Sunday, 11:59 p.m. MT at the end of Week 2.
Milestone #1 is worth 175 points (75 points for the PICO worksheet and 100 points for the evidence appraisal worksheet).
- Read this document including the grading rubrics below.
- Download the PICO/Evidence Appraisal worksheets form from Doc Sharing. Consider what is the nursing problem or issue that you have uncovered. Make sure it is related to nursing, i.e., one that a nurse can solve independently. Do not select a medical problem that is dependent upon a medical professional to resolve. Completion of PICO worksheet will offer a tool for your literature search.
- For the evidence appraisal worksheet, find AT LEAST FOUR sources to support the need for change and the potential intervention you have selected to solve the problem. Three of these sources must be peer-reviewed articles while one can be a reliable professional source.
- Submit the completed PICO/Evidence Appraisal worksheet to the Week 2 Dropbox.