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.
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
2: Identify the problem.What have you noticed in
your work or school environment that isnâ€™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)
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.
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 question?
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
element of the question below:
P- (Patient, population, or problem):
C- (Comparison with other treatment/current practice):
O- (Desired outcome):
What is the
What is the
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
must be gathered? (check all that apply)
___ Expert Opinion
___ Patient Preferences
___ Clinical Expertise
___ Financial Analysis
___ Standards (Regulatory, professional, community)
Databases to search:
Purpose: To find evidence to support an intervention that will change the
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 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
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.
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
nonâ€“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
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.
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
Evidence Appraisal Worksheet
Reference for Article
Give the APA-formatted reference for the article.
*Research: Peer-reviewed article
*Non-research systematic review, clinical practice
guidelines, organizational experience, or expert opinion/case
Discuss 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.
Description of Research
Address the questions.
*How does the information in the article apply to
the project problem or proposed intervention?
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
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