Project

PICO and Evidence Appraisal Worksheets

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: 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 question?

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?

PICO Worksheet
What is the PICO question?____________________________________________________________

Define each element of the question below:
P- (Patient, population, or problem):
I- (Intervention):
C- (Comparison with other treatment/current practice):
O- (Desired outcome):
What is the practice issue/problem?

What is the practice area?
___ Clinical
___ Education
___ Administration
___ Other
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
___ Other:
What evidence must be gathered? (check all that apply)
___ Literature search
___ Guidelines
___ Expert Opinion
___ Patient Preferences ___ Clinical Expertise
___ Financial Analysis
___ Standards (Regulatory, professional, community)
___ Other

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 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 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?