Develop a PICOT Question
The focus of this assignment is to identify a practice issue/problem within the student’s area of nursing practice. This can be the same topic you identified in your discussions or a new problem/topic. Describe the background of the practice issue and construct a well formulated clinical question and then identify the specific elements of the question using the PICOT model.
Your assignment is a narrative assignment of 1-2 pages plus the title page and reference page. Use these first level headings for your paper:
Background of Problem- Write a Paragraph
Importance to Nursing – Write a Paragraph
Improvement of Patient Outcomes- Write a Paragraph
Well Worded Clinical Question- Write a Sentence
Identification of PICO elements- See format below
This assignment supports the following course learning outcomes:
CLO 1 Leadership:
Formulate strategies to utilize nursing research in clinical practice
Examine a clinical problem utilizing the process of nursing research
CLO 3 Scholarship:
Examine evidence based research as it applies to a variety of nursing practice settings
CLO 6 Professionalism:
Develop skills in using the research process to identify clinical problems and learn how to apply evidence based studies to clinical practice
CLO – 7 Diversity
Examine evidence based practice as it relates to different cultures and ethnicities
Assignment Instructions:
For the individual written PICOT assignment:
1. State the background of the problem, and why you believe it is important to nursing care and improvement of patient outcomes. This should be 1-3 paragraphs and include “proofâ€Â, such as data and statistics.
Formulate a well-worded clinical question in one sentence.
Using the PICO model, identify the specific elements of the clinical question (i.e. P:, I:, C:, O:, T)
You can use the John Hopkins Nursing Evidence Based Practice, Question Development Tool to get started, but DO NOT submit the John Hopkins template as your assignment. This can be located in the content area of the classroom, under week 3 information.
Example of Clinical Question:
In the hospitalized setting is the use of alcohol based hand sanitizer as effective as using soap and water in reducing infection
Once you have identified your clinical question use the PICOT model to develop the specific elements of the question of interest.
The PICOT question has five elements that are:
P
– Patient, problem, or population
I
– Intervention, Prognostic Factor or Exposure. (For the purposes of this assignment your I should be an intervention)
C
– Comparison of the intervention
O
– Outcome you would like to measure or achieve
T
– Time frame
Example of PICOT based on clinical question above:
P: Current floor data is a nosocomial infection rate (MRSA) 10% with current hospitalized patients on the medical-surgical unit
I: Use of alcohol based hand sanitizer upon entry to room, prior to touching patient, and upon exit of room
C: Use of Soap and Water upon entry and exit of room
O: Reduced MRSA infection rates on floor to 5% or below
T: Within 3 months
Asking the right clinical question is the first step towards discovering whether there is evidence, based on sound research, to address a clinical problem and improve safety, quality care and ultimately improve patient outcomes. Be sure the problem you are addressing is
nursing
sensitive. (i.e. there is a strong connection between nursing action and patient outcome). Some ways to do this are to think about problems you have encountered in taking care of patients recently that made you wonder why you were doing something a certain way.
Examples may include such things as patient care situations where there is a high risk, or an important clinical outcome such as falls, infection, pain. Other areas where problems can occur are in high volume situations such as Foley care or IV care. Additional areas could be associated with regulatory requirements or organizational relevance such as length of stay, patient satisfaction, hand washing, restraints, medication errors.
You can also look at research priorities from national guidelines/benchmarks or quality indicators such as: AHRQ Patient Safety Indicators, NQF National Quality Forum, Centers for Medicare and Medicaid Services (CMS) indicators, and Professional Practice Organizations such as Sigma Theta Tau or American Association of Critical Care Nurses.
Start by looking at your patients and the care you provide and then look at the agenda’s of some of the national research organizations. Narrow your focus by addressing, high risk, high volume, high benefit problems.
Resources https://guides.nyu.edu/c.php?g=276561&p=1847897
Johns Hopkins Nursing Evidence-Based Practice
Appendix B: Question Development Tool
1. What is the problem and why is it important?
2. What is the current practice?
3. What is the focus of the problem?
ï‚£ Clinical
ï‚£ Educational
4. How was the problem identified?
ï‚£ Administrative
(Check all that apply)
ï‚£ Safety/risk management concerns
ï‚£ Quality concerns (efficiency, effectiveness,
timeliness, equity, patient-centeredness)
ï‚£ Unsatisfactory patient, staff, or organizational
outcomes
ï‚£ Variations in practice within the setting
ï‚£ Variations in practice compared with
external organizations
ï‚£ Evidence validation for current practice
ï‚£ Financial concerns
5. What is the scope of the problem?
ï‚£ Individual
ï‚£ Population
ï‚£ Institution/system
6. What are the PICO components?
P – (Patient, population, problem):
I – (Intervention):
C – (Comparison with other interventions, if applicable):
O – (Outcomes that include metrics for evaluating results):
7. Initial EBP question:
8. List possible search terms, databases to search, and search strategies:
9. What evidence must be gathered?
(Check all that apply)
ï‚£ Literature search
ï‚£ Standards (regulatory, professional, community)
ï‚£ Guidelines
ï‚£ Expert opinion
ï‚£ Patient/family preferences
ï‚£ Clinical expertise
ï‚£ Organizational data
© The Johns Hopkins Hospital/Johns Hopkins University. May not be used or reprinted without permission.
Johns Hopkins Nursing Evidence-Based Practice
Appendix B: Question Development Tool
Directions for Use of the Question Development Tool
Purpose: This form is used to develop an answerable question and to guide the team in
the evidence search process. The question, search terms and strategy, and
sources of evidence can be revised as the EBP team refines the EBP project
focus.
What is the problem and why is it important? Indicate why the project was
undertaken. What led the team to seek evidence? Make sure the problem
statement defines the actual problem and does not include a solution statement.
What is the current practice? Define the current practice as it relates to the problem.
What is the focus of the problem? Is the problem a clinical concern (e.g., preventing
blood stream infections); an educational concern (e.g., discharge teaching for
patients); or an administrative concern (e.g., safety of 12-hour nursing shifts)?
How was the problem identified? Check the statements that describe how the
problem was identified.
What is the scope of the problem? Does the problem look at an individual (e.g.,
clinician, patient, family member); a population (e.g., adult cardiac patients,
recovery room nurses); or an institution/system (e.g., patient transportation, patient
or staff satisfaction)?
What are the PICO components?
â–ª
P (patient, population, problem) e.g., age, sex, setting, ethnicity, condition,
disease, type of patient, or population
â–ª
I (intervention) e.g., treatment, medications, education, diagnostic tests or best
practice(s)
â–ª
C (comparison with other interventions or current practice) may not be applicable
if your question is looking for best practice.
â–ª
O (outcome) stated in measurable terms, expected outcomes based on the
intervention identified, e.g., decrease in fall rate, decrease in length of stay,
increase in patient satisfaction.
Initial EBP Question. A starting question that can be refined and adjusted as the team
searches through the literature.
List possible search terms. Using PICO components and the initial EBP question, list
relevant terms to begin the evidence search. Terms can be added or adjusted as
the evidence search continues. Document the search terms, strategy, and
databases searched in sufficient detail for replication.
What evidence must be gathered? Check the types of evidence the team will gather
based on the PICO and initial EBP question.
© The Johns Hopkins Hospital/Johns Hopkins University. May not be used or reprinted without permission.
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