Milestone 1 – PICO and Evidence Appraisal NR451

Milestone 1 – PICO and Evidence Appraisal NR451

NR451

NR 451 DeVry Capstone Project Milestone 1 – PICO and Evidence Appraisal Guidelines

Purpose

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.

Course 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)
Due Date
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 ofWeek 2.
Points
Milestone #1 is worth 175 points (75 points for the PICO worksheet and 100 points for the evidence appraisal worksheet).

Milestone 1 – PICO and Evidence Appraisal NR451 Directions

1. Read this document including the grading rubrics below.
2. 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.
3. For the evidence appraisal worksheet, find AT LEAST FOURsources 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.
4. Submit the completed PICO/Evidence Appraisal worksheet to the Week 2 Dropbox.

Grading Criteria: PICO

Category Points % Description

PICO question and components 40 53% Question or nursing problem is identified and is an independent nursing decision. PICO elements are correctly identified. Outcomes are measurable.
Practice issue and scope of the problem 20 27% Practice issue/problem is thoroughly described. The need for change is evident.Practice area is identified. Identification of the practice issue is clear. Scope of the problem is identified.
Evidence and search terms 15 20% Appropriately identifies the types of evidences that should be gathered (must include literature search). Uses manageable search terms and ways in which the search can be narrowed if discussed.
Total 75 points 100%

Grading Rubric: PICO

Assignment Criteria Outstanding or Highest Level of Performance
A (92–100%) Very Good or High Level of Performance
B (84–91%) Competent or Satisfactory Level of Performance
C (76–83%) Poor or Failing or Unsatisfactory Level of Performance
F (0–75%) Total

PICO question and components

40 points Question or nursing problem is identified and is an independent nursing decision. PICO elements are correctly identified. Outcomes are measurable.
37–40 points Question or nursing problem is identified and is an independent nursing decision. PICO elements are correctly identified. Outcomes but are not measurable.
34–36 points Question or nursing problem is identified and is an independent nursing decision. One PICO element is not correctly identified. Outcomes but are not measurable.
30–33 points Question or nursing problem is identified but is not an independent nursing decision. Several PICO elements are not correctly identified. Outcomes are not measurable or may not be present.
0–29 points /40

Practice issue and scope of the problem

20 points *Practice issue/problem is thoroughly described. The need for change is evident.*Practice area is identified. *Identification of the practice issue is clear.
*Scope of the problem is identified.
19–20 points *Practice issue/problem is vaguely described. The need for change is evident.
*Practice area is identified. *Identification of the practice issue is clear.
*Scope of the problem is identified.
17–18 points *Practice issue/problem is vaguely described. The need for change is not obvious.
*Practice area is identified. *Identification of the practice issue is clear.
*Scope of the problem is identified.
15–16 points *Practice issue/problem is vaguely described. Need for change is not obvious.
*Practice issues or scope of the problem are not addressed and/or not accurate.
0–14 points /20 Milestone 1 – PICO and Evidence Appraisal NR451

Evidence and search terms.

15 points Appropriately identifies the types of evidences that should be gathered (must include literature search). Uses manageable search terms and ways in which the search can be narrowed if discussed.
14–15 points Appropriately identifies the types of evidences that should be gathered (must include literature search). Uses manageable search terms. Ways in which the search can be narrowed is not included.
13 points Appropriately identifies the types of evidences that should be gathered (must include literature search). Search terms are not measurable. Ways in which the search can be narrowed is not included.
11–12 points Types of evidence that should be gathered is not noted or not correct, literature search not identified. Search terms are not measurable or absent. Ways in which the search can be narrowed is not included.
0–10 points /15
Total Points /75

Grading Criteria: Evidence Appraisal – Milestone 1 – PICO and Evidence Appraisal NR451

Category Points % Description

Article Selection 30 30% Four articles used. At least three articles are peer-reviewed research. Other source is scholarly and appropriate for the change project. Type of source is properly identified. References are listed in APA format.
Strength of Research 20 20% Strength of the research is listed as High, Good, or Low/Major Flaw. Reasons why the rating was given is clearly discussed and logical.
Description of Research 50 50% Description of the research is thorough and detailed. Summary was given in own words. Results of the study were summarized with the application to the project noted. Recommendations for clinical practice were discussed.
Total 100 points 100%

Grading Rubric: Evidence Appraisal

Assignment Criteria Outstanding or Highest Level of Performance
A (92–100%) Very Good or High Level of Performance
B (84–91%) Competent or Satisfactory Level of Performance
C (76–83%) Poor or Failing or Unsatisfactory Level of Performance
F (0–75%) Total

Article Selection

30 points Four articles used. At least three articles are peer-reviewed research. Other source is scholarly and appropriate for the change project. Type of source is properly identified. References are listed in APA format.
28–30 points Four articles used. At least three articles are peer-reviewed research. Other source is scholarly and appropriate for the change project. Type of source is not properly identified. References are listed in APA format.
25–27 points Four articles used. At least three articles are peer-reviewed research. Other source is scholarly and appropriate for the change project. Type of source is not properly identified. References some errors in APA format.
23–24 points Less than three articles are peer-reviewed research. Other source is not scholarly or appropriate for the change project. Type of source is not properly identified. References have multiple errors in APA format.

Milestone 1 – PICO and Evidence Appraisal NR451
0–22 points /30

Strength of Research
20 points Strength of the research is listed as High, Good, or Low/Major Flaw. Reasons why the rating was given is clearly discussed and logical.
19–20 points Strength of the research is listed as High, Good, or Low/Major Flaw. Reason why the rating was given is documented but is not logical.
17–18 points Strength of the research is listed as High, Good, or Low/Major Flaw. Reason why the rating was given is vague or absent.
15–16 points Strength of the research is not listed as High, Good, or Low/Major Flaw. Reason why the rating was given is vague or absent.
0–14 points /20

Description of Research
50 points Description of the research is thorough and detailed. Summary was given in own words. Results of the study were summarized with the application to the project noted. Recommendations for clinical practice were discussed.
46–50 points Description of the research is thorough and detailed. Summary was given in own words. Results of the study were listed but no application or summary of results were given. Recommendations for clinical practice were discussed.
42–45 points Description of the research is vague. Summary was given in own words. Results of the study were listed but no application or summary of results were given. Recommendations for clinical practice were not discussed.
38–41 points Description of the research is vague. Summary was not in own words but rather quotes from the source. Results of the study may not be listed. Recommendations for clinical practice were not discussed.
0–37 points /50
Total Points /100 NR 451 CAPSTONE PROJECT MILESTONE 1 PAPER Milestone 1 – PICO and Evidence Appraisal NR451

Capstone Project Milestone #1:
PICO and Evidence Appraisal Worksheets
PICO Worksheet
Your Name:
Date:
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: 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
Search terms: Milestone 1 – PICO and Evidence Appraisal NR451
Databases to search:
Search Strategies:

Evidence Appraisal Worksheet
Your Name:
Date:
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 Milestone 1 – PICO and Evidence Appraisal NR451
PICO Question:
APA Reference for Article
Give 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 Research
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. Brief Description of Research
Address 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?
1
2
3
4

Capstone Project: Milestone #2: Design for Change Proposal Paper (graded)
Your Capstone Project Milestone #2: Design for Change Proposal Paper is due Sunday. Guidelines may be found in Doc Sharing.
Your assignment is due by Sunday, end of week, 11:59 p.m. (MT). Submit your assignment to the Dropbox.

Milestone 1 – PICO and Evidence Appraisal NR451

ADDITIONAL INFORMATION 

PICO and Evidence Appraisal

Introduction

What is the most common error in research? The answer might surprise you. It’s not bias or misconduct; rather, it’s an issue of scale. The problem is that it’s difficult to find enough data to support your hypothesis if you want results that are statistically significant (or even just within a reasonable range). This means you need more participants or observations than exist in the world today. For instance: In order to estimate the average price of a new car based on historical data, we’d need at least 10 years worth of prices along with every model sold since 1971!

PICO

The PICO framework is a method for developing research questions. It stands for Population, Intervention, Comparison and Outcome.

The first step in the PICO framework is to define the population you’re interested in studying. This may be difficult if you have no idea who your participants are (for example: “People who play video games”). Instead, try to think about an age range or other criteria that will help narrow down your potential participants.

Next comes defining your intervention—what do we want to study? What changes can our intervention bring about? What outcomes do we hope for? For example: We want to know whether playing video games improves hand-eye coordination as measured by reaction time; therefore our intervention would involve measuring reaction times before and after playing one video game over another (comparison group). Finally we need an outcome measurement tool so that we can accurately measure changes in this particular health domain with respect to certain factors such as age groups etcetera…

What about observational studies?

You should be aware that observational studies are important and can provide useful insights into the effects of interventions. However, they have some limitations:

• Observational studies are often vulnerable to bias—that is, if a study does not follow all the rules of good research design (like randomization), then it’s more likely to find an association where there is none or less-than-perfect evidence for causation between two variables. This can happen even if you’re using one of our best methods for evaluating PICO questions!

• The results from observational studies may also be hard to interpret because they involve small numbers of subjects who self-report their experiences rather than having independent observers assess them under rigorous conditions; this makes it hard for researchers looking at those data sets (and their results) over time as well as anyone else reading about them now or in future years when more information becomes available

Sample Size and Power Calculations

Sample size is the number of times you need to test a sample before you can be sure that it’s representative of your population. The larger your sample size, the more likely it is that your results will show what you’re looking for.

In most cases, scientists use power calculations—which estimate how many times their experiments will be able to detect differences between groups when there really aren’t any—to decide how much data they need in order to make confident conclusions about their results. Power analyses take into account various factors like statistical significance and chance, so they can help researchers determine how confident they should be in making generalizations from their research findings.

When To Stop Looking For Evidence

When you have enough evidence, you can stop looking for more. If your data indicates that a particular hypothesis is false, then it’s time to move on and accept that conclusion.

When you’re ready to reach a conclusion, there are three things to consider:

• How much certainty do I need? The answer depends on what kind of project or research question we’re dealing with here (i.e., whether the end goal is simply to understand something about human behavior or whether our goal is more specific). In general terms though, if someone else has already reached their own conclusions based on the same evidence as yours (or worse), then this might not be enough for them—and vice versa if theirs turned out different from yours! So consider yourself lucky if one person’s experience matched yours closely enough so that both conclusions could be drawn from existing data sets; but don’t get too cocky about how unique your approach was since chances are good there were other people doing similar work when those results came out earlier this week; just don’t forget all those others who might have had different ideas during their own investigations into this topic at other times in history–or perhaps even today!

Takeaway:

The takeaway is a summary of the main points that you’ve learned. It’s important to write this section because it gives your reader a sense of what they can expect from reading more in your article, and it helps keep them interested by showing how relevant your article is to other topics.

If you’re writing an article about a new way to do something, then the takeaway will be very different from one that discusses evidence appraisal techniques for evaluating scientific studies. For example:

• You might want to say “Evidence Appraisal is an approach used by scientists who study medical treatments.” This sentence shows up as part of a bigger paragraph about Evidence Appraisal but doesn’t have much meaning on its own; it’s just filler text meant only as an introduction for someone who hasn’t read any further yet (or maybe even just skimmed through).

• To give readers more context about Evidence Appraisal, though—and make them feel like they understand why this topic is important—you could expand upon it by saying something like: “In order for doctors and researchers to make effective decisions using evidence-based medicine methods such as systematic reviews/ meta-analysis/ evidence based medicine…

Conclusion

I hope this has been helpful for you in your journey to becoming an evidence-based clinical expert! I know that the process can be difficult at times, but keep in mind that it’s a journey worth taking. You don’t have to finish all the way—in fact, sometimes it’s better if you don’t—but if you decide to continue down this path, then good luck!