Capstone Project Milestone #1: PICO and Evidence Appraisal Worksheets

Capstone Project Milestone #1:
PICO and Evidence Appraisal Worksheets

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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? Does the adult patient age 65 years or older, at risk for developing delirium and its complications have better outcomes with frequent nursing assessment and intervention for early signs of delirium than no screening and intervention when symptoms obvious? Define each element of the question below:

P- (Patient, population, or problem): Adult patients age 65 years or older in acute care settings. I- (Intervention): Early identification and intervention of delirium. Nurses will screen for signs of delirium using evidence based screening tool upon admission and daily, intervening when tool indicates delirium present or developing C- (Comparison with other treatment/current practice): No Screening tools used and intervention when obvious signs of delirium present. O- (Desired outcome): With early identification and intervention of delirium patients will experience fewer complications from delirium during their hospitalization. What is the practice issue/problem?

As much as 24% of patients in acute care setting outside the ICU develops delirium and can experience long-term complications. With early identification of symptoms, clinical staff can put into effect EBP protocols to help reduce the risk of patients developing these com……………………………

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