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 “proof”, 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.  Be sure that it is something that you are interested in and which is nursing sensitive. 

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