Please see the attachment for instruction 

Assessment 3

PICO(T) Questions and an Evidence-Based Approach

Create a 3-5 page submission in which you develop a PICO(T) question for a specific care issue and evaluate the evidence you locate, which could help to answer the question.

Introduction-PICO(T) is an acronym that helps researchers and practitioners define aspects of a potential study or investigation.

It stands for:

· P – Patient/population/problem.

· I – Intervention.

· C – Comparison (of potential interventions, typically).

· O – Outcome(s).

· T – Time frame (if time frame is relevant).

The end goal of applying PICO(T) is to develop a question that can help guide the search for evidence (Boswell & Cannon, 2015). From this perspective, a PICO(T) question can be a valuable starting point for nurses who are starting to apply an evidence-based model or EBPs. By taking the time to precisely define the areas in which the nurse will be looking for evidence, searches become more efficient and effective. Essentially, by precisely defining the types of evidence within specific areas, the nurse will be more likely to discover relevant and useful evidence during their search. When applying the PICO(T) approach, the nurse can isolate the interventions of interest and compare to other existing interventions for the evidenced impact on the outcome of the concern.

You are encouraged to complete the Vila Health PICO(T) Process activity before you develop the plan proposal. This activity offers an opportunity to practice working through creating a PICO(T) question within the context of an issue at a Vila Health facility. These skills will be necessary to complete Assessment 3 successfully. This is for your own practice and self-assessment and demonstrates your engagement in the course.

Reference

Boswell, C., & Cannon, S. (2015). 
Introduction to nursing research. Jones & Bartlett Learning.

Professional Context-As a baccalaureate-prepared nurse, you will be responsible for locating and identifying credible and scholarly resources to incorporate the best available evidence for the purposes of enhancing clinical reasoning and judgement skills. When reliable and relevant evidence-based findings are utilized, patients, health care systems, and nursing practice outcomes are positively impacted.

PICO(T) is a framework that can help you structure your definition of the issue, potential approach that you are going to use, and your predictions related to the issue. Word choice is important in the PICO(T) process because different word choices for similar concepts will lead you toward different existing evidence and research studies that would help inform the development of your initial question. When writing a PICO(T)-formatted research question, you want to focus on the impact of the intervention and the comparison on the outcome you desire.

Scenario-For this assessment, please use a health care issue of interest from your current or past nursing practice.

If you do not have an issue of interest from your personal nursing practice, then review the optional Case Studies presented in the resources and select one of those as the basis for your assessment.

Instructions-For this assessment, select a health care issue of interest and apply the PICO(T) process to develop the research question and research it.

Your initial goal is to define the population, intervention, comparison, and outcome. In some cases, a time frame is relevant and you should include that as well, when writing a question you can research related to your issue of interest. After you define your question, research it, and organize your initial findings, select the two sources of evidence that seem the most relevant to your question and analyze them in more depth. Specifically, interpret each source's specific findings and best practices related to your issues, as well explain how the evidence would help you plan and make decisions related to your question.

If you need some structure to organize your initial thoughts and research, the PICOT Question and Research Template document (accessible from the ”
Create PICO(T) Questions” page in the Capella library's Evidence Based Practice guide) might be helpful.

In your submission, make sure you address the following grading criteria:

· Define a practice issue to be explored via a PICO(T) approach. Create a PICO(T)-formatted research question

· Identify sources of evidence that could be potentially effective in answering a PICO(T) question (databases, journals, websites, etc.).

· Explain the findings from articles or other sources of evidence as it relates to the identified health care issue.

· Explain the relevance of the findings from chosen sources of evidence to making decision related to a PICO(T) question.

· Communicate using writing that is clear, logical, and professional with correct grammar and spelling using the current APA style.

Example Assessment: You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like:

·
Assessment 3 Example [PDF]
 Download Assessment 3 Example [PDF].

Additional Requirements- Your assessment should meet the following requirements:

·
Length of submission:
 Create a 3-5-page submission focused on defining a research question and interpreting evidence relevant to answering it.

·
Number of references:
 Cite a minimum of four sources of scholarly or professional evidence that support your findings and considerations. Resources should be no more than 5 years old.

·
APA formatting: Format references and citations according to the current APA style.

Portfolio Prompt: Remember to save the final assessment to your ePortfolio so that you may refer to it as you complete the final capstone course.

Competencies Measured-By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:

· Competency 1: Interpret findings from scholarly quantitative, qualitative, and outcomes research articles and studies.

· Explain the findings from articles or other sources of evidence that are relevant to the health care issue.

· Competency 2: Analyze the relevance and potential effectiveness of evidence when making a decision.

· Identify sources of evidence that could be potentially effective in answering a PICO(T) question.

· Explain the relevance of the findings from chosen sources of evidence to making decision related to a PICO(T) question.

· Competency 3: Apply an evidence-based practice model to address a practice issue.

· Define a practice issue to be explored via a PICO(T) approach and develop a PICO(T)-formatted research question.

· Competency 5: Apply professional, scholarly communication strategies to lead practice changes based on evidence.

· Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.

· Apply APA formatting to in-text citations and references exhibiting nearly flawless adherence to APA format.

Scoring Guide

Use the scoring guide to understand how your assessment will be evaluated.

PICO(T) Questions and an Evidence-Based Approach Scoring Guide

CRITERIA	NON-PERFORMANCE	BASIC	PROFICIENT	DISTINGUISHED
Define a practice issue to be explored via a PICO(T) approach and develop a PICO(T)-formatted research question.

Identify sources of evidence that could be potentially effective in answering a PICO(T) question.

Explain the findings from articles or other sources of evidence that are relevant to the health care issue.

Explain the relevance of the findings from chosen sources of evidence to making decision related to a PICO(T) question.

Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.

Apply APA formatting to in-text citations and references exhibiting nearly flawless adherence to APA format.

Anti-inflammatory drugs, such as nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids, are widely used for managing various inflammatory conditions. Discuss the potential challenges and considerations a Nurse Practitioner might face when initiating and monitoring therapy with these medications. Consider factors such as the patient’s renal function, gastrointestinal risk, potential drug-drug interactions, and contraindications to therapy. How can a Nurse Practitioner manage these challenges to ensure the safe and effective use of anti-inflammatory drugs in their patients? 

A 68-year-old client lives alone and is independent with all ADLs, has no restrictions for mobility, and is competent, and oriented x4. The client is on a fixed income, but has enough to manage a modest lifestyle. The client has family and social supports but is very independent and is proud of her self-reliance. The client’s height is 5’ 6”, weight is 210 lb. / 95.25 kg.

Please answer the following:

• What is the client’s BMI?
• Identify what screening tools you would use to assess nutritional and exercise knowledge, and why?
• One Outcome/Intervention/Rationale:
  • Identify one outcome/goal that is reasonable, measurable and realistic. Identify 1 nursing intervention for the outcome and give rationale for the intervention.
• Identify what weakness in the client’s life may be impacting the client’s activity and diet?
• What referrals would you make and why?

(Use references for your responses, not just opinion.)

EVIDENCE-BASED PROJECT, PART 4: RECOMMENDING AN EVIDENCE-BASED PRACTICE CHANGE

The collection of evidence is an activity that occurs with an endgame in mind. For example, law enforcement professionals collect evidence to support a decision to charge those accused of criminal activity. Similarly, evidence-based healthcare practitioners collect evidence to support decisions in pursuit of specific healthcare outcomes.

In this Assignment, you will identify an issue or opportunity for change within your healthcare organization and propose an idea for a change in practice supported by an EBP approach.

To Prepare:

· Reflect on the four peer-reviewed articles you critically appraised in Module 4, related to your clinical topic of interest and PICOT.

· Reflect on your current healthcare organization and think about potential opportunities for evidence-based change, using your topic of interest and PICOT as the basis for your reflection.

· Consider the best method of disseminating the results of your presentation to an audience. 

The Assignment: (Evidence-Based Project)

Part 4: Recommending an Evidence-Based Practice Change

Create an 8- to 9-slide 
narrated PowerPoint presentation in which you do the following:

· Briefly describe your healthcare organization, including its culture and readiness for change. (You may opt to keep various elements of this anonymous, such as your company name.)

· Describe the current problem or opportunity for change. Include in this description the circumstances surrounding the need for change, the scope of the issue, the stakeholders involved, and the risks associated with change implementation in general.

· Propose an evidence-based idea for a change in practice using an EBP approach to decision making. Note that you may find further research needs to be conducted if sufficient evidence is not discovered.

· Describe your plan for knowledge transfer of this change, including knowledge creation, dissemination, and organizational adoption and implementation.

· Explain how you would disseminate the results of your project to an audience. Provide a rationale for why you selected this dissemination strategy.

· Describe the measurable outcomes you hope to achieve with the implementation of this evidence-based change.

· Be sure to provide APA citations of the supporting evidence-based peer reviewed articles you selected to support your thinking.

· Add a lessons learned section that includes the following:

· A summary of the critical appraisal of the peer-reviewed articles you previously submitted

· An explanation about what you learned from completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template (1-3 slides)

LEARNING RESOURCES

Required Readings

· Hoffman, T. C., Montori, V. M., & Del Mar, C. (2014). 

The connection between evidence-based medicine and shared decision makingLinks to an external site.
. 
Journal of the American Medical Association, 312(13), 1295–1296. doi:10.1001/jama.2014.10186

· Kon, A. A., Davidson, J. E., Morrison, W., Danis, M., & White, D. B. (2016). 

Shared decision making in intensive care units: An American College of Critical Care Medicine and American Thoracic Society policy statementLinks to an external site.
. 
Critical Care Medicine, 44(1), 188–201. doi:10.1097/CCM.0000000000001396

· Opperman, C., Liebig, D., Bowling, J., & Johnson, C. S., & Harper, M. (2016). 

Measuring return on investment for professional development activities: Implications for practiceLinks to an external site.
. 
Journal for Nurses in Professional Development, 32(4), 176–184. doi:10.1097/NND.0000000000000483

· Schroy, P. C., Mylvaganam, S., & Davidson, P. (2014). 

Provider perspectives on the utility of a colorectal cancer screening decision aid for facilitating shared decision makingLinks to an external site.
. 
Health Expectations, 17(1), 27–35. doi:10.1111/j.1369-7625.2011.00730.xThe Ottawa Hospital Research Institute. (2019). 

Patient decision aidsLinks to an external site.
. Retrieved from https://decisionaid.ohri.ca/