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Instructions
PICO(T) Questions and an Evidence-Based Approach
Create a 3-5 page submission in which you develop a PICO(T) question for the diagnosis you worked with in the first two assessments and evaluate the evidence you locate, which could help to answer the question.
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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 the 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 them 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 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 to enhance clinical reasoning and judgment skills. When reliable and relevant evidence-based findings are utilized, patients, healthcare systems, and nursing practice outcomes are positively impacted.
PICO(T) is a framework that can help you structure your definition of the issue, the 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 of the outcome you desire.
Scenario
For this assessment, please use the diagnosis you worked with in the first two assessments.
Instructions
After reviewing the materials you created to research a specific diagnosis in the first two assessments, apply the PICO(T) process to develop a 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 chosen diagnosis, and 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 they relate to the identified healthcare issue.
Explain the relevance of the findings from chosen sources of evidence to making a 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:
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 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 a 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; contain 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.
Resources
This course has been completed and no further assessments may be submitted.
Use the resources linked below to help complete this assessment.
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PICO(T) Process
The resources below explore the PICO(T) process:
Abbade, L. P. F., Wang, M., Sriganesh, K., Jin, Y., Mbuagbaw, L., & Thabane, L. (2017). The framing of research questions using the PICOT format in randomized controlled trials of venous ulcer disease is suboptimal: A systematic survey. Wound Repair & Regeneration, 25(5), 892-900.
This article presents a study that examined the use of PICO(T) questions to locate evidence related to specific types of resources and research.
Ho, G. J., Liew, S. M., Ng, C., Shunmugam, R., & Glasziou, P. (2016). Development of a search strategy for an evidence-based retrieval service. PLoS One, 11(12), 1-14. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0167170
This article presents a study comparing the use of PICO(T) questions in a literature search to other search strategies.
The first two chapters in the following text, of which the Capella library has limited copies, could help expand your knowledge regarding the PICO(T) process.
Boswell, C., & Cannon, S. (2020). Introduction to nursing research. Jones & Bartlett Learning.
Communicating Research
The resources below explore communicating research:
Bullington, J., Söderlund, M., Elisabeth Bos Sparén, Kneck, Å., Omérov, P., & Cronqvist, A. (2019). Communication skills in nursing: A phenomenologically-based communication training approach. Nurse Education in Practice, 39, 136-141.
This article presents the approach to communication in clinical situations and also discusses the barriers related to nurses sharing and communicating.
Gutiérrez-Puertas, L., Márquez-Hernández, V.,V., Gutiérrez-Puertas, V., Granados-Gámez, G., & Aguilera-Manrique, G. (2020). Educational interventions for nursing students to develop communication skills with patients: A systematic review. International Journal of Environmental Research and Public Health, 17(7), 2241.
This article provides preliminary evidence of the effectiveness of interventions used to train nursing students in patient-centered communication. Although all the interventions obtained significant results in communication skills, it has not yet been determined which methodology is more effective.
Program Resources and Library Resources
Writing Resources
A variety of writing resources are available in the NHS Learner Support Lab, linked in the course room navigation menu. Access these resources to help you better understand and improve your writing.
APA Style and Format
Capella University follows the style and formatting guidelines in the Publication Manual of the American Psychological Association, known informally as the APA manual. Refer to the Writing Center’s APA Module for tips on proper use of APA style and format.
Library Resources
Access the following library resources:
BSN Program Library Research Guide.
The library research guide will be useful in guiding you through the Capella library, offering tips for searching the literature and other references for your assessments.
Databases A-Z: Nursing Health Sciences.
This is a list of the library databases that are relevant to nursing and health sciences.
Evidence-Based Practice in Nursing Health Sciences.
Library guide to EBP-related topics with a focus on nursing and health sciences.
Find Scholarly Peer-Reviewed Sources.
Guide to help you more efficiently locate scholarly and peer-reviewed resources.
This guide offers a five-step approach to improving your research search effectiveness.
Case Studies
If you choose not to use a problem from your practice experience as the basis of this assessment, consider reviewing the following case studies:
National League for Nursing. (n.d.). ACE.D unfolding cases. https://www.nln.org/education/teaching-resources/professional-development-programsteaching-resourcesace-all/ace-d/unfolding-cases
National League for Nursing. (n.d.). Unfolding cases: Advancing care excellence for seniors. http://www.nln.org/professional-development-programs/teaching-resources/ace-s
Activity
Click the linked Vila Health: PICO(T) Process title to complete this formative activity, which 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 practice and self-assessment.
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Step-By-Step Guide NURS-FPX 4030 Assessment 3: PICO(T) Questions and an Evidence-Based Approach
Introduction to NURS 4030 Assessment Three
The NURS-FPX 4030 Assessment 3: PICO(T) Questions and an Evidence-Based Approach involves developing a PICO(T) question based on a specific diagnosis, evaluating the evidence related to the question, and integrating this evidence into clinical practice. The PICO(T) framework is valuable for defining and refining research questions to guide evidence-based practice. By following this How-To NURS-FPX 4030 Owlisdom Guide, you will learn how to formulate a straightforward research question, find relevant evidence, and apply this evidence to improve patient care.
Definition and Components
The PICO(T) framework stands for Patient/Population/Problem, Intervention, Comparison, Outcome(s), and Time Frame. It helps structure research questions to facilitate the search for evidence.
Define a practice issue to be explored using a PICO(T) approach. Create a PICO(T)- formatted research question.
Define the Practice Issue
Start by identifying a specific practice issue or diagnosis you have worked with in previous assessments. Clearly define the problem or area of interest.
Identify the Patient/Population/Problem (P): Determine the patient group or population affected by the issue. Be specific about demographics, conditions, or characteristics.
Determine the Intervention (I): Identify the central intervention you want to investigate. This could be a treatment, procedure, or educational program.
Establish the Comparison (C): Decide if an alternative intervention exists to compare. This could be a different treatment or a standard practice.
Specify the Outcomes (O): Define the desired outcomes you want to measure. These could include improvements in health, patient satisfaction, or cost-effectiveness.
Include the Time Frame (T), if relevant: If applicable, specify the time frame over which the intervention and outcomes will be assessed.
Example
The PICO(T) model is a structured method to formulate clinical questions and find evidence-based solutions, especially for addressing CHF diagnosis. This model involves defining the Patient, Intervention, Comparison, Outcome, and Time frame. For CHF, a potential question might be: “Assessing outcomes between (I) pa
rticipation in cardiac rehabilitation (P) and (C) standard care alone (C) over (T) six months post-enrollment (T) to determine if (I) functional capacity improves and hospital readmissions (O) decrease (O)?” Utilizing PICO(T) allows healthcare professionals to systematically search through various sources (Schiavenato & Chu, 2021). Clearly defined problems enable precise reviews, potentially enhancing care quality and outcomes for heart failure patients.
Researching the PICO(T) Question
Next, we will conduct our research on the PICO(T) questions.
Selecting Databases and Sources: Choose credible databases such as PubMed, CINAHL, and Cochrane Library. Use scholarly journals, websites, and other reputable sources.
Effective Search Strategies: Refine your search using keywords and Boolean operators. To find relevant studies, combine terms related to your PICO(T) components.
Example
The PICO(T) question is the next step in developing the research question for a chronic heart failure (CHF) article after establishing a general topic.
- Population: Among CHF patients who have survived the past year, not only do preexisting conditions worsen, but psychosocial aspects of health also deteriorate.
- Intervention: Exploring whether participation in a structured cardiac rehabilitation program that includes exercise and education significantly affects prognosis.
- Comparison: Heart failure management programs yield better health outcomes than usual care or standard CHF management methods.
- Outcome: Do cardiac rehabilitation programs enhance functional capacity, quality of life, and mortality rates while reducing hospitalization and readmission rates?
- Timeframe: The following steps should be assessed within six months to one year post-admission.
Identify sources of evidence that could be potentially effective in answering a PICO(T) question (databases, journals, websites, etc.).
Evaluating and Analyzing Evidence
Here, we will evaluate the evidence, and we will also analyze the evidence.
- Criteria for Selecting Relevant Evidence: Select evidence directly addressing your PICO(T) question. Consider the study design, sample size, and relevance to your population.
- Analyzing Findings from Sources: Summarize the findings of each source. Focus on how the evidence supports or refutes the intervention’s effectiveness.
Example
Identifying data sources related to chronic heart failure (CHF) begins by utilizing accessible and reliable resources pertinent to evidence-based practice and clinical judgment. Medical practitioners often refer to academic databases like PubMed, CINAHL, and Cochrane Library to access up-to-date peer-reviewed literature, including journal articles, systematic reviews, and meta-analyses specific to CHF. These databases serve as comprehensive repositories, housing the latest knowledge on CHF diagnosis and management, thus keeping healthcare providers informed of new findings and enabling the adoption of evidence-based interventions.
Peer-reviewed journals are essential for identifying evidence on CHF as they publish original case studies, reviews, and research that undergo rigorous peer review before publication. These articles cover various aspects of CHF, including pathological pathways, diagnostics, treatment, and therapeutic strategies. Additionally, systematic reviews and meta-analyses compile and synthesize existing studies to provide a thorough overview of the effectiveness and safety of CHF interventions.
Clinical practice guidelines from reputable organizations, such as the American Heart Association (AHA) and the European Society of Cardiology (ESC), offer evidence-based recommendations for CHF management. These guidelines are based on peer-reviewed articles and expert consensus, providing best practice recommendations to support physicians in diagnosis, treatment application, management, and monitoring strategies for CHF. By consulting a broad spectrum of peer-reviewed journals, systematic reviews, meta-analyses, and clinical practice guidelines, healthcare providers can access a comprehensive evidence base that informs evidence-based practice and optimizes patient outcomes in CHF management.
Explain the findings from articles or other sources of evidence related to the identified healthcare issue. Explain the relevance of the findings from chosen sources of evidence to making a decision related to a PICO(T) question.
Applying Evidence to Practice
For this section of the NURS 4030 Assessment, we will explore the practice of the evidence in real life.
- Integrating Evidence into Clinical Decision-Making: Use the analyzed evidence to make informed decisions about patient care. Consider the practical implications and feasibility of implementing the findings.
- Implications for Nursing Practice: Reflect on how the evidence can improve nursing practices and patient outcomes. Identify potential barriers and strategies for successful implementation.
Example
The most critical aspect of research findings on CHF for healthcare providers is their ability to aid patient recovery and their application in clinical practice. Organizational programs and policies that base their decisions on well-established research findings effectively support those caring for CHF patients. Therefore, when evaluating the relevance of findings, healthcare professionals ensure that the intervention meets the specific needs and conditions of CHF patients, thereby providing higher-quality care.
For instance, studies on ACEIs and beta-blockers, which are vital in reducing CHF-related deaths and hospitalizations, are highly significant for evidence-based clinical decision-making. Healthcare providers can use this data to make informed treatment decisions that consider the severity of the patient’s condition, their medication regimen, and their tolerance to treatments.
Moreover, evidence-based practices, supported by guidelines from professional organizations, offer clinicians practical insights into CHF diagnostics and therapeutic approaches. Adhering to these guidelines helps standardize care and achieve positive clinical outcomes, ensuring patient safety (Moradi et al., 2020). Furthermore, research studies and meta-analyses can highlight new trends or innovations in CHF treatment, providing healthcare providers with an enriched knowledge base for professional decision-making and further research.
In summary, research findings support policymaking in CHF management and promote the use of scientific, patient-centered, evidence-based practices.
Demonstration of Proficiency
Competency 1: Interpret Findings from Scholarly Articles
Explain the significance of findings from relevant articles. Highlight how they relate to your PICO(T) question.
Competency 2: Analyze the Relevance and Potential Effectiveness of Evidence
Identify and evaluate the most effective sources. Discuss their relevance to your clinical question.
Competency 3: Apply an Evidence-Based Practice Model
Define your practice issue using the PICO(T) approach. Develop a structured research question.
Competency 5: Apply Professional, Scholarly Communication Strategies
Ensure your writing is clear and professional. Use smooth transitions and adhere to APA formatting.
Closing
The NURS-FPX 4030 Assessment 3: PICO(T) Questions and an Evidence-Based Approach requires you to create a PICO(T) question research evidence and apply it to improve clinical practice. By following the PICO(T) framework, you can systematically address practice issues and enhance patient care. Integrating relevant research into clinical decision-making is critical to successful evidence-based practice, which ultimately benefits patients and healthcare systems. The next Assessment of NURS 4030 revolves around Remote Collaboration and Evidence-Based Care.
References
Boswell, C., & Cannon, S. (2022). Introduction to nursing research: Incorporating evidence-based practice. Jones & Bartlett Learning.
Cartotto, R., Johnson, L., Rood, J. M., Lorello, D., Matherly, A., Parry, I., … & Nedelec, B. (2023). Clinical practice guideline: early mobilization and rehabilitation of critically ill burn patients. Journal of Burn Care & Research, 44(1), 1–15.
Kim, M., Mallory, C., & Valerio, T. (2020). Statistics for evidence-based practice in nursing. Jones & Bartlett Publishers.
McDonagh, T. A., Metra, M., Adamo, M., Gardner, R. S., Baumbach, A., Böhm, M., … & Kathrine Skibelund, A. (2021). 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: Developed by the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) With the exceptional contribution of the Heart Failure Association (HFA) of the ESC. European Heart Journal, 42(36), 3599-3726.
Moradi, M., Daneshi, F., Behzadmehr, R., Rafiemanesh, H., Bouya, S., & Raeisi, M. (2020). Quality of life of chronic heart failure patients: a systematic review and meta-analysis. Heart failure reviews 25, 993-1006.
Schiavenato, M., & Chu, F. (2021). PICO: What it is and is not—nurse education in practice, 56, 103194.
