Candidate Summary· is an experienced Registered Nurse wit

Candidate Summary:
· is an experienced Registered Nurse with over 5 recent years’
experience in the Emergency Room 9 years in surgical services
and over 20 years in the medical area.
· She has extensive experience in the Emergency, Surgical
Services, Medical -Surgical, Rehabilitation,Telemetry, and
other settings
· She is very proficient with her computer usage and currently
resides in Houston, TX
· currently has active and clear multistate Texas licenses and is
actively seeking employment with a growing organization
Professional Experience:
HCA Houston Healthcare Northwest
Internal Transfer August 2019-Current
Pre-Admit Testing-Ambulatory Care Center
· Obtains health assessments and medication reconcillation
· Counsels and educates patients about their upcoming surgeries
or procedures
· Performs test ordered by the surgeon or anesthesiologist
· Obtains signatures and witnesses informed consents from
patients for upcoming surgeries
· Communicates with surgeon and anesthesiologist regarding
abnormal labs, EKGs, V/S
· Communicates with patients regarding appointments times,
schedule changes, cancellations
HCA Houston Medical Center (Park Plaza Hospital)
August 2018-August 2019
ER Registered Nurse
· Provides holistic care to patients in an ER setting fr om all age

groups
· Triages patients after receiving from EMS, walk-ins, or
transfer
· Takes vital signs, places patient on a monitor, pulse oximetry,
administers oxygen do assessment, start IV, obtain labs,
administers medications, inserts catheters, NGT’s, applies
splints, slings, assist ER physician’s with codes, intubations,
suturing, admission, transfers, discharges, teaches, educates
patient’s and family
· Answer phones, interacts with staff and physican from other
specialities
St. Joseph’s Hospital, Emergency Center
March 2016-September 2018
ER Registered Nurse
· Provides holistic care to patients in an ER setting from all age
groups
· Triages patients after receiving from EMS, walk-ins, or
transfer
· Takes vital signs, places patient on a monitor, pulse oximetry,
administers oxygen, do assessment, start IV, obtain labs,
transports specimens, administers medications, inserts catheters,
NGT’s, cast, splints, slings, assist with codes, intubations,
suturing, admission, transfers, discharges, teaches, educates
· Calls report, transports patients to the floor, ICU answers
phones, interacts with other staff and physician from other
specialities.
Doctor’s Hospital Tidwell, Day Surgery/Emergency Center
October 2014-March 2016
ER Registered Nurse PRN
· Provides holistic care to patients in a day surgery setting
· Assist patient with completing Consent forms, assist with
getting them prepped for surgery, takes height and weight,
medical and medication history etc. Starts iv’s
· Monitors patients after surgery for pain, reactions, sedation,

etc. Takes frequent vital signs, removes, iv’s, make sure
patient’s are safe to be discharged, give discharge instructions
to patient and family, gives prescriptions, transports patient’s to
car via wheelchair
· Provides holistic care to patients in an ER setting
· Triages patients after receiving from EMS or walk-ins. Takes
vital signs, places patient on a monitor, pulse oximetry, do
assessment, start IV, obtain labs, transports specimens,
administers medications, inserts catheters, NGT’s, cast, splints,
slings, assist with lacerations, trauma’s, admits, transfers,
discharges
· Transports patients to the floor, to car, Answers phones,
contact transfer centers at various hospital locations, completes
Memorandum of Transfers, call report, page various physicians,
ETC
Spring Central Hospital
October 2013- December 2015
Registered Nurse
· Inpatient Surgical Unit/Float ER Nurse
· Provided holistic care to patients in a surgical setting
· Followed plan of care, admitance and discharges
· Transcribed physician orders, teached and educated patients
and family Administered analgesics, antibiotics, IVF’s, blood
and blood products
· Started IV’s, draws blood, discontinued JP drains, nerve block
catheters, On Q pain pumps
· Responsible for dressing changes, charges, and precepts
TOPS Surgical Specialty Hospital
October 2009- July 2013
Registered Nurse
· Inpatient Surgical Unit/Float ER Nurse
· Provides holistic care to patients in a surgical setting
· Followed plan of care, admission and discharges
· Transcribed physician orders, teached, and educated patients

and family administered analgesics, antibiotics, IVF’s, blood
and blood products
· Started IV’s, obtained blood, discontinued JP drains, nerve
block catheters, On Q pain pumps
· Responsible for dressing changes, Charges the floor, and
precepts
Memorial Hermann Hospital Northwest Hospital
April 2009-July 2010
Registered Nurse
· General Surgery Unit
· Provided holistic care for surgical patients on a general
surgery orthopedic floor
· Assessed patients, started iv’s, obtained blood, followed plan
of care, admitance and discharged
· Transcribed physician orders, patient teaching, administerd,
scheduled and PRN medications, TPN, blood transfusions,
dressing changes, wound care, etc.
Supplemental Healthcare Staffing Agency (Corrections)
September 2007-September 2008
Licensed Vocational Nurse
· Triage and assessed inmates, obtained vital signs, checked
blood glucose levels, assist physicians in provided medical care,
administered medications, performed dressing changes, wound
care, EKG’s transcribed Physician orders, charts nursing notes,
etc
All About Staffing
August 2006-September 2007
· Provided care for patients at various hospital locations on a
medical- surgical, telemetry, immediate care, and observation
units under the supervision of a registered nurse
· Transcribed physician orders, charted nurse’s notes, 24 hour
charts checks, viewed and reported any abnormal labs to

physician, Admitted and discharged patient’s
Tomball Regional Med. Center
June 2006-August 2006
· Provided care for patients on a Rehabilitation unit under the
supervision of a registered nurse.
· Administered medications, transcribed physician’s orders,
reported abnormal labs to physician, charted nurse’s notes, 12-
24 hours chart checks, answered phones, etc.
Conroe Regional Medical Center
August 2004-May 2006
· Provided care for patients on a medical- surgical, telemetry
floor under the supervision of a registered nurse
· Administered medications, transcribed physician orders,
charted nurse’s notes, reported abnormal labs to physician,
answered phones, 12-24 hour chart checks, etc
Education:
Associates Degree Nursing, San Jacinto College
Currently pursuing a BSN, UTA- Graduation 7/2021
Licensure:
Registered Nurse – Multi State of Texas – RN 764265
Rubric Assessment
Close

Warning:
The NCBI web site requires JavaScript to function.
more...NCBISkip to main
contentSkip to
navigationResourcesAll ResourcesChemicals &
BioassaysBioSystemsPubChem BioAssayPubChem
CompoundPubChem Structure SearchPubChem SubstanceAll
Chemicals & Bioassays Resources...DNA & RNABLAST (Basic
Local Alignment Search Tool)BLAST (Stand-alone)E-
UtilitiesGenBankGenBank: BankItGenBank: SequinGenBank:
tbl2asnGenome WorkbenchInfluenza VirusNucleotide

DatabasePopSetPrimer-BLASTProSplignReference Sequence
(RefSeq)RefSeqGeneSequence Read Archive (SRA)SplignTrace
ArchiveAll DNA & RNA Resources...Data & SoftwareBLAST
(Basic Local Alignment Search Tool)BLAST (Stand-
alone)Cn3DConserved Domain Search Service (CD Search)E-
UtilitiesGenBank: BankItGenBank: SequinGenBank:
tbl2asnGenome ProtMapGenome WorkbenchPrimer-
BLASTProSplignPubChem Structure SearchSNP Submission
ToolSplignVector Alignment Search Tool (VAST)All Data &
Software Resources...Domains &
StructuresBioSystemsCn3DConserved Domain Database
(CDD)Conserved Domain Search Service (CD Search)Structure
(Molecular Modeling Database)Vector Alignment Search Tool
(VAST)All Domains & Structures Resources...Genes &
ExpressionBioSystemsDatabase of Genotypes and Phenotypes
(dbGaP)E-UtilitiesGeneGene Expression Omnibus (GEO)
Database Gene Expression Omnibus (GEO) DatasetsGene
Expression Omnibus (GEO) ProfilesGenome
WorkbenchHomoloGeneOnline Mendelian Inheritance in Man
(OMIM)RefSeqGeneAll Genes & Expression
Resources...Genetics & MedicineBookshelfDatabase of
Genotypes and Phenotypes (dbGaP)Genetic Testing
RegistryInfluenza VirusOnline Mendelian Inheritance in Man
(OMIM)PubMedPubMed Central (PMC)PubMed Clinical
QueriesRefSeqGeneAll Genetics & Medicine
Resources...Genomes & MapsDatabase of Genomic Structural
Variation (dbVar)GenBank: tbl2asnGenomeGenome
ProjectGenome Data Viewer (GDV)Genome ProtMapGenome
WorkbenchInfluenza VirusNucleotide
DatabasePopSetProSplignSequence Read Archive
(SRA)SplignTrace ArchiveAll Genomes & Maps
Resources...HomologyBLAST (Basic Local Alignment Search
Tool)BLAST (Stand-alone)BLAST Link (BLink)Conserved
Domain Database (CDD)Conserved Domain Search Service (CD
Search)Genome ProtMapHomoloGeneProtein ClustersAll
Homology Resources...LiteratureBookshelfE-UtilitiesJournals

in NCBI DatabasesMeSH DatabaseNCBI HandbookNCBI Help
ManualNCBI News & BlogPubMedPubMed Central
(PMC)PubMed Clinical QueriesAll Literature
Resources...ProteinsBioSystemsBLAST (Basic Local Alignment
Search Tool)BLAST (Stand-alone)BLAST Link
(BLink)Conserved Domain Database (CDD)Conserved Domain
Search Service (CD Search)E-UtilitiesProSplignProtein
ClustersProtein DatabaseReference Sequence (RefSeq)All
Proteins Resources...Sequence AnalysisBLAST (Basic Local
Alignment Search Tool)BLAST (Stand-alone)BLAST Link
(BLink)Conserved Domain Search Service (CD Search)Genome
ProtMapGenome WorkbenchInfluenza VirusPrimer-
BLASTProSplignSplignAll Sequence Analysis
Resources...TaxonomyTaxonomyTaxonomy BrowserTaxonomy
Common TreeAll Taxonomy Resources...Training &
TutorialsNCBI Education PageNCBI HandbookNCBI Help
ManualNCBI News & BlogAll Training & Tutorials
Resources...VariationDatabase of Genomic Structural Variation
(dbVar)Database of Genotypes and Phenotypes
(dbGaP)Database of Single Nucleotide Polymorphisms
(dbSNP)SNP Submission ToolAll Variation Resources...How
ToAll How ToChemicals & BioassaysDNA & RNAData &
SoftwareDomains & StructuresGenes & ExpressionGenetics &
MedicineGenomes &
MapsHomologyLiteratureProteinsSequence
AnalysisTaxonomyTraining & TutorialsVariationAbout NCBI
Accesskeys
2
Student Name:
PICO and Literature Search
NUR4440

Scenario: Non-Pharmacological Management of Dementia: On
the neurology inpatient unit, there are increasing numbers of
patients with dementia. Some of the symptoms noted in these
patients include agitation, wandering and even screaming and
violence. A nurse on the unit was recently injured by an elderly
man who attacked and hit her while she was providing nursing
care to him. Your task is to propose a plan that will address the
non-pharmacological management of dementia on the unit and
train the nurses to provide quality care to patients with
dementia.
PICO Question: In adults with Alzheimer’s disease, what is the
effect of animal-assisted therapy compared to usual care on the
intensity of agitation?
P: adults with Alzheimer’s disease
I: animal-assisted therapy
C: usual care
O: intensity of agitation
3 Keywords: Alzheimer’s, animal-assisted therapy, agitation
1 Synonym: dementia
1 MeSH term: psychomotor agitation
References
Majic, T., Gutzmann, H., Heinz, A., Lang, U. E., & Rapp, M. A.
(2013). Animal-assisted therapy and agitation and depression in
nursing home residents with dementia: A matched case-control
trial. American Journal of Geriatric Psychiatry, 21(11), 1052-
1059. https://doi.org/10.1016/j.jagp.2013.03.004
Nordgren, L., & Engström, G. (2014). Effects of dog-assisted
intervention on behavioural and psychological symptoms of
dementia. Nursing Older People, 26(3), 31-38.

https://doi.org/10.7748/nop2014.03.26.3.31.e517
Olsen, C., Pedersen, I., Bergland, A., Enders‐ Slegers, M.,
Patil, G., & Ihlebæk, C. (2016). Effect of animal-assisted
interventions on depression, agitation and quality of life in
nursing home residents suffering from cognitive impairment or
dementia: A cluster randomized controlled trial. International
Journal of Geriatric Psychiatry, 31(12), 1312-1321.
https://doi.org/10.1002/gps.4436
Swall, A., Ebbeskog, B., Lundh Hagelin, C., & Fagerberg, I.
(2017). Stepping out of the shadows of Alzheimer’s disease: A
study of older people with Alzheimer’s disease caring for a
therapy dog. International Journal of Studies on Health & Well -
Being, 12(1), 124-127.
https://doi.org/10.1080/17482631.2017.1347013
Updated 8/29/2020 CJP
PICO and Literature Search Scenarios
1:
Delegation: A unit employs RNs, LPN’s and PCTs (patient care
techs) to provide direct care. The unit has had an issue with
appropriate delegation. The PCTs and LPNs report that they are
being asked to perform more than their “fair share”, and things
they should not do. The RN’s state that they are the only ones
who do anything, and every time they ask the LPNs and PCTs to
do anything they are told the PCTs and LPNs are not allowed to
perform the task. The Unit manager recognizes that efforts to
improve delegation need to be made. Your task is to research
an intervention to enhance the quality and practice of delegation
on this unit.
2:
Decreasing wait times in ER or patient flow time to move from
ED: A manager of an Emergency Department is concerned that
patient satisfaction scores have dropped significantly for the

department. The primary complaint is long wait times. Internal
tracking of patient flow has shown patients are waiting up to 7
hours for transfers to patient care areas, or to hospital units.
Your task is to research an intervention to decrease wait times
with improved flow to the care areas.
3:
New grad nurse retention: The manager of a medical surgical
unit that is expanding needs to hire additional staff. Over the
last 3 years 90% of the new graduates hired have quit within the
first year of hire. The current RN staff is comprised of 8 nurses
with greater than 10 yrs experience, 6 nurses with 5-10 yrs
experience and 7 nurses with less than 5 yrs experience on the
unit. Six new graduates are hired for the expansion. They will
start 3 months before the new beds open. Your task is to
research an intervention to enhance retention of the new
graduates.
4:
Reducing medication errors: A medical surgical unit manager
has had a significant increase in medication administration
errors over the last two months. The errors involve many staff
members and are occurring on all shifts. The budget does not
allow for the purchase of new administration system. Your task
is to research an intervention to decrease medication
administration errors from the nursing staff within these
parameters.
5:
Patient family centered care: The manager of a medical
surgical unit has experienced a significant drop in patient
satisfaction with the primary complaints being a lack of
communication to patients and their family members. Your task
is to research an intervention to increase patient-family centered
care environment that would address this issue.
6:

Evidence-based practice: A hospital is seeking Magnet Hospital
status. The managers of the units are charged with enhancing
the incorporation of evidenced based practice on a unit level.
Your task is to research an intervention to enhance the exposure
to and application of evidence-based practice among nurses on
the medical surgical unit.
7:
Enhancing teamwork across care provider levels: The manager
of a medical surgical unit has observed, and had complaints
about, lack of teamwork between the RN’s and the patient care
techs (PCT’s). Your task is to research an intervention to
enhance teamwork on the unit.
8:
Call light response time: The manager of a medical surgical
unit that employs RN’s and patient care techs (PCT’s) has had a
significant increase in call light response time and decrease in
patient satisfaction related to the answering of call lights. Your
task is to research an intervention that addresses the answering
of call light in a timely, respectful manner.
9:
Decreasing the incidence of DVT’s in post-op orthopedic
patients: Quality assurance reports for an orthopedic surgery
unit identify an increase in the incidence of DVT’s over the last
6 months. The unit uses a standard prevention plan of Lovenox
subQ and sequential compression devices (SCD’s) for all
appropriate post-op patients. A recent survey found that 64% of
the patients did not have SCD’s on while in bed and 32% did
not receive Lovenox with the notation “refused”. Your task is
to research an intervention to increase the use of SCD’s and
decrease the number of refused Lovenox doses.
1

T
o fully implement evidence-
based practice (EBP),
nurses need to have both
a spirit of inquiry and a culture
that supports it. Inour first article
in this series (“Igniting a Spirit of
Inquiry:AnEssential Foundation
for Evidence-Based Practice,”
November 2009),we defined a
spirit of inquiry as “an ongoing
curiosity about the best evidence
toguide clinical decisionmaking.”
A spirit of inquiry is the founda-
tionof EBP, andonce nurses pos-
sess it, it’s easier to take the next
step—toask the clinical question.1
Formulating a clinical question
in a systematicwaymakes it pos-
sible to find an answermore
quickly and efficiently, leading to
improved processes and patient
outcomes.
In the last installment,wegave
an overviewof themultistepEBP
process (“The Seven Steps of
Evidence-Based Practice,” Janu-
ary). Thismonthwe’ll discuss
step one, asking the clinical
question. As a context for this
discussionwe’ll use the same
scenariowe used in the previous

articles (see Case Scenario for
EBP: Rapid Response Teams).
In this scenario, a staff nurse,
let’s call herRebeccaR., noted
that patients on hermedical–
surgical unit had a high acuity
level thatmay have led to an in-
crease in cardiac arrests and in the
number of patients transferred
to the ICU.Of thepatientswho
had a cardiac arrest, four died.
Rebecca sharedwith her nurse
manager a recently published
study onhow the use of a rapid
response teamresulted in reduced
in-hospital cardiac arrests andun-
planned admissions to the critical
Asking the Clinical Question: A Key Step in
Evidence-Based Practice
A successful search strategy starts with a well-formulated
question.
This is the third article in a series from the Arizona State
University College of Nursing and Health Innovation’s Center
for the Advancement of Evidence-Based Practice. Evidence-
based practice (EBP) is a problem-solving approach to the
delivery of health care that integrates the best evidence from
studies and patient care data with clinician expertise and
patient preferences and values. When delivered in a context of
caring and in a supportive organizational culture, the
highest quality of care and best patient outcomes can be
achieved.

The purpose of this series is to give nurses the knowledge and
skills they need to implement EBP consistently, one
step at a time. Articles will appear every two months to allow
you time to incorporate information as you work toward
implementing EBP at your institution. Also, we’ve scheduled
“Ask the Authors” call-ins every few months to provide a
direct line to the experts to help you resolve questions. Details
about how to participate in the next call will be pub-
lished with May’s Evidence-Based Practice, Step by Step.
Case Scenario for EBP: Rapid Response Teams
You’re a staff nurse on a busy medical–surgical unit. Overthe
past three months, you’ve noticed that the patients on
your unit seem to have a higher acuity level than usual, with
at least three cardiac arrests per month, and of those patients
who arrested, four died. Today, you saw a report about a
recently published study in Critical Care Medicine on the use
of rapid response teams to decrease rates of in-hospital car-
diac arrests and unplanned ICU admissions. The study found
a significant decrease in both outcomes after implementation
of a rapid response team led by physician assistants with spe-
cialized skills.2 You’re so impressed with these findings that
you bring the report to your nurse manager, believing that a
rapid response team would be a great idea for your hospital.
The nurse manager is excited that you have come to her with
these findings and encourages you to search for more evidence
to support this practice and for research on whether rapid re-
sponse teams are valid and reliable.
58 AJN � March 2010 � Vol. 110, No. 3 ajnonline.com
care unit.2 Shebelieved this could

be a great idea for her hospital.
Based onher nursemanager’s
suggestion to search formore evi-
dence to support theuseof a rap-
id response team,Rebecca’s spirit
of inquiry ledher to take thenext
step in the EBPprocess: asking
the clinical question. Let’s follow
Rebecca as shemeetswithCar-
losA., oneof the expertEBPmen-
tors from the hospital’s EBP and
research council, whose role is to
assist point of care providers in
enhancing their EBPknowledge
and skills.
Types of clinical questions.
Carlos explains toRebecca that
finding evidence to improve pa-
tient outcomes and support a
practice change depends upon
how the question is formulated.
Clinical practice that’s informed
by evidence is based onwell-
formulated clinical questions
that guide us to search for the
most current literature.
There are two types of clinical
questions: backgroundquestions
and foregroundquestions.3-5 Fore-
ground questions are specific and
relevant to the clinical issue. Fore-
groundquestionsmust be asked
in order to determinewhich of

two interventions is themost ef-
fective in improving patient out-
comes. For example, “In adult
patients undergoing surgery, how
does guided imagery compared
withmusic therapy affect anal-
gesia usewithin the first 24hours
post-op?” is a specific,well-
defined question that can only
guides her in formulating a fore-
groundquestionusing PICOT
format.
PICOT is an acronym for the
elements of the clinical question:
patient population (P), interven-
tion or issue of interest (I), com-
parison intervention or issue of
interest (C), outcome(s) of inter-
est (O), and time it takes for the
intervention to achieve the out-
come(s) (T).WhenRebecca asks
why the PICOTquestion is so
important, Carlos explains that
it’s a consistent, systematicway
to identify the components of a
clinical issue. Using the PICOT
format to structure the clinical
question helps to clarify these
components,whichwill guide the
search for the evidence.6, 7 Awell-
built PICOTquestion increases
the likelihood that the best evi-
dence to informpracticewill be
foundquickly and efficiently.5-8

To helpRebecca learn to for-
mulate a PICOTquestion,Car-
los uses the earlier example of a
foregroundquestion: “In adult
patients undergoing surgery, how
does guided imagery compared
be answered by searching the
current literature for studies
comparing these two interven-
tions.
Background questions are
considerably broader andwhen
answered, provide general knowl-
edge. For example, a background
question suchas, “What therapies
reduce postoperative pain?” can
generally be answeredby looking
in a textbook. Formore informa-
tion on the two types of clinical
questions, see Comparison of
Background and Foreground
Questions.4-6
Ask the question in PICOT
format. Now thatRebecca has
an understanding of foreground
andbackgroundquestions,Carlos
Comparison of Background and Foreground Questions4-6
Question type Description Examples

Background
question
A broad, basic-knowledge question
commonly answered in textbooks.
May begin with what or when.
1) What is the best method to pre-
vent pressure ulcers?
2) What is sepsis?
3) When do the effects of
furosemide peak?
Foreground
question
A specific question that, when
answered, provides evidence for clin-
ical decision making. A foreground
question includes the following ele-
ments: population (P), intervention or
issue of interest (I), comparison inter-
vention or issue of interest (C), out-
come (O), and, when appropriate,
time (T).
1) In mechanically ventilated pa-
tients (P), how does a weaning
protocol (I) compared with no
weaning protocol (C) affect venti-
lator days (O) during ICU length
of stay (T)?
2) In hospitalized adults (P), how

does hourly rounding (I) com-
pared with no rounding (C) affect
fall rates (O)?
The PICOT question is a consistent,
systematic way to identify the components
of a clinical issue.
By Susan B. Stillwell, DNP, RN, CNE, Ellen Fineout-Overholt,
PhD,
RN, FNAP, FAAN, Bernadette Mazurek Melnyk, PhD, RN,
CPNP/PMHNP, FNAP, FAAN, and Kathleen M. Williamson,
PhD, RN
[email protected] AJN � March 2010 � Vol. 110, No. 3 59
also not always required. But
population, intervention or issue
of interest, and outcome are es-
sential to developing any PICOT
question.
Carlos asksRebecca to reflect
on the clinical situation onher
unit in order to determine the
unit’s current intervention for ad-
dressing acuity. Reflection is a
strategy to help clinicians extract
critical components from the clin-

ical issue to use in formulating
the clinical question.3 Rebecca
andCarlos revisit aspects of the
clinical issue to seewhichmaybe-
come components of the PICOT
question: the high acuity of pa-
tients on the unit, the number of
cardiac arrests, the unplanned
ICUadmissions, and the research
article on rapid response teams.
Once the issue is clarified, the
PICOTquestion can bewritten.
withmusic therapy affect analge-
sia usewithin the first 24 hours
post-op?” In this example, “adult
patients undergoing surgery” is
thepopulation (P), “guided imag-
ery” is the interventionof interest
(I), “music therapy” is the com-
parison intervention of interest
(C), “pain” is the outcomeof in-
terest (O), and“the first 24hours
post-op” is the time it takes for
the intervention to achieve the
outcome (T). In this example,
music therapy or guided imagery
is expected to affect the amount
of analgesia used by the patient
within the first 24hours after sur-
gery.Note that a comparisonmay
not be pertinent in somePICOT
questions, such as in “meaning
questions,”which are designed
to uncover themeaning of a

particular experience.3, 6 Time is
Templates and Definitions for PICOT Questions5, 6
Question type Definition Template
Intervention or
therapy
To determine which treatment leads to the
best outcome
In _____________________ (P),
how does ______________ (I)
compared with ___________ (C)
affect __________________ (O)
within __________________ (T)?
Etiology To determine the greatest risk factors or
causes of a condition
Are ______________________________ (P)
who have ________________________ (I),
compared with those without ________ (C),
at ____ risk for ____________________ (O)
over _____________________________ (T)?
Diagnosis or
diagnostic test
To determine which test is more accurate and
precise in diagnosing a condition
In ______________________________ (P),
are/is ___________________________ (I)
compared with ___________________ (C)

more accurate in diagnosing _______ (O)?
Prognosis or
prediction
To determine the clinical course over time
and likely complications of a condition
In ___________________ (P),
how does _____________ (I)
compared with ________ (C),
influence _____________ (O)
over _________________ (T)?
Meaning To understand the meaning of an experience
for a particular individual, group, or commu-
nity
How do ______________ (P)
with _________________ (I)
perceive ______________ (O)
during _______________ (T)?
A well-built PICOT question increases the
likelihood that the best evidence to inform
practice will be found.
60 AJN � March 2010 � Vol. 110, No. 3 ajnonline.com
BecauseRebecca’s issue of in-
terest is the rapid response team—
an intervention—Carlos provides

herwith an“interventionor ther-
apy” template to use in formu-
lating the PICOTquestion. (For
other types of templates, see Tem-
plates and Definitions for PICOT
Questions.5, 6) Since the hospital
doesn’t have a rapid response
teamanddoesn’t have a plan for
addressing acuity issues before a
crisis occurs, the comparison, or
(C) element, in the PICOTques-
tion is “no rapid response team.”
“Cardiacarrests”and“unplanned
admissions to the ICU”are the
outcomes in the question.Other
potential outcomes of interest to
the hospital could be “lengths of
stay” or “deaths.”
Rebecca proposes the follow-
ing PICOTquestion: “In hospi-
talized adults (P), howdoes a
rapid response team (I) compared
with no rapid response team (C)
clinical question that’smost ap-
propriate for each scenario, and
choose a template to guide you.
Then formulate onePICOTques-
tion for each scenario. Suggested
PICOTquestionswill be pro-
vided in the next column. �
Susan B. Stillwell is clinical associate
professor and program coordinator of
the Nurse Educator Evidence-Based

Practice Mentorship Program at Arizona
State University in Phoenix, where Ellen
Fineout-Overholt is clinical professor and
director of the Center for the Advance-
ment of Evidence-Based Practice, Ber-
nadette Mazurek Melnyk is dean and
distinguished foundation professor of
nursing, and Kathleen M. Williamson is
associate director of the Center for the
Advancement of Evidence-Based Prac-
tice. Contact author: Susan B. Stillwell,
[email protected]
REFERENCES
1.MelnykBM, et al. Igniting a spirit of
inquiry: an essential foundation for
evidence-based practice. Am J Nurs
2009;109(11):49-52.
2.DaceyMJ, et al. The effect of a rapid
response teamonmajor clinical out-
comemeasures in a community hos-
pital. Crit Care Med 2007;35(9):
2076-82.
3.Fineout-Overholt E, JohnstonL.
TeachingEBP: asking searchable, an-
swerable clinical questions. World-
views Evid Based Nurs 2005;2(3):
157-60.
4.NollanR, et al. Asking compelling
clinical questions. In:MelnykBM,
Fineout-Overholt E, editors. Evidence-
based practice in nursing and health-
care: a guide to best practice.
Philadelphia: LippincottWilliams
andWilkins; 2005. p. 25-38.
5.Straus SE. Evidence-based medicine:

how to practice and teach EBM. 3rd
ed. Edinburgh;NewYork: Elsevier/
Churchill Livingstone; 2005.
6.Fineout-Overholt E, Stillwell SB.Ask-
ing compelling questions. In:Melnyk
BM, Fineout-Overholt E, editors.
Evidence-based practice in nursing
and healthcare: a guide to best practice
[forthcoming]. 2nd ed. Philadelphia:
WoltersKluwerHealth/Lippincott
Williams andWilkins.
7.McKibbonKA,Marks S. Posing clini-
cal questions: framing the question
for scientific inquiry. AACN Clin
Issues 2001;12(4):477-81.
8.Fineout-Overholt E, et al. Teaching
EBP: getting to the gold: how to search
for thebest evidence. Worldviews Evid
Based Nurs 2005;2(4):207-11.
affect the number of cardiac ar-
rests (O) and unplanned admis-
sions to the ICU (O) duringa
three-month period (T)?”
Now thatRebecca has formu-
lated the clinical question, she’s
ready for thenext step in theEBP
process, searching for the evi-
dence. Carlos congratulates
Rebecca ondeveloping a search-
able, answerable question and
arranges tomeetwith her again
tomentor her in helping her find
the answer to her clinical ques-
tion. The fourth article in this

series, tobepublished in theMay
issue of AJN, will focus on strat-
egies for searching the literature
to find the evidence to answer
the clinical question.
Now that you’ve learned to
formulate a successful clinical
question, try this exercise: after
reading the two clinical scenarios
in Practice Creating a PICOT
Question, select the type of
Practice Creating a PICOT Question
Scenario 1: You’re a recent graduate with two years’ experi-
ence in an acute care setting. You’ve taken a position as a
home health care nurse and you have several adult patients
with various medical conditions. However, you’ve recently
been assigned to care for hospice patients. You don’t have
experience in this area, and you haven’t experienced a loved
one at the end of life who’s received hospice care. You notice
that some of the family members or caregivers of patients in
hospice care are withdrawn. You’re wondering what the fam-
ily caregivers are going through, so that you might better un-
derstand the situation and provide quality care.
Scenario 2: You’re a new graduate who’s accepted a position
on a gerontology unit. A number of the patients have demen-
tia and are showing aggressive behavior. You recall a clinical
experience you had as a first-year nursing student in a long-
term care unit and remember seeing many of the patients in
a specialty unit for dementia walking around holding baby
dolls. You’re wondering if giving baby dolls to your patients
with dementia would be helpful.
What type of PICOT question would you create for each of

these scenarios? Select the appropriate templates and formu-
late your questions.
[email protected] AJN � March 2010 � Vol. 110, No. 3 61
Module 7: Synthesis Paper
Submit by 2359 CT Saturday of Module 7.
NOTE: You will create a new Word document for this
Assignment instead of typing directly into this document.
Overview: Synthesis Paper
You have been reflecting on changes you have undergone since
beginning this program in each of your Journal entries in this
course. Now you will synthesize those reflections, plus any
other insights into a paper articulating your RN to BSN
educational journey. You will use your module Journal entries
as well as examples from other RN BSN courses to construct the
Synthesis paper.
Objectives
Synthesis Paper in a reflective activity comprised of your
experience in the RN BSN program.
You will address your experiences before the RN BSN program,
you as a lifelong learner, you in the continuum of novice to
expert in the professional nursing role, an account of your role

transition to a professional nurse, and an evaluation of the
program.
N4585 Capstone Seminar
The Synthesis Paper will reflect your understa nding and use of
APA format and scholarly writing.
Boyd 2020
Rubric –Synthesis Paper
The following rubric will be used to grade the Synthesis Paper.
The paper has 6 sections:
Introduction
Before RN-BSN Program
Lifelong Learning
Novice to Expert
Synthesis of Role Transition to Professional Nursing
Evaluation
The paper must have title page, reference page, plus no more
than 4 pages that address the 6 sections of the paper outlined in
the grading rubric. So with the title page, 4 pages for the body
of the paper, and the reference page, the Synthesis Paper must
not be more than 6 total pages using 12-point Times Roman
font.
The first 2 grading criteria noted in the rubric below apply to all
sections of the paper. APA format, scholarly writing, grammar
and spelling are graded in each section. Use Spell Check and
Grammar Check!
In-text citations are required to support each section when you

discuss the RN BSN courses or the program. Points will be
deducted if this information is not detailed and referenced in the
document and on the reference page. References need to be
evidence-based if you choose to reference literature instead of
information in RN BSN courses.
Target
Acceptable
Unacceptable
Title page, Reference page, APA format , and Scholarly wri ting.
(10 Points)
Each section must be 3-4 well constructed, grammatically
correct sentences supported with in-text citation (current
literature) as required. Includes title and reference page. All
sections included.
(10 Points)
1-2 errors in information, formatting or less than 3 sentences.
Omits title or reference page.
(5 Points)
More than 3 errors in information, formatting or only 2
sentences.
Omits both title and reference page.
(0 Points)

Grammar and Spelling (5 Points)
Error-free grammar and spelling
(5 Points)
1-3 grammar or spelling errors
( 3 Points)
4 or more errors in grammar or spelling
(0 Points)
Sections
Target
Acceptable
Unacceptable
Introduction
(5 points)
Addresses all these questions:
When did you start the RN BSN program? Did you take 1 course
at a time, or 2 or more at a time? Did you take classes each
start date? If not, why?
(5 Points)
Omitted one of the required questions.
(3 Points)
Omitted 2 or more of the required questions.
(0 Points)
Before RN-BSN Program (5 Points)

Narrative includes at least two specific examples of change in
behaviors, attitudes, and/or practices as a result of RN-BSN
program
(5 Points)
Narrative includes at least one specific example of change in
behaviors,
attitudes, or practices as a result of RN-BSN program
(3 Points)
Narrative includes no specific examples of change in behaviors,
attitudes, and/or practices.
( 0 Points)
Before RN-BSN Program
Reference (5 Points)
Includes at least one specific reference to RN- BSN courses or
one reference to specific evidence-based research article(s)
(5 Points)
Source is not evidenced based or course not referenced
accurately
(3 Points)
Includes no specific references to RN-BSN courses or articles
(0 Points)
Lifelong Learning
(10 Points)

Narrative includes in depth discussion and highlights new
learning about self and describes attitudes, characteristics, and
actions as a lifelong learner
(10 Points)
Narrative lacks in depth discussion or highlights new learning
about self and describes attitudes, characteristics, and actions
as a lifelong learner
(5 Points)
Narrative fails to demonstrate ongoing learning
( 0 Points)
Lifelong Learning Examples (5 Points)
Includes at least two specific examples of change in behaviors,
attitudes, and/or practices as a result of RN-BSN program
(5 Points)
Includes at least one specific example of change in behaviors,
attitudes, or practices as a result of RN-BSN program.
(3 Points)

Includes no specific examples of change in behaviors, attitudes,
and/or practices
(0 Points)
Lifelong Learning Reference (5 Points)
(5 Points)
accurately
(3 Points)
(0 Points)
Novice to Expert
(10 Points)
Narrative includes detailed description of steps taken toward

becoming an expert/professional, including interest and actions
toward a specific focus area of nursing
(10 Points)
Narrative includes brief description of steps taken toward
becoming an expert/professional, including interest or actions
toward a specific focus area of nursing
(5 Points)
Narrative fails to demonstrate steps toward becoming an
expert/professional
(0 Points)
Novice to Expert- Examples( 5 Points)
attitudes, and practices as a result of RN-BSN program
(5 Points)
(3 Points)
and/or practices
(0 Points)

Novice to Expert- References (5 Points)
( 5 Points)
accurately
(3 Points)
(0 Points)
Synthesis of Role Transition
(10 points)
Narrative synthesizes changes in personal nursing philosophy
and image of the role of nursing
(10 Points)
Narrative describes changes in personal nursing philosophy or
image of the role of nursing but does not provide a synthesis of
these changes.
(5 Points)
Narrative fails to mention change in personal nursing
philosophy or role of nursing
( 0 Points)

Examples (5 points)
attitudes, and/or practices as a result of RN-BSN program
(5 Points)
(1 point)
(3 Points)
and/or practices
(0 Points)
References ( 5 Points)
Includes at least one specific reference to RN- BSN courses and
one reference to specific evidence-based research article(s).
Must include a reference addressing Nursing Theory.
(5 Points)
(2 Points)

Source is not evidenced based, course not referenced accurately
or no Nursing Theory referenced
(3 Points)
No specific references to RN-BSN courses, no articles included,
and no Nursing Theory referenced.
(0 Points)
Evaluation
(10 points)
Narrative that addresses:
1 aspect of the program that worked for you; 1 suggestion for
program improvement; 1 aspect of the program you would not
want to see changed; and, would you recommend the program to
others and why.
(10 Points)
Narrative omits one of the areas to be addressed.
( 5 Points )
Narrative omits 2 or more areas to be addressed.
( 0 Points)
Late submission of assignment are penalized 5% per day late
beginning with 0001 Sunday (1 minute after midnight) after the
due date of assignment at 2359 Saturday.
Communicated with your Coach before the assignment is due if
you are unable or are having difficulty submitting an

assignment on time. With documentation the Coach can work
with you in some defined instances.
Instructions
Study the rubric to determine the expectations for each section
of the paper. Notice that you are required to cite at least one
research article or specific RN-BSN course topic or activity for
each section. Locate and record citations for articles you may
want to reference, and skim the articles to review the contents.
Create an outline that incorporates your main ideas into each
section. Follow the outline and the rubric to write a rough draft.
You may want to draft your paper by hand, or you might prefer
to “type as you go,” editing and making changes both during
and after writing the draft.
Your final document should include a title page, all 6 sections
of the paper as identified in the grading rubric, and a reference
page. Including title and reference pages the paper is not to
exceed 6 pages. Part of scholarly writing is to be concise in
your writing. The Coach is instructed to grade the title page,
the first 4 pages of the body of the paper, and the reference
page. If the Synthesis Paper is longer than 6 total pages points
may be deducted based on grading rubric sections that were not
addressed in the allotted 6 pages.
The title page and paper are in APA format.
Your writing should be in first person, and is expected to
include opinions and personal statements, but have a
professional tone. It should flow as a narrative, mostly
chronological description your progression through the program
including your reflections on specific nursing courses and
reflections throughout the program.
Be sure to include a final page titled “References,” and cite

your references in correct APA formats. Reference list will
include any RN-BSN courses or activities in APA format.
Each section must contain 3-4 well constructed, grammatically
correct sentences supported by citations and references as
appropriate. Ensure that your writing is informative and
interesting, not redundant.
After your write your paper, set it aside and review it again
several hours later or the next day. Read it from an objective
viewpoint to see if it flows and makes sense. If not, make
necessary changes. Have someone else proofread your paper
both for content and grammatical accuracy is a vital step. Read
your paper out loud before submitting it. Hearing yourself read
your own written words can find those last minute mistakes or
incomplete thoughts before you submit the paper for grading.

Candidate Summary· is an experienced Registered Nurse wit

Recommended

Recommended

More Related Content

Similar to Candidate Summary· is an experienced Registered Nurse wit

Similar to Candidate Summary· is an experienced Registered Nurse wit (20)

More from TawnaDelatorrejs

More from TawnaDelatorrejs (20)

Recently uploaded

Recently uploaded (20)

Candidate Summary· is an experienced Registered Nurse wit