PICOTPICO QUESTION Week 2 Discussion Post Dear Dr. Hellem and.docx

PICOT/PICO QUESTION
Week 2 Discussion Post
Dear Dr. Hellem and Classmates,
My EBP project will be related to Catheter-Associated
Urinary Tract Infection – CAUTIs. After reading between
quantitative and qualitative approaches to use on my EBP
project proposal, I decided to use qualitative research due to the
target of the particular group and the technicalities involved
with the above issue. Understanding that Catheter-Associated
Urinary Tract Infection, comes as a result of the involvement of
the medical practitioner and staff, as it comes to life when
proper medical care is not administered to the patient
(Charlotte, 2019). Prolong use of indwelling urinary catheters is
a significant risk factor for CAUTI, therefore catheters should
be placed only when appropriate indications are present and its
appropriateness and prevalence should be tracked daily as
proper documentation for indication of use along with
identifying and collecting process measures such as staff
competency to perform insertion, audits of aseptic insertion
technique, and maintenance measures followed insertion (e.g.
drainage bag positioned below patient’s bladder and off the
floor) (Saint, Greene, Krein, Rogers, Ratz, Fowler, Edson,
Watson, Meyer-Lucas, Masuga, Faulkner, Gould, Battles, and
Fakih, 2016).
Using a qualitative research approach will allow the research
to undertake some methods such as participant observation, in-
depth interviews, small sample of participants, use of written
data, among others, keeping in mind that qualitative research
design is mainly focused on understanding the issue at hand by
embracing alternative ways of knowing in which findings will
be implemented in practice. Grounded Theory, a type of
qualitative research approach, generates theory by gathering and
analysing data which focus on the development of knowledge
that will help us understand the experience of a particular

situation and how relevant they are to our practice to identify
common risk factors among ICU and non-ICU patients (Saint et
al., 2016).
PICO question: How does the use nurse driven protocol for
evaluating the appropriateness and prevalence of catheter use or
removal, compared with no protocol affect the CAUTI rates?
Reference
Charlotte Lillis. (2019). Uses and types of urinary cateter.
Retrieved from
https://www.medicalnewstoday.com/articles/324187.php
Saint, S., Greene, T., Krein, S., Rogers, M., Ratz, D., Fowler,
K., Edson, B., Watson, S., Meyer-Lucas, B., Masuga, M.,
Faulkner, K., Gould, C., Battles, J., and Fakih, M. (2016). A
Program to Prevent Catheter-Associated Urinary Tract
Infection in Acute Care. The New England Journal of
Medicine. 374(22). Retrieved from
https://www.nejm.org/doi/pdf/10.1056/NEJMoa1504906?ar
ticleTools=true
Week 3
In this week you will learn about the security principles of
Diversity and Commonality
Copyright © 2012, Elsevier Inc. All rights Reserved
‹#›

Copyright © 2012, Elsevier Inc. All Rights Reserved
Chapter 5
Commonality
Cyber Attacks
Protecting National Infrastructure, 1st ed.
‹#›
‹#›
The University of Adelaide, School of Computer Science
14 July 2019
Chapter 2 — Instructions: Language of the Computer
2
Certain security attributes must be present in all aspects and
areas of national infrastructure to ensure maximum resilience
against attack
Best practices, standards, and audits establish a low-water mark
for all relevant organizations
Audits must be both meaningful and measurable

Chapter 5 – Commonality
Introduction
‹#›
14 July 2019
3
Common security-related best practice standards
Federal Information Security Management Act (FISMA)
Health Insurance Portability and Accountability Act (HIPAA)
Payment Card Industry Data Security Standard (PCI DSS)
ISO/IEC 27000 Standard (ISO27K)
Introduction
‹#›
14 July 2019
4

Fig. 5.1 – Illustrative security audits for two organizations
‹#›
Fig. 5.2 – Relationship between meaningful and measurable
requirements
‹#›
The primary motivation for proper infrastructure protection
should be success based and economic
Not the audit score
Security of critical components relies on
Step #1: Standard audit
Step #2: World-class focus
Sometimes security audit standards and best practices proven
through experience are in conflict

Meaningful Best Practices for Infrastructure Protection
‹#›
14 July 2019
7
Fig. 5.3 – Methodology to achieve world-class infrastructure
protection practices
‹#›
Four basic security policy considerations are recommended
Enforceable: Policies without enforcement are not valuable
Small: Keep it simple and current
Online: Policy info needs to be online and searchable
Inclusive: Good policy requires analysis in order to include
computing and networking elements in the local national
infrastructure environment

Locally Relevant and
Appropriate Security Policy
‹#›
14 July 2019
9
Fig. 5.4 – Decision process for security policy analysis
‹#›
Create an organizational culture of security protection
Culture of security is one where standard operating procedures
provide a secure environment
Ideal environment marries creativity and interest in new
technologies with caution and a healthy aversion to risk

Culture of Security Protection
‹#›
14 July 2019
11
Fig. 5.5 – Spectrum of organizational culture of security options
‹#›
Organizations should be explicitly committed to infrastructure
simplification
Common problems found in design and operation of national
infrastructure
Lack of generalization
Clouding the obvious
Stream-of-consciousness design
Nonuniformity

Infrastructure Simplification
‹#›
14 July 2019
13
Fig. 5.6 – Sample cluttered engineering chart
‹#›
Fig. 5.7 – Simplified engineering chart

‹#›
How to simplify a national infrastructure environment
Reduce its size
Generalize concepts
Clean interfaces
Highlight patterns
Reduce clutter
Infrastructure Simplification
‹#›
14 July 2019
16
Key decision-makers need certification and education programs
Hundred percent end-user awareness is impractical; instead
focus on improving security competence of decision-makers
Senior Managers
Designers and developers
Administrators
Security team members

Create low-cost, high-return activities to certify and educate
end users
Certification and Education
‹#›
14 July 2019
17
Fig. 5.8 – Return on investment (ROI) trends for security
education
‹#›
Create and establish career paths and reward structures for
security professionals
These elements should be present in national infrastructure
environments

Attractive salaries
Career paths
Senior managers
Career Path and Reward Structure
‹#›
14 July 2019
19
Companies and agencies being considered for national
infrastructure work should be required to demonstrate past
practice in live security incidents
Companies and agencies must do a better job of managing their
inventory of live incidents
Responsible Past Security Practice
‹#›

14 July 2019
20
Companies and agencies being considered for national
infrastructure work should provide evidence of the following
past practices
Past damage
Past prevention
Past response
Responsible Past Security Practice
‹#›
14 July 2019
21
A national commonality plan involves balancing the following
concerns
Plethora of existing standards
Low-water mark versus world class
Existing commissions and boards

National Commonality Program
‹#›
14 July 2019
22
Week 3
In this week you will learn about the security principles of
Diversity and Commonality
‹#›
Copyright © 2012, Elsevier Inc. All Rights Reserved
Chapter 4
Diversity
Cyber Attacks
Protecting National Infrastructure, 1st ed.

‹#›
‹#›
14 July 2019
2
Chapter 4 – Diversity
Introduction
The securing any set of national assets should include a
diversity strategy
The deliberate introduction of diversity into national
infrastructure to increase security has not been well explored
Two system are considered diverse if their key attributes differ
Diversity bucks the trend to standardize assets for efficiency's
sake
‹#›

14 July 2019
3
Fig. 4.1 – Diverse and nondiverse components through attribute
differences
‹#›
Diversity and Worm Propagation
Worm propagation is an example of an attack that relies on a
nondiverse target environment
Worm functionality in three steps:
Step #1: Find a target system on the network for propagation of
worm program
Step #2: Copy program to that system
Step #3: Remotely execute program
Repeat
Diversity may be expensive to introduce, but saves money on
response costs in the long run

‹#›
14 July 2019
5
Fig. 4.2 – Mitigating worm activity through diversity
‹#›
Desktop Computer System Diversity
Most individual computers run the same operating system
software on a standard processor platform and browse the
Internet through one or two popular search engines with the one
of only a couple browsers
The typical configuration is a PC running Windows on an Intel
platform, browsing the Internet with Internet Explorer,
searching with Google
This makes the average home PC user a highly predictable
target

‹#›
14 July 2019
7
Fig. 4.3 – Typical PC configuration showing diversity
‹#›
Desktop Computer System Diversity
Three Considerations
Platform costs
Application interoperability
Support and training

‹#›
14 July 2019
9
Fig. 4.4 – Spectrum of desktop diversity options
‹#›
Ultimate solution for making desktops more secure involves
their removal
Not a practical solution
Cloud computing may offer home PC users a diverse, protected
environment
Diversity Paradox of Cloud Computing

‹#›
14 July 2019
11
Modern telecommunications consist of the following two types
of technologies
Circuit-switched
Packet-switched
When compared to one another, these two technologies
automatically provide diversity
Diversity may not always be a feasible goal
Maximizing diversity may defend against large-scale attacks,
but one must also look closely at the entire architecture
Network Technology Diversity
‹#›
14 July 2019
12

Fig. 4.6 – Worm nonpropagation benefit from diverse
telecommunications
‹#›
Fig. 4.7 – Potential for impact propagation over shared fiber
‹#›
Any essential computing or networking asset that serves a
critical function must include physical distribution to increase
survivability
Physical diversity has been part of the national asset system for
years
Backup center diversity
Supplier/vendor diversity
Network route diversity
Physical Diversity

‹#›
14 July 2019
15
Fig. 4.8 – Diverse hubs in satellite SCADA configurations
‹#›
A national diversity program would coordinate between
companies and government agencies
Critical path analysis
Cascade modeling
Procurement discipline
National Diversity Program

‹#›
14 July 2019
17
Week 2: Refinement of a Nursing Concern into an Evidence-
based Practice Proposal Using the Research ProcessPurpose
This assignment provides the opportunity for the student to
continue work on a previously identified area or phenomenon of
interest related to their MSN specialty track. Week Two’s
assignment builds upon the identified area of interest by
developing an overview of the evidence-based practice (EBP)
project and the PCIOT/PICo question. This assignment
initiates the evidence-based practice proposal that is continued
throughout the entire course with each assignment adding
components of the research process. Course Outcomes
This assignment enables the student to meet the following
course outcomes:
CO#1 Integrate evidence-based practice and research to support
advancement of holistic nursing care in diverse healthcare
settings. PO 1
CO#2 Integrate knowledge related to evidence-based practice
and person-centered care to improve healthcare outcomes. PO
2, 5
CO#4 Develop knowledge related to research and evidence-
based practice as a basis for designing and critiquing research
studies. PO 1, 2, 3, 5
Due Date: Sunday 11:59 PM MT at the end of Week Two

Total Points Possible: 150 points Requirements
Description of the Assignment
This assignment builds on the identification of a nursing
concern from NR 500 and the application of a nursing theory to
the selected concern from NR 501. For this course, the selected
concern and nursing theory then serve as a foundation to the
identification of PICOT/PICo. Identification of the literature
search strategy is also required. The purpose of the MSN
project proposal is to translate evidence currently found in the
literature into practice within the chosen specialty track. Due
to the research complexity, time involvement, and implications
regarding human subjects, drug studies are not acceptable areas
of interest for a MSN project.
Criteria for Content
1. Overview of Selected Evidenced-based Practice Project: This
section provides a foundation to the MSN EBP scholarly
project. It should contain the following elements:
· Explain the relationship between research and evidenced-
based practice (EBP)
· Distinguish how EBP is different from research
· Explain the contribution of EBP to professional nursing
· Identify your MSN Program Specialty Track and practice
focus
· Explain how EBP promotes change within your future practice
setting
2. Identification of the Nursing Concern to be Improved: This
section provides a comprehensive discussion of the selected
nursing concern (MY WILL BE ABOUT CAUTI – CATHETER
ACQUIRER URINARY TRACT INFECTION). It should
contain the following elements:
· Explain the selected nursing concern in detail
· Identify how frequently the selected concern occurs within
your specialty track setting

· Identify the stakeholders impacted by the concern
· Identify the consequences of the selected concern
· Identify your proposed solution to the selected concern
· Identify a purpose statement for this EBP proposal
3. PICOT/PICo question and Literature Search Process: This
section identifies the PICOT/PICo question that will used for
this EBP proposal. The literature search parameters will also be
identified. It should contain the following elements:
· Identify the question in correct format with all required
elements
· PICOT for quantitative research approach
· PICo for qualitative research approach
· Identify how the expected outcome will be useful to your
future practice setting
· Discuss the purpose of conducting a literature review and the
contribution it will provide to this EBP proposal
· Identify the steps used to conduct a literature review for this
EBP proposal by including:
· The specific library databases used
· The key search terms and phrases used
· The minor (additional) search terms and phrases used
· Identify any specialty organization that is relevant to this EBP
proposal
4. Theoretical Framework: This section presents the theoretical
framework that will used in this EBP project. It should contain
the following section:
· Explain the theoretical framework to be used in this EBP
proposal
· Describe how the identified theoretical framework is applied
to this EBP proposal
Preparing the Assignment
Criteria for Format and Special Instructions
1. The paper (excluding the title page and reference page)
should be at least 5, but no more than 8 pages. Points will be

lost for not meeting these length requirements.
2. Title page, running head, body of paper, and reference page
must follow APA guidelines as found in the 6th edition of the
manual. This includes the use of headings for each section of
the paper except for the introduction where no heading is used.
3. A minimum of 6 (six) appropriate research-based scholarly
references must be used. Required textbook for this course,
dictionary and Chamberlain College of Nursing lesson
information may NOT be used as scholarly references for this
assignment. For additional assistance regarding scholarly
nursing references, please see “What is a scholarly source”
located in the Course Resources tab. Be aware that information
from .com websites may be incorrect and should be avoided.
References are current - within a 5-year time frame unless a
valid rationale is provided and the instructor has approved them
prior to submission of the assignment.
4. Ideas and information from scholarly, peer reviewed, nursing
sources must be cited and referenced correctly.
5. Rules of grammar, spelling, word usage, and punctuation are
followed and consistent with formal, scientific
writing.Directions and Assignment Criteria
Assignment Criteria
Points
%
Description
Overview of Selected Evidenced-based Practice Project
25
17
Required content for this section includes:
· Explain the relationship between research and evidenced-
based practice (EBP)
focus

setting
Identification of the Nursing Concern to be Improved
25
17
Required content for this section includes:
your specialty track
PICOT/PICo question and Literature Search Process
20
13
The required content for this section includes:
Identify the question in correct format with all required
elements:
· Discuss the purpose of conducting a literature review and the
proposal
Theoretical Framework
20

16
The required content for this section includes:
proposal
· Describe how the identified theoretical framework is applied
Paper Specifications
10
8
Paper meets length requirements of 5 to 8 pages.
Minimum of 6 (six) appropriate research scholarly nursing
references
A dictionary, required textbook for this course and Chamberlain
College of Nursing lesson information, may NOT be used as
scholarly references for this assignment.
References are current - within a 5-year time frame unless a
valid rationale is provided and the instructor has approved them
prior to assignment submission.
APA Format (6th edition)
25
17
Title page, running head, body of paper, and reference page
must follow APA guidelines as found in the 6th edition of the
manual. This includes the use of headings for each section of
the paper except for the introduction where no heading is used.
One deduction for each type of APA style error
Citations in Text
10
7
Ideas and information that come from readings must be cited
and referenced correctly.
Writing Mechanics
15
10
Rules of grammar, spelling, word usage, and punctuation are
followed and consistent with formal written work as found in

the 6th edition of the APA manual.
Total
150
100 %
Chamberlain College of Nursing NR505 Advanced
Research Methods: Evidenced Based Practice
Chamberlain College of Nursing NR505 Advanced
Research Methods: Evidenced Based Practice
NR505: W2 Assignment Refinement of Nsg. Concern Rev-
7/31/2017 (AR)
7/31/2017 (AR),
REV 1/10/18 (AR)
1
Grading Rubric
Assignment Criteria
Exceptional
(100%)
Outstanding or highest level of performance
Exceeds
(88%)
Very good or high level of performance
Meets
(80%)
Competent or satisfactory level of performance
Needs Improvement
(38%)
Poor or failing level of performance
Developing
(0)
Unsatisfactory level of performance

Content
Possible Points = 100 Points
Overview of Selected Evidenced-based Practice Project
25 Points
22 Points
20 Points
10 Points
0 Points
Presentation of information was exceptional and included all of
the following elements:
· Explain the relationship between research and evidence-based
practice (EBP)
focus
setting
Presentation of information was good, but was superficial in
places and included all of the following elements:
practice (EBP)
focus
setting
Presentation of information was minimally demonstrated in the
all of the following elements:
practice (EBP)

focus
setting
Presentation of information in one or two of the following
elements fails to meet expectations:
practice (EBP)
focus
setting
Presentation of information is unsatisfactory in three or more of
practice (EBP)
focus
setting
Identification of the Nursing Concern to be Improved
25 Points
22 Points

20 Points
10 Points
0 Points
Presentation of information in one, two or three of the

following elements fails to meet expectations:
Presentation of information is unsatisfactory in four or more of
PICOT/PICo question and Literature Search Process
20 Points
18 Points
16 Points
8 Points
0 Points
elements

· Discuss the purpose of conducting literature review and the
proposal
elements
proposal
elements
· Identify how the expected outcome
will be useful to your future practice setting

proposal
Presentation of information in one or two of the following
elements fails to meet expectations:
elements
proposal
Presentation of information is unsatisfactory in three or more of
elements

proposal
Theoretical Framework
20 Points
18 Points
16 Points
8 Points
0 Points
proposal
· Describe how the identified theoretical framework is applies
proposal

proposal
Presentation of information in one of the following elements
fails to meet expectations:
proposal
Presentation of information is unsatisfactory in two of the
following:
proposal
Paper Specifications
10 Points
9 Points
8 Points
4 Points
0 Points
This section included all of the following:
· Paper meet length requirements of 5 to 8 page.
· Minimum of 6 (six) scholarly nursing references
· Dictionary, required textbook for this course and Chamberlain
College of Nursing lesson information, were NOT used as
scholarly references.
· All references are current - within a 5-year time frame unless
a valid rationale was provided and the instructor approved them.

This section included three of the following:
This section included only two of the following:
This section included only one of the following:
This section included none of the following:
Content Subtotal ________of 100 points
Format
Possible Points = 50 Points

APA Style
25 Points
22 Points
20 Points
10 Points
0 Points
APA guidelines, as per the 6th edition of the manual, are
demonstrated for the
· title page,
· running head,
· body of paper (including margins, headings, font etc), and
reference page
One deduction for each type of APA format error
0 to 1 APA error was present
· title page,
· running head,
reference page
2 - 3 APA errors were present
· title page,
· running head,
reference page
4 – 5 APA errors were are present

· title page,
· running head,
reference page
6 – 7 APA errors were present
· title page,
· running head,
body of paper (including margins, headings, font etc), and
reference page
8 or greater APA errors were present
Citations
10 Points
9 Points
8 Points
4 Points
0 Points
There were 0-1 errors in the crediting of ideas, and information
that contributed to knowledge

There were 8 or greater errors in the crediting of ideas, and
information that contributed to knowledge
Writing Mechanics
15 Points
13 Points
12 Points
6 Points
0 Points
1–2 errors or exceptions to the rules of grammar, spelling, word
usage, punctuation and other aspects of formal written work as
found in the 6th edition of the APA manual
3 – 4 errors or exceptions to the rules of grammar, spelling,
word usage, punctuation and other aspects of formal written
work as found in the 6th edition of the APA manual
9 or greater errors or exceptions to the rules of grammar,
spelling, word usage, punctuation and other aspects of formal
written work as found in the 6th edition of the APA manual
Format Subtotal
_____of 50 points
Total Points
_____of 150 points
7/31/2017 (AR); Rev 11/20/2017 (AR)

PICOTPICO QUESTION Week 2 Discussion Post Dear Dr. Hellem and.docx

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