Chamberlain College of Nursing NR 451 RN Capstone Course Capstone Project Milestone #1: PICO and Evidence Appraisal Worksheets PICO Worksheet Your Name: Date: Your Instructor’s Name: Purpose: To identify a problem or concern that nursing can change and develop a PICO question to guide the change project. Directions: Use the form below to complete the PICO assignment in Milestone #1. This includes filling in the table with information about your research question and your PICO elements. Step 1: Identify the problem. What have you noticed in your work or school environment that isn’t achieving the desired patient or learning outcomes? What needs to change in nursing, what can you change with the support of evidence in the literature? Briefly describe the problem or practice issue that you want to research. What is your practice area; clinical, education, or administration? Step 2: How was the practice issues identified? How did you come to know this was a problem in your clinical practice? Review the listed concerns and check all that apply. Step 3: What is the scope of the problem? Does this problem affect an individual, population, or an entire institution? Step 4: Select the key PICO terms for searching the evidence. Clearly define your PICO question. List each element P (problem, population, or problem), I (intervention), C (Comparison with other treatment/current practice), and O (Desired outcome). Is the potential solution something for which you (as nurse or student) can find a solution through evidence research? Look in your book for guidelines to developing your PICO question. Step 5: What evidence must be gathered? Everyone should have a literature search. However, what other sources of reliable information will be helpful for your particular question? Step 6: State the search question in narrow, manageable terms. What terms will you use in order to make sure that your search is wide enough to obtain required information but narrow enough to keep it focused? How will you narrow your search if needed? PICO Worksheet What is the practice issue/problem? What is the practice area? ___ Clinical ___ Education ___ Administration ___ Other How was the practice issue identified? (check all that apply) ___ Safety/risk management concerns ___ Unsatisfactory patient outcomes ___ Wide variations in practice ___ Significant financial concerns ___ Difference between hospital and community practice ___ Clinical practice issue is a concern ___ Procedure or process is a time waster ___ Clinical practice issue has no scientific base ___ Other What is the scope of the problem? ___ Individual ___ Population ___ Institution/system What is the PICO question? ___ P- (Patient, population, or problem): ___ I- (Intervention): ___ C- (Comparison with other treatment/current practice): ___ O- (Desired outcome): What evidence must be gathered? (check all that apply) ___ Literature search ___ Guidelines ___ Expert Opinion ___ Patient Preferences ___ ...

1. Chamberlain College of Nursing NR 451 RN Capstone
Course
Capstone Project Milestone #1:
PICO and Evidence Appraisal Worksheets
PICO Worksheet
Your Name:
Date:
Your Instructor’s Name:
Purpose: To identify a problem or concern that nursing can
change and develop a PICO question to guide the change
project.
Directions: Use the form below to complete the PICO
assignment in Milestone #1. This includes filling in the table
with information about your research question and your PICO
elements.
Step 1: Identify the problem. What have you noticed in your
work or school environment that isn’t achieving the desired
patient or learning outcomes? What needs to change in nursing,
what can you change with the support of evidence in the
literature? Briefly describe the problem or practice issue that
you want to research. What is your practice area; clinical,
education, or administration?
Step 2: How was the practice issues identified? How did you
come to know this was a problem in your clinical practice?
Review the listed concerns and check all that apply.
Step 3: What is the scope of the problem? Does this problem
affect an individual, population, or an entire institution?
Step 4: Select the key PICO terms for searching the evidence.
Clearly define your PICO question. List each element P
(problem, population, or problem), I (intervention), C
(Comparison with other treatment/current practice), and O
(Desired outcome). Is the potential solution something for

2. which you (as nurse or student) can find a solution through
evidence research? Look in your book for guidelines to
developing your PICO question.
Step 5: What evidence must be gathered? Everyone should have
a literature search. However, what other sources of reliable
information will be helpful for your particular question?
Step 6: State the search question in narrow, manageable terms.
What terms will you use in order to make sure that your search
is wide enough to obtain required information but narrow
enough to keep it focused? How will you narrow your search if
needed?
PICO Worksheet
What is the practice issue/problem?
What is the practice area?
___ Clinical
___ Education
___ Administration
___ Other
How was the practice issue identified? (check all that apply)
___ Safety/risk management concerns
___ Unsatisfactory patient outcomes
___ Wide variations in practice
___ Significant financial concerns
___ Difference between hospital and community practice
___ Clinical practice issue is a concern
___ Procedure or process is a time waster
___ Clinical practice issue has no scientific base
___ Other
What is the scope of the problem?
___ Individual
___ Population

3. ___ Institution/system
What is the PICO question?
___ P- (Patient, population, or problem):
___ I- (Intervention):
___ C- (Comparison with other treatment/current practice):
___ O- (Desired outcome):
What evidence must be gathered? (check all that apply)
___ Literature search
___ Guidelines
___ Expert Opinion
___ Patient Preferences
___ Clinical Expertise
___ Financial Analysis
___ Standards (Regulatory, professional, community)
___ Other
State the search question in narrow, manageable terms:
Evidence Appraisal Worksheet
Your Name:
Date:
Your Instructor’s Name:
Purpose: To find evidence to support an intervention that will
change the outcomes.
Directions: Type your search question below. Find AT LEAST
FOUR sources to support the need for change and the potential
intervention you have selected to solve the problem. At least
three of your sources must be peer-reviewed articles. The forth
source could be another peer-reviewed article or a reliable,
credible source. Look in your text for ideas of other sources that
can be used. Using the table below, insert and describe your
four chosen resources.
Step 1: APA Reference for the article. You will need to list the
reference for the source in APA format. Be careful when using
built-in APA formats and library citations. They may not be in
APA format. Refer to Chapter 7 of your APA manual.
Step 2: Type of Source. If your source is a research article, you

4. will need to ensure that it is a peer review article. You need at
least three peer-reviewed articles for your project. If your
article is a non–research source, then you will need to list what
type of source it is; systematic review, clinical practice
guidelines, organizational experience, or individual expert
opinion/case study/literature review. You may only use ONE
non-research source.
Step 3: Strength of Research. Refer to page 238-240 for
research evidence and page 242-244 for non-research evidence.
While you do not need to assign a level for each study, you will
assign a quality of evidence (high, good, or low/major flaw) and
should discuss the study using some of the elements that are
discussed in the appraisal forms. For example, Research
evidence: was the sample size adequate? Was there a controlled
group? Was it a randomized study? Were results clearly stated?
Was the conclusion based on the results? Were study limitations
discussed? Not all of these elements need to be discussed, but
you should discuss this information to determine if the strength
of the evidence is HIGH, GOOD, or LOW/MAJOR FLAW.
Step 4: Brief Description of the Research. In this section, you
will summarize the source in your own words. How does this
information apply to your project? What are the results of the
source? What are their recommendations?
Evidence Appraisal Worksheet
PICO Question:
APA Reference for Article
Give the APA-formatted reference for the article.
Type of Source
*Research: Peer-reviewed article
*Non-research systematic review, clinical practice guidelines,
organizational experience, or expert opinion/case
study/literature review
Strength of Research

5. Discuss the strength of the sources.
Report if evidence is High, Good, or Low/Major Flaw. Use the
tools on page 238-244 of your text and discuss the reasons why
you have assigned a particular level of quality.
Brief Description of Research
Address the questions.
*How does the information in the article apply to the project
problem or proposed intervention?
*Summarize in your own words.
* Include results of the study and how these results are
applicable to your project.
* What is the recommendation of the source for clinical
practice?
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6. NR451 Milestone1 PICO Evidence Appraisal Worksheets.docx
03/24/14 mk
1
Chamberlain College of Nursing NR451 RN Capstone
Course
Capstone Project Milestone #1:
PICO and Evidence Appraisal Guidelines
Purpose
Clear identification of the problem or opportunity is the first
step in evidence-based nursing. This first milestone offers two
tools to assist in the identification and gathering of evidence to
link the problem, proposed intervention, and desired outcomes.
Completion of the milestone will include identification of the
problem or concern using the PICO format and an evidence
appraisal to find evidence to support an intervention that will
change the outcomes.
Course Outcomes
This assignment enables the student to meet the following
Course Outcomes.
CO4: Develops and outlines a scientific, systematic decision-
making process to integrate critical thinking with clinical
judgment to assure safe and effective outcomes. (PO #4)
CO8: Selects evidence for best practice when planning
professional nursing care for individuals, families, aggregates,
and communities. (PO #8)
Due Date
Milestone #1 consists of the completion of one worksheet that
contains two parts (i.e., the PICO worksheet and the evidence
appraisal worksheet). Submit the file with the two worksheets
completed to the Dropbox by Sunday, 11:59 p.m. MT at the end
of Week 2.
Points

7. Milestone #1 is worth 175 points (75 points for the PICO
worksheet and 100 points for the evidence appraisal worksheet).
Directions
1. Read this document including the grading rubrics below.
2. Download the PICO/Evidence Appraisal worksheets form
from Doc Sharing. Consider what is the nursing problem or
issue that you have uncovered. Make sure it is related to
nursing, i.e., one that a nurse can solve independently. Do not
select a medical problem that is dependent upon a medical
professional to resolve. Completion of PICO worksheet will
offer a tool for your literature search.
3. For the evidence appraisal worksheet, find AT LEAST FOUR
sources to support the need for change and the potential
intervention you have selected to solve the problem. Three of
these sources must be peer-reviewed articles while one can be a
reliable professional source.
4. Submit the completed PICO/Evidence Appraisal worksheet to
the Week 2 Dropbox.
Grading Criteria: PICO
Category
Points
%
Description
Practice issue and scope of the problem
20
27%
Practice issue/problem is thoroughly described. The need for
change is evident. Practice area is identified. Identification of
the practice issue is clear. Scope of the problem is identified.
PICO question and components
40
53%
Question or nursing problem is identified and is an independent
nursing decision. PICO elements are correctly identified.
Outcomes are measurable.
Evidence and search terms

8. 15
20%
Appropriately identifies the types of evidences that should be
gathered (must include literature search). Uses manageable
search terms and ways in which the search can be narrowed if
discussed.
Total
75 points
100%
Grading Rubric: PICO
Assignment Criteria
Outstanding or Highest Level of Performance
A (92–100%)
Very Good or High Level of Performance
B (84–91%)
Competent or Satisfactory Level of Performance
C (76–83%)
Poor or Failing or Unsatisfactory Level of Performance
F (0–75%)
Total
Practice issue and scope of the problem
20 points
*Practice issue/problem is thoroughly described. The need for
change is evident. *Practice area is identified. *Identification of
the practice issue is clear.
*Scope of the problem is identified.
19–20 points
*Practice issue/problem is vaguely described. The need for
change is evident.
*Practice area is identified. *Identification of the practice issue
is clear.
*Scope of the problem is identified.

9. 17–18 points
*Practice issue/problem is vaguely described. The need for
change is not obvious.
*Practice area is identified. *Identification of the practice issue
is clear.
*Scope of the problem is identified.
15–16 points
*Practice issue/problem is vaguely described. Need for change
is not obvious.
*Practice issues or scope of the problem are not addressed
and/or not accurate.
0–14 points
/20
PICO question and components
40 points
Question or nursing problem is identified and is an independent
nursing decision. PICO elements are correctly identified.
Outcomes are measurable.
37–40 points
Question or nursing problem is identified and is an independent
nursing decision. PICO elements are correctly identified.
Outcomes but are not measurable.
34–36 points
Question or nursing problem is identified and is an independent
nursing decision. One PICO element is not correctly identified.
Outcomes but are not measurable.
30–33 points
Question or nursing problem is identified but is not an
independent nursing decision. Several PICO elements are not

10. correctly identified. Outcomes are not measurable or may not be
present.
0–29 points
/40
Evidence and search terms.
15 points
Appropriately identifies the types of evidences that should be
gathered (must include literature search). Uses manageable
search terms and ways in which the search can be narrowed if
discussed.
14–15 points
Appropriately identifies the types of evidences that should be
gathered (must include literature search). Uses manageable
search terms. Ways in which the search can be narrowed is not
included.
13 points
Appropriately identifies the types of evidences that should be
gathered (must include literature search). Search terms are not
measurable. Ways in which the search can be narrowed is not
included.
11–12 points
Types of evidence that should be gathered is not noted or not
correct, literature search not identified. Search terms are not
measurable or absent. Ways in which the search can be
narrowed is not included.
0–10 points
/15
Total Points

11. /75
Grading Criteria: Evidence Appraisal
Category
Points
%
Description
Article Selection
30
30%
Four articles used. At least three articles are peer-reviewed
research. Other source is scholarly and appropriate for the
change project. Type of source is properly identified.
References are listed in APA format.
Strength of Research
20
20%
Strength of the research is listed as High, Good, or Low/Major
Flaw. Reasons why the rating was given is clearly discussed and
logical.
Description of Research
50
50%
Description of the research is thorough and detailed. Summary
was given in own words. Results of the study were summarized
with the application to the project noted. Recommendations for
clinical practice were discussed.
Total
100 points
100%
Grading Rubric: Evidence Appraisal
Assignment Criteria
Outstanding or Highest Level of Performance

12. A (92–100%)
Very Good or High Level of Performance
B (84–91%)
Competent or Satisfactory Level of Performance
C (76–83%)
Poor or Failing or Unsatisfactory Level of Performance
F (0–75%)
Total
Article Selection
30 points
Four articles used. At least three articles are peer-reviewed
research. Other source is scholarly and appropriate for the
change project. Type of source is properly identified.
References are listed in APA format.
28–30 points
Four articles used. At least three articles are peer-reviewed
research. Other source is scholarly and appropriate for the
change project. Type of source is not properly identified.
References are listed in APA format.
25–27 points
Four articles used. At least three articles are peer-reviewed
research. Other source is scholarly and appropriate for the
change project. Type of source is not properly identified.
References some errors in APA format.
23–24 points
Less than three articles are peer-reviewed research. Other
source is not scholarly or appropriate for the change project.
Type of source is not properly identified. References have
multiple errors in APA format.
0–22 points
/30

13. Strength of Research
20 points
Strength of the research is listed as High, Good, or Low/Major
Flaw. Reasons why the rating was given is clearly discussed and
logical.
19–20 points
Strength of the research is listed as High, Good, or Low/Major
Flaw. Reason why the rating was given is documented but is not
logical.
17–18 points
Strength of the research is listed as High, Good, or Low/Major
Flaw. Reason why the rating was given is vague or absent.
15–16 points
Strength of the research is not listed as High, Good, or
Low/Major Flaw. Reason why the rating was given is vague or
absent.
0–14 points
/20
Description of Research
50 points
Description of the research is thorough and detailed. Summary
was given in own words. Results of the study were summarized
with the application to the project noted. Recommendations for
clinical practice were discussed.
46–50 points
Description of the research is thorough and detailed. Summary
was given in own words. Results of the study were listed but no
application or summary of results were given.
Recommendations for clinical practice were discussed.

14. 42–45 points
Description of the research is vague. Summary was given in
own words. Results of the study were listed but no application
or summary of results were given. Recommendations for
clinical practice were not discussed.
38–41 points
Description of the research is vague. Summary was not in own
words but rather quotes from the source. Results of the study
may not be listed. Recommendations for clinical practice were
not discussed.
0–37 points
/50
Total Points
/100
NR451_ Milestone1_Guidelines.docx Revised 3/24/14 mk
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