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: 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 2: 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? Describe the problem or practice issue that you want to research. What is your practice area; clinical,

education, or administration? (This is NOT where you will list your PICO question)
Step 3: 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 4: 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 5: 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? What databases will you search? How will you narrow your search if needed?
PICO Worksheet
What is the PICO question?____________________________________________________________

Define each element of the question below:
P- (Patient, population, or problem):
I- (Intervention):
C- (Comparison with other treatment/current practice):
O- (Desired outcome):
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 evidence must be gathered? (check all that apply)
___ Literature search
___ Guidelines
___ Expert Opinion
___ Patient Preferences ___ Clinical Expertise
___ Financial Analysis
___ Standards (Regulatory, professional, community)
___ Other
Search terms:

Databases to search:
Search Strategies:

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

fourth 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 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
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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