PICO Worksheet Assignment: Evidence-Based Practice in Nursing

This PICO worksheet assignment delves into the core components of evidence-based practice within a nursing context. The assignment begins by defining the PICO question framework, breaking down its elements: Population, Intervention, Comparison, and Outcome, using an example related to diabetes and retinal detachment. The document then explores practice issues, including safety concerns, patient outcomes, variations in practice, and financial considerations, identifying how these issues are recognized and addressed. Furthermore, it outlines the importance of gathering evidence through literature searches, guidelines, expert opinions, and patient preferences. The assignment provides a detailed guide to search terms, databases, and search strategies, emphasizing the strength of research and the importance of clinical expertise. It includes an APA reference list of relevant articles and provides a brief description of the research and its application to nursing practice. The document highlights the significance of the patient's role and the use of various research sources for improved patient care, emphasizing a holistic approach to patient healing.

PICO WORKSHEET 1
Assignment
PICO WORKSHEET
Student Name:
Student ID:
Course Name:
Course ID:
Faculty Name:
University Name:

PICO WORKSHEET 2
PICO WORKSHEET
What is the PICO QUESTION?
A well-built question which has all components of PICO is called a PICO QUESTION. It is
based on evidence-based practise to obtain answers to clinical problems.
PICO QUESTION- In men with Diabetes what are the chances of developing retinal
detachment?
Population-P-Adult males
Intervention-I-Diabetes
Comparator-C-Check blood sugar
Outcome- O-Retinal detachment
Define each element of the question below:
P- (Patient, population, or problem): This includes the chief complaints of the patient or the
primary problem. The disease from which the patient is suffering. Also, it includes age and
sex of the patient.
I- (Intervention): This step is most important because it is important to identify what plan
we need further for the patient . It helps in selecting the diagnostic tests, therapy, medication
and other recommendation to the patient.
C- (Comparison with other treatment/current practice): This stage helps us determining the
main alternative for the patient which we are considering. It has to be specific.
O- (Desired outcome): This is the final part. In this, we have decided the plan to be followed.
This must benefit the patient in eliminating the specific symptom and improving functions.

PICO WORKSHEET 3
What is the practice issue/problem?
In nursing for us, any problem which will put the patient’s life at risk or it is anything that
interferes with the standards of nursing practice, the employer guidelines or the clinical
standards are the practice issue. We need to adhere to the standards of nursing while taking
proper care of the patient.
What is the practice area?
The practise area is the main area of expertise. Nowadays there is a requirement of constant
development of skills by pursuing different specialisation such as Psychiatric Nursing
practice, nurse anaesthetists, labor and delivery nurse etc.
Clinical practice areas- There is wide range of opportunities which we come across in
clinical practice areas. These are medical services, surgical services , specialised centres and
also providing emergency services. There are areas like preoperative services, hospital
services and critical care services which provides a very good opportunity to learn in the
clinical practice area.
Administration- Administration deals with comprehensive data collection pertaining to the
patient’s issue, situation and trends. It attains knowledge and competency that shows in the
nursing practice.
Education-In this there is the use of extensive knowledge and competency that reflects on the
nursing practice.
Other-There is other areas like research, resource utilisation, leadership , advocacy on which
a nurse must work.
How was the practice issue identified?

PICO WORKSHEET 4
Safety/risk management concerns- In this, we need to work with the institute leaders for
quality improvement. Regular discussion of daily challenges and expectation are required.
The risk management and safety are a huge concern. Patient safety is of prime importance
hence continuous improvement in this field is required. It is required to share our challenges
with the institute management and ensure proper redressal of complaints.
Unsatisfactory patient outcomes- We need to work on this area as a team. This can be
improved by teamwork. The patient outcome is human controlled. It requires collaborated
and effective teamwork.
Wide variations in practice- There is a wide variation present in research and practice area of
nursing. It must put this in use for patient care. Improved patient care can be achieved by
applying various methods of nursing practice.
Significant financial concerns- We need to understand the financial compensation has to be
fair. Unfair compensation can cause demotivation. This will cause low motivation to work.
The health care managers need to take proactive measures to address the concerns.
The difference between hospital and community practice-In community practice aims is to
lower the risk of patients who require hospital treatment. In the hospital, there are dealings
with progressed diseases. The community practice focuses on early detection of treatment
while the hospital there is a requirement of taking care of the person who is already having
some disease.
Clinical practice issue is a concern-In this there is a brainstorm on the list of problems. Then
the ideas are taken down. The clinical problem is tracked down and the results are utilised to
improved performance on site. For Example- Smoking cessation in hospitals.

PICO WORKSHEET 5
Procedure or process is a time waster- There are many processes which are lengthy and
wastes time. The outcome is not significant and does not bring any change in patient care.
These processes need to be identified and removed.
Clinical practice issue has no scientific base-There are many variations in practices exit. It
varies from one institute to another. By putting the new way of care into practice we can have
improved quality and patient safety. By developing new ways of care research papers can be
prepared.
What evidence must be gathered?
Literature search- In this, there will be provided information about any particular topic to
describe and analyse the publish literature. This provides evidence-based patient care.
Guidelines-The guidelines should include proper methods of care, midwifery and other
therapies. There is a systemic review of all the evaluations.
Expert Opinion- Through clinical practice, we can gather a huge amount of information
though it is necessary to take an expert opinion for better understanding and learning. Expert
opinion helps in proper guidance which is utilised for further development.
Patient Preferences- It is necessary to identify the patient preferences and make a thoughtful
and compassionate use of it. Judicious use of patient preference results in better patient care.
Clinical Expertise-In this there is the utilisation of skills, cumulative clinical experience,
education and knowledge. All these put together will help to develop clinical expertise.
Financial Analysis- It is important to keep the financial dealing fair and impartial. We should
be paid on equal criteria. There should not any financial exploitation.

PICO WORKSHEET 6
Standards (Regulatory, professional, community) - Maintaining professional standard is very
important .It is important to understand the importance of the regulatory body and the
nursing practice. The regulatory body sets nursing standards and helps us for better patient
care.
Search terms: This is done by identifying the major elements in a question. Then that is
translated in the natural language. EXAMPLE- intervention (I) = HAND WASH
( NATURAL LANGUAGE) = HAND DISINFECTION (MeSH)-TERM IN DATABASE
VOCABULARY
Databases to search: There are databases are for search in health sciences. These databases
help in reference and improving knowledge. These database provides as a source of
information to everything. There should be the use of database filters to refine the search and
make it more accurate.
Search Strategies: A simple search should begin with P and I. This will keep the initial search
result broad. After viewing the result then we can decide to narrow the result
Strength of Research- The research is taken from various books which have focussed on
health care and evidence-based practice in nursing. Also in the sources, it is described that
how effective skills improves evidence-based practice. There is also a literature review in
health and social care.
There has not been the in-depth analysis of the clinical aspect of nursing.

PICO WORKSHEET 7
Brief Description of Research- The research has helped us in the analysis of many aspects of
nursing which will help us in better patient recovery. This allows us to follow a holistic
approach towards the overall healing of the patient. The best source for clinical practice is the
patient only along with the various literature available. The various research sources
described below has helped for the better understanding of the strategies followed. The study
enabled us to understand the concept of nursing and its use for better care of the patient.
APA Reference for Article
Straus, S., Tetroe, J., & Graham, I. D. (Eds.). (2013). Knowledge translation in health care:
moving from evidence to practice. John Wiley & Sons.
Bath-Hextall, F. (2014). The Systematic Review of Health Care Evidence: Methods, Issues,
and Trends. Nursing Clinics of North America, 49(4), 461-473.
Cullum, N., Ciliska, D., Haynes, B., & Marks, S. (Eds.). (2013). Evidence-based nursing: an
introduction. John Wiley & Sons.
Leung, K., Trevena, L., & Waters, D. (2016). Development of a competency framework for
evidence-based practice in nursing. Nurse education today, 39, 189-196.