Order Description
please follow instruction in Capstone Project Milestone #2: Design for Change Proposal Paper.
I have included a copy of Capstone Project Milestone # 1 to refer to in order to complete this assignment.
Also included is the Capstone Project Template to be completed for this assignment.
5 pages , excluding title page and reference page. thank you

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?
How does Amoxicillin function?____________________________________________________________

Define each element of the question below:
P- (Patient, population, or problem): Addresses a given population, its significant nature and information pertaining to demography.
I- (Intervention): Your plan to find treatment for the patient which can be in the form of a new therapy, a test done to diagnose, and a factor of prognosty.
C- (Comparison with other treatment/current practice): giving a comparison between a new therapy and the existing one.
O- (Desired outcome): The result obtained after an intervention has been done.
What is the practice issue/problem?
A mother was concerned about her two-year old boy and decided to take him to a hospital. Her son had fever and a severe pain on the right side of his ear. The boy in the past has suffered from ear infections and has been using antibiotics for a few weeks.
What is the practice area?
The practice area was Clinical

How was the practice issue identified? (check all that apply)
__X_ Unsatisfactory patient outcomes
___ Wide variations in practice
___ Significant financial concerns
___ Clinical practice issue is a concern
___ Clinical practice issue has no scientific base

What evidence must be gathered? (check all that apply)
__X_ Literature search
___ Guidelines
_X__ Expert Opinion __X_ Clinical Expertise
___ Standards (Regulatory, professional, community)
Search terms: Clinical research project, PICO format, research question
Databases to search: PubMed, Medline Plus and CINAHL
Search Strategies: Simple searching strategy

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: How does amoxicillin function?

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?
1 Miller, S. A., & Forrest, J. L. (2001). Enhancing your practice through evidence-based decision making: PICO, learning how to ask good questions. Journal of Evidence Based Dental Practice, 1(2), 136-141.
Peer-reviewed article Good The article describes the steps necessary for diagnosing otitis media.
2 Morley, P. T. (2009). Evidence evaluation worksheets: the systematic reviews for the evidence evaluation process for the 2010 International Consensus on Resuscitation Science. Resuscitation, 80(7), 719-721.
Peer-reviewed article good The article gives a clear description of how amoxicillin functions.
3 Gray, G. E., & Gray, L. K. (2002). Evidence-based medicine: applications in dietetic practice. Journal of the American Dietetic Association, 102(9), 1263-1272.
Peer-reviewed article good Gives a comparison of two diagnostic methods of otitis media.
4 Slavin, M. D. (2004). Teaching evidence-based practice in physical therapy: critical competencies and necessary conditions. Journal of Physical Therapy Education, 18(3), 4.
Peer-reviewed article high This article outlines the PICO approach.