Order Description
Brief description of your identified nursing practice issue or clinical problem. (This paragraph should be your part A: Question 1: a, b, c)
Patient Population
(This paragraph should be your part A: Question 2)
Relevance/Significance
(This paragraph should be your part B: Please do not physically type the template in this paragraph. The template is to help you formulate your question. The paragraph should be written in APA format with a summary of what type of issue your question is, then the question statement set-up correctly. In a dialysis clinic, most of our patients get admitted to the hospital for heart or blood pressure issues. My PICCO topic would be on readmission of patients with heart failure. With the proper patient education and follow up could a percentage of these readmissions be avoided? Would a follow up phone call with a RN and follow up appointments with the physician decease the readmissions? They would have very specific instructions on medications and discharge education. Also following up with the dialysis clinic on changes of medications.

P- Patients at the clinic on hemodialysis with heart failure, high risk will be will be determined utilizing the American Heart Association cardiovascular risk assessment tool (American Heart Association, 2013)

I – Follow up phone calls by nursing staff and involving the hemo. Clinic nurses 3 days post-hospitalization

C – No contact with a nurse or staff at the clinic made

O – Fewer readmission of patients with heart failure, this would measure the rate of readmission from an acute setting like the dialysis clinic

1.Determine if the issue is a: 1.Treatment/Intervention/Therapy
2.Prevention,
3.Diagnosis,
4.Prognosis/Prediction; or
5.Etiology style question.

2.The template questions below will help you to frame the question. Utilize one of the templates questions below to guide your formulation of a question to address in your Evidence Based Practice Report.

FOR AN TREATMENT/INTERVENTION/THERAPY
In_____ (P), what is the effect of ________ (I) on _________(C) compared with _________ (0)?

PREVENTION
For ___ (P) does the use of _________ (I) reduce the future risk of _________ (C) compared with __________ (O)?

DIAGNOSIS OR DIAGNOSTIC TEST
In ________ (P) are /is or how does _____ (I) compared with ____________ (C) more accurate in diagnosing ________ (O)?

PROGNOSIS/PREDICTION
Does _________ (I) influence __________ (O) in patients who have ____________ (P) _____________?

ETIOLOGY
Are ______ (P) who have ______ (I) compared with those with/without _____ (C) at risk for/of ___________ (O)?

MEANING
How do __________ (P) with ___________ (I) ______________ perceive/experience _______________ (O)?

Melnyk, B. M., & Fineout-Overholt, E. (2011). Evidence-based practice in nursing & healthcare: A guide to best practice. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins.

Examples:

THERAPY
In patients with ulcerative colitis, what is the effect of low residue foods on their nutritional status as compared with patients who eat high fiber diets?

PREVENTION
For patients with heart failure spending more than 50% of their time in bed, does the use of ted hose reduce the future risk of DVT compared with sequential compression devices?

DIAGNOSIS OR DIAGNOSTIC TEST
In teens with a minor sports related head injury, does the use of a CT scan compared with data from other clinical findings more accurate in diagnosing a concussion?

PROGNOSIS/PREDICTION
Does exposure to secondary smoke influence the likelihood of neuropathy in patients who have diabetes mellitus?

ETIOLOGY
Are children under the age of 4 who have been exposed to more than five hours of electronic games per week (IPAD/IPHONE etc) compared with those without exposure to playing electronic games at risk for/of developmental delays?

MEANING
How do patients with gestational diabetes perceive the importance of monitoring their blood sugars?

Part C: PICO PICO is a mnemonic used to clarify a clinical question. This framework helps to think specifically about what you want to investigate. As you create and document your PICO question in the report, be as clear and specific as possible. If changing a verb or term in the question makes the question clearer, please do so. This helps you target the right evidence to use in practice.
What are the PICO Components?

P – (Patients, Population, or Problems):