Purpose: To identify a problem or concern that nursing can change and develop a PICOT question to guide the change project.
Directions: Use the form below to complete the Week 3 Assignment PICOT Evidence Worksheet. This includes filling in the table with information about your research question and your PICOT elements and the second part is filling in the Evidence Worksheet.
Step 1: Select the key PICO terms for searching the evidence. Clearly define your PICOT question. List each element P (problem, population, or problem), I (intervention), C (Comparison with other treatment/current practice), and O (Desired outcome), T (Time Frame). 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 PICOT question and also read the required articles.
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 PICOT 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: Identifies and documents four sources of evidence. What evidence must be gathered? What sources of reliable information will be helpful for your particular question? Describes rationale for all checked types of evidence
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? How will you narrow your search if needed?

You are the supervisor of a surgical services department in a nonunion hospital. The staff on your unit have become increasingly frustrated with hospital policies regarding staffing ratios, on-call pay, and verbal medical orders but feel that they have limited opportunities for providing feedback to change the current system. You would like to explore the possibility of moving toward a shared governance model of decision making to resolve the issue and others like it but are not quite sure where to start.
Instructions:
Review Learning Exercise 12.6 – Problem Solving: Working Toward Shared Governance (located in Chapter 12 of the textbook) Answer the following questions: Who do I need to involve in the discussion and at what point? How might I determine if the overarching organizational structure supports shared governance? How would I determine if external stakeholders would be impacted? How would I determine if organizational culture and subculture would support a shared governance model? What types of nursing councils might be created to provide a framework for operation? Who would be the members on these nursing councils? What support mechanisms would need to be in place to ensure success of this project? What would be my role as a supervisor in identifying and resolving employee concerns in a shared governance model?