REad the instructions attached and follow them.
Carg92
_MRU-DNPPICOTFORM..docx
PICOT FORM
To be completed by students and submitted during the course DNP 8000 in Moodle week #3 - 90 days before their first practicum course DNP 7700. The PICOT question must be approved by Dr. Gonzalez and Dr. Dionne. Once the form is approved and signed, the student must submit the approved form in the course DNP 8000 week #6. Failure to submit this form and all required information in a timely manner may result in the inability to register for DNP-7700 for the desired session.
These forms are typeable, handwritten forms will not be accepted.
Student information
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Student Name:
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Email:
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Address:
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Student ID:
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Phone:
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1. What is the practice issue (foreground?)
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2. What is the practice area?
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Administration: Yes ___ No___
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Clinical: Yes ___ No___
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Educational administration: Yes ___ No _____
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Informatics: Yes ___ No ___
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Policy: Yes ___ No ___
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Organization philosophy or mission and vision statement:
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3. How was the practice issue identified? (check all that apply)
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Quality and safety/risk management: Yes ___ No ____
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Significant financial concerns: Yes ____ No _____
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Procedural or process issue: Yes ____ No ____
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Unsatisfactory patient outcomes: Yes ____ No ______
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Different between hospital and community practice: Yes _____ No _____
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Other (define in space below): Yes ____ No _____
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Wide variation in practice: Yes _____ No _____
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Clinical practice issue: Yes ____ No _____
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4. How will the project align with institution mission?
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5. How will the project help improve the organization performance? Does your project align with the site business models?
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6. What is the scope of the problem?
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Family: Yes ___ No ___
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Individual: Yes ___ No ___
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Institution/system: Yes ___ No ___
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Other (define in space below):
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7. What are the PICOT elements?
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Quantitative (PICOT)
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Population:
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Intervention:
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Comparison:
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Outcome:
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Timeframe:
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8. What evidence must be gathered? (check all that apply)
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Integrative Literature review: Yes ____ No ___
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Guidelines: Yes ___ No ___
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Clinical Expertise: Yes ___ No ___
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Systematic Literature review: Yes ____ No ____
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Expert opinion: Yes ____ No ____
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Financial analysis: Yes ___ No ___
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Standards (regulatory, professional, community): Yes ___ No ___
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Patient preferences: Yes ___ No ___
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Other (define in space below): Yes ___ No ___
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____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
9. State the PICOT question in narrow manageable terms.
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Example: Will the implementation of xyz intervention on the inpatient unit of xyz Hospital or clinic the decrease the rate of xyz or improve the rate of xyz, compared to current practice, over 8-weeks? Please remove this sample prior submitting. |
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Student’s Name ______________________________________
PICOT Question Approved Yes _____ No _____
____________________________________________________
Course DNP8000 Professor
__________________________________________________
Associate Dean DNP program
