Nursing Essay
Helpful Tips for Completing the C301 Task
Creating your PICO statement
The development of a sound PICO statement is important as it provides direction for your literature search for evidence and acts as a “compass” as you work through the C301 task. The PICO itself does not actually appear in your paper. However, by following the task instructions you will end up discussing each piece of the PICO. Also, your PICO does not need to be approved by a CM unless you want feedback. Following is a guideline for creating your PICO for this assignment.
(P)roblem: Identify a nursing practice problem that you are noticing at your place of employment.
(I)ntervention: What is the solution that you “think” might fix the problem? You will then go into the library to see if there is evidence to support this intervention. If there is sufficient evidence, you can move forward with writing your paper. If there is not sufficient evidence, it is possible that your search may lead you to “stumble upon” a new solution to the problem that you had not yet considered.
Remember that the intervention/change of practice that you choose must be something that you, as a nurse in your facility, could potentially implement. For example, if the intervention requires a physician order, it would not be appropriate for this task. Or, if the intervention requires hiring additional staff, it also would not work for this task – unless you are a hospital administrator and are in a position to approve increased staffing.
(C)urrent Practice: This is what you are doing at your facility right now…that does not seem to be working very well.
(O)utcome that you hope to improve after implementing the Intervention.
Click here for the PICOT Topic Worksheet. This is not a document that will be turned in, but rather a tool that you may find helpful as you are developing your PICO statement.
Getting started on your paper
You will find the instructions and grading rubric by clicking the “Taskstream” button under the “Assessments” tab in your C301 course of study. Follow the instructions closely and use headings that correspond to the rubric. Avoid the letters and numbers (A1, B2, etc.) in your headings. Instead create headings that consist of words that will quickly provide the reader with a glimpse of what will be found under that heading. Headings are an important part of APA formatting.
Part A
A. In part A your first of all need to state the nursing practice, at your facility, that needs to be changed.
A1. You will then go on to provide a detailed description of that nursing practice. Be sure that you are describing the specific practice at your facility, For example, if the practice that needs to change is change of shift nursing report, describe in detail how that report is taking place at the present time (ie. in the report room).
A2. Next, in at least 1 paragraph, provide a description of why the nursing practice at your facility needs to change. Perhaps you can give an example of an event that occurred at your facility that may not have occurred, had the report taken place in a different manner or location. You should also then, go on to discuss the issue in a more global sense. For example, perhaps you want to discuss a national trend in this area of care (ie. bedside-nursing report) and cite your source.
Part B
As you are working on Aspect B. of the C301 you will note that the task instructions ask you to identify each stakeholder and the role that each particular stakeholder plays in your proposed change of practice. Perhaps the easiest way to address this segment is to think about each and every person/department that would be involved in the change in order for the change to occur. to occur.
The following is an excerpt from the C301 Course of Study:
Part C
Below is an excerpt from the C301 Course of Study. For Aspect C (Parts 1,2, and 3) of your paper, you will create a table like the one below, and insert it into the body of your paper. Be sure that every article is less than 5 years old, is from a peer reviewed journal, and provides support for the change you are proposing. This table, when complete, meets all of the requirements for Part C of the task.
Students often struggle with the 2nd column of the table as this is where you will identify the Evidence Strength and Hierarchy for each article. For assistance with this part of the task, work through the entire Asynchronous Cohort, including all of the videos. Once you have completed those videos and readings, come back and complete the 2nd column of the table. You will find it much easier to level your evidence after watching all of the videos.
Part D
Here are a few pointers on what the evaluators are looking for in Part D:
Write one paragraph about each of the 5 articles/sources of evidence.
Each source must be discussed separately….this does not have to be lengthy….but in general, highlight the research design and methods, the study findings or conclusion, and how it relates to your topic.
Do not refer to the articles as “Article 1” or Article “2” or by the title. Instead, refer to each study by the author name using correct APA format for in text citations. If you are struggling with APA formatting, please consult one of our excellent writing mentors at the CWE-Center for Writing Excellence.
It should be very clear as to how each study supports your practice change intervention.
Each study in the summary must conceptually relate to each other….(using words like “likewise, the authors of ABC had similar findings”, in contrast to….etc.)
This is what makes a cohesive ‘evidence summary’
Part E
Think of this next section (E) as your natural conclusion to the evidence summary that you developed above in Part D. You might begin this section with something like:
“Based on the above summary of the evidence, which supports ________ as best practice, the recommended change of practice is____________.”
Section E does not need to be lengthy. Whereas in Part D, you summarized the evidence; here, in Part E, you are now synthesizing the evidence. This is the paragraph where you are really providing the evidence to support your change of practice. You might end up repeating a few aspects from the previous 5 paragraphs, but that is okay. You will use connecting words such as “similarly”, or “likewise” as you compare and contrast the 5 articles.
Part F
Most of what you need to know for aspect F of the C301 task instructions can be found in the Schaffer, Sandau & Dietrick (2013) article (also found in the C301 Course of Study). Be sure to read through the brief Introduction (2 paragraphs) as it gives an excellent explanation as to why Change Theory Models are important when implementing a change of practice.
The article then goes on (Table 2 – p. 1201) to briefly describe/discuss 6 of the most common Change Models in use as per current literature:
ACE Star Model of Knowledge Transformation
Advancing Research and Clinical Practice Through Close Collaboration (ARCC)
Iowa Model
Johns Hopkins Nursing Evidence-Based Practice Model (JHNEBP)
Promoting Action on Research Implementation in Health Services Framework (PARIHS)
Stetler Model
Below is an excerpt from the task instructions regarding what is required for Aspect F of the task:
For F: Choose the Change Model that best suits the change you are proposing. Please note that your course of study discusses several change models in addition to those mentioned in this article.
For F1: Explain your justification for why you think that model is appropriate for your facility and the change of practice you are proposing. As you are writing your justification, think about the key features of that model and how those features would work well with your proposed change.
For F2: Describe how you will address each step of the change model (as listed in Table 2 of the Schaffer, Sandau and Dietrick (2013) article (see link above). It is recommended that you use a different sub-heading for each step. For example: Iowa Model Step 1, Iowa Model Step 2, etc. Write this section as if your facility is starting from scratch with the change proposal. Because you have already written the paper, this section can be confusing. Remember that you, alone, with just 5 supporting articles, are probably not going to be able to make any big changes at your facility. However, a committee of many, that have performed an exhaustive search of the literature, and having found compelling evidence to support the change of practice, will likely be much more effective. Write F2 as if you are a member of that committee and you may find this section much easier to write.
Part G
For this section you are simply discussing any potential barriers that may occur in the implementation process of this change. Read pages 445–449 from section "Barriers to Connecting Research and Practice" up to section "16.2 Creating Change" in chapter 16 of Schmidt and Brown (2015) and as you do think about the problems and barriers that might be encountered during the implementation of your practice change. Common barriers are nurse resistance, physician resistance, cost, time, energy, etc. You do not have to come up with the solutions, although in the “real world” the barriers would have a bearing on whether you moved forward with the change or not.
Part H
With regard to the aspect on ethics, the rubric directs you to consider potential ethical issues related to the planning and implementation of your EBP practice change. To expand your discussion on ethics, take a look at chapter 2 in your Schmidt and Brown (2015) text as there is a discussion about ethical concerns that you might find helpful. Table 2.5 may also be helpful. In addition, you can check out the Code of Ethics from the ANA here: ANA Code of Ethics for Nurses. See what provisions may apply to the planning and implementation of EBP.
You MUST come up with a minimum of 2 ethical implications. If you state in your paper that there are no ethical implications the paper will be returned.
Once you have written this section of the paper, read through it and ask yourself whether your work represents that of an MSN. As an MSN you have an elevated role in upholding ethical principles. In this paper, your written work must reflect the advanced thinking of the MSN nurse.
