Create a 3-5-page submission in which you develop a PICO(T) question for a specific care issue and evaluate the evidence you locate, which could help to answer the question.IntroductionPICO(T) is an acronym that helps researchers and practitioners define aspects of a potential study or investigation. It stands for:P – Patient/population/problem.I – Intervention.C – Comparison (of potential interventions, typically).O – Outcome(s).T – Time frame (if time frame is relevant).The end goal of applying PICO(T) is to develop a question that can help guide the search for evidence (Boswell & Cannon, 2015). From this perspective, a PICO(T) question can be a valuable starting point for nurses who are starting to apply an evidence-based model or EBPs. By taking the time to precisely define the areas in which the nurse will be looking for evidence, searches become more efficient and effective. Essentially, by precisely defining the types of evidence within specific areas, the nurse will be more likely to discover relevant and useful evidence during their search.You are encouraged to complete the Vila Health PCI(T) Process activity before you develop the plan proposal. This activity offers an opportunity to practice working through creating a PICO(T) question within the context of an issue at a Vila Health facility. These skills will be necessary to complete Assessment 3 successfully. This is for your own practice and self-assessment and demonstrates your engagement in the course.ReferenceBoswell, C., & Cannon, S. (2015). Introduction to nursing research. Jones & Bartlett Learning.Professional ContextAs a baccalaureate-prepared nurse, you will be responsible for locating and identifying credible and scholarly resources to incorporate the best available evidence for the purposes of enhancing clinical reasoning and judgement skills. When reliable and relevant evidence-based findings are utilized, patients, health care systems, and nursing practice outcomes are positively impacted.PICO(T) is a framework that can help you structure your definition of the issue, potential approach that you are going to use, and your predictions related to the issue. Word choice is important in the PICO(T) process because different word choices for similar concepts will lead you toward different existing evidence and research studies that would help inform the development of your initial question.ScenarioFor this assessment, please use an issue of interest from your current or past nursing practice.If you do not have an issue of interest from your personal nursing practice, then review the optional Case Studies presented in the resources and select one of those as the basis for your assessment.InstructionsFor this assessment, select an issue of interest an apply the PICO(T) process to define the question and research it.Your initial goal is to define the population, intervention, comparison, and outcome. In some cases, a time frame is relevant and you should include that as well, when writing a question you can research related to your issue of interest. After you define your question, research it, and organize your initial findings, select the two sources of evidence that seem the most relevant to your question and analyze them in more depth. Specifically, interpret each source’s specific findings and best practices related to your issues, as well explain how the evidence would help you plan and make decisions related to your question.If you need some structure to organize your initial thoughts and research, the PICOT Question and Research Template document (accessible from the “Create PICO(T) Questions” page in the Capella library’s Evidence Based Practice guide) might be helpful.In your submission, make sure you address the following grading criteria:Define a practice issue to be explored via a PICO(T) approach.Identify sources of evidence that could be potentially effective in answering a PICO(T) question.Explain the findings from articles or other sources of evidence.Explain the relevance of the findings from chosen sources of evidence to making decision related to a PICO(T) question.Communicate using writing that is clear, logical, and professional with correct grammar and spelling using the current APA style.Example Assessment: You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like:Assessment 3 Example [PDF].Additional RequirementsYour assessment should meet the following requirements:Length of submission: Create a 3–5-page submission focused on defining a research question and interpreting evidence relevant to answering it.Number of references: Cite a minimum of four sources of scholarly or professional evidence that support your findings and considerations. Resources should be no more than 5 years old.APA formatting: Format references and citations according to the current APA style.Portfolio Prompt: Remember to save the final assessment to your ePortfolio so that you may refer to it as you complete the final capstone course.Competencies MeasuredBy successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:Competency 1: Interpret findings from scholarly quantitative, qualitative, and outcomes research articles and studies.Explain the findings from articles or other sources of evidence.Competency 2: Analyze the relevance and potential effectiveness of evidence when making a decision.Identify sources of evidence that could be potentially effective in answering a PICO(T) question.Explain the relevance of the findings from chosen sources of evidence to making decision related to a PICO(T) question.Competency 3: Apply an evidence-based practice model to address a practice issue.Define a practice issue to be explored via a PICO(T) approach.Competency 5: Apply professional, scholarly communication strategies to lead practice changes based on evidence.Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.Apply APA formatting to in-text citations and references exhibiting nearly flawless adherence to APA format.

Writing About Research & Structuring the Research Essay
When a writer begins to plan a research essay it can feel overwhelming – there is so much research gathered and information to choose from, but where to start? For an inquiry-based research essay, which follows a question and considers the significance of researched information on an audience, it makes sense to structure the essay around that significance.
The writer can start to structure the essay simply, by asking: what should I tell readers I want to discuss (Introduction); what is the main idea I want to get across to readers (Thesis); what are the key ideas around that main idea that I want to convey (Paragraphs); and what is the most significant point I want readers to take away from reading this essay – what is the one thing I want them to understand (Conclusion). With that basic structure identified, the writer can build from there by developing paragraphs based on evidence in the sources found, and by expanding on ideas or refining them so they are clear and concise.
Just like building a house, a solid foundation is important – ideas are like the framing and concrete foundation on which you add evidence (basic floors, walls, wiring, plumbing) that there is a house, you expand on that evidence with detail to convey the significance of this particular house (tile or wood flooring, kitchen cabinets, bathroom fixtures), and you connect all the parts so that house is one cohesive unit (maybe open concept with a modern theme). If that metaphor doesn’t work, think of building the perfect sandwich or burger or taco with the foundation, the toppings, and the bread/bun/tortilla holding it all together as one cohesive unit.
As the writer writes and revises through several drafts of the essay, expanding on ideas in greater detail, providing evidence in support of those ideas, and providing analysis about the evidence and how it supports, contradicts, or otherwise frames an idea, continues until the essay is a much more robust and fully-formed version of its initial structure.
A writer might prefer to start by creating a diagram or cluster map of ideas – something visual to represent ideas and how they relate to one another. Whether a simple diagram on a post-it note, an elaborate mapping scheme, a traditional outline, or a written reflection of statements, writers generally have some sort of structure to guide them as they begin a research essay and to provide structure as they continue to build on that foundation. The CARS model (Links to an external site.) is also helpful.
Writing About Research
Writers often find a simple self-reflection to be the best place to start thinking about how to organize thoughts. In a five-minute free write, describe as much as you can to answer the following questions about your topic – this will help develop a structure for your essay:

What is interesting to know about this topic?(choose any topic )
What has already been said about it – what did you find in the research?
What is important/interesting about what has been said – what matters most?
What do I know now about this topic that I didn’t understand before researching?
What do I think is important to say about what I now understand?
What one thing is most important to say – what one thing do I want readers to take away from reading my essay about this topic?

This should give you some basic ideas about what to write about from your research. But it’s not enough to just report on what your research sources provide. You have to organize all the information into your own ideas about the topic. This resource on organizing (Links to an external site.) might be helpful. Use the following to further develop a potential structure for your research essay:
Developing a Potential Structure

Introduce the research problem or question and the rationale for exploring it.

Explain the issue or the problem
Describe the surrounding context if relevant
What would make someone curious about it? What would make someone want to read more about the topic? 

Establish the significance of the problem or question and why readers should care about it.

How many people are affected?
What aspects of our society are affected?
What difference will it make in people’s lives?
Why is this particular question significant? 

Describe and analyze what has already been written or said by others about the topic.

Who has made a significant contribution to the conversation (existing research) about this?
Who are the strongest, most credible voices in the conversation?
What have they said and how does that relate to your research question?
What important questions do these other voices raise for you? 

Explain what you find to be the most significant or key answer to the research question?

In the end, which voices were most convincing? Why?
What aspects of the conversation turned out to be most important? Why?
What might you add to the conversation?
What do you want to say?

Describe what you’ve come to understand about the topic that you didn’t fully appreciate when you began the project. What is left to explore? What would others still want to know?

What difference will the discoveries you made about your topic make in your life? In your readers’ lives? In the lives of any specific audience to which your essay might be targeted?
What do you remain curious about?
What questions remain unanswered or what issue is unresolved?
What directions might you take if you were to continue the inquiry?

Now go back and identify anything you can’t answer, any areas you might need more sources to support, or any questions that come up. Even if you can’t answer all the prompts above, do you have enough to develop a structure for your essay that will guide your writing. Can you imagine using this structure to build on – can you imagine adding evidence from various sources to each of your points? Can you envision how you might provide analysis of all that evidence? Can you determine a clear thesis that represents your essay and to which all your other points will connect? Can you see ahead to a possible conclusion that gives readers a sense of what’s most important to know about your topic?

Your client is large, urban hospital located in Singapore. The hospital has an Emergency Department, which is having trouble meeting government-established targets for the timely provision of emergency care. That is, patients who attend the ED are waiting too long for assessment, treatment, and discharge or admission. These delays are risky and stressful for patients, and stressful for patients’ families and carers. Overcrowding and poor patient flow through the ED also creates an environment where treatment errors are more likely, and is highly stressful for hospital staff (triage nurses, doctors, nurses, management and administrative staff, porters, and the range of professional staff who run tests and x-rays). This situation is also damaging to the hospital’s reputation and the morale of staff, because the hospital’s performance against their targets is made public, in the interests of transparency. Staff in the ED feel stretched, under pressure, and concerned about the timeliness and quality of care for their patients. To rectify the situation, hospital management has hired a consultancy firm that specialises in the Toyota Production System and all of its process improvement derivatives (business process reengineering, Lean thinking, Total Quality Management, Six Sigma, and so on). The consultant has worked with the hospital’s Improvement Advisor, whose role is to coach medical staff in the development and implementation of process improvement techniques to solve process problems (for example, the flow of patients through the Emergency Department; waiting lists for outpatient services; discharge processes). The consultant and the improvement advisor have attempted to consult with the ED staff (doctors, nurses, administrative staff, porters, managers, etc.) but had low levels of engagement with the improvement project, which led them develop a new process effectively on their own to aid the flow of patients from entering the ED, through to being seen, assessed, treated, and either discharged or admitted. The new process involved giving the nurses more power and control over the flow of low-risk patients, and conducting and ordering standard preliminary tests (blood tests, x-rays, and so on) – i.e. the nurses conducted a preliminary “workup”. The nurses would then advise the doctors on which low-risk patients to see, when, and in what order. The nurses would control the flow of patients so that patients were seen by doctors only when all required tests (e.g. blood and urine tests) had been completed and results received. The aim was to remove “waste” in the system in the form of doctors’ time, who could be devoting their attention in the meantime to more critical cases, and step in when and as needed to swiftly finalise and administer treatment, with all relevant information at hand. As part of this process, a physical whiteboard was made up with a grid with the steps in the process, and magnets indicating how many patients were being processed at a given time, and at what stage of their journey they were at (e.g. “waiting for urine test results”; “waiting for availability of ultrasound”; “waiting for blood test results”. The time the patients entered the ED, and the time that their “target” expired (e.g. the government target was for all patients to be seen and treated within four hours of arrival) was recorded on the white board, so that the nurses in control of the system were visibly confronted with the “clock” ticking down and the processes yet to be navigated. This system of visual management is called “Kanban”.When the consultant and the Improvement Advisor attempted to implement the system, disappointed ensued. No one understood the new process, and everyone felt it was overly complex, despite the fact that the process was meant to streamline patient flow. The new process was followed half-heartedly. Doctors behaved autonomously, refusing to take process advice from the nurses, and complaining to the Head of the ED about the Improvement Advisor, the consultant, and the management change sponsor intruding into their professional jurisdiction. Nurses were uncomfortable providing an advisory role to doctors. Doctors also protested that “patients are not cars” and that the application of the Toyota Production System was inappropriate for medical contexts. Doctors and nurses protested against their performance being timed and measured at every step within the new process, claiming the measurements did not account for the nuances of the decisions they needed to make, and the complexity of the pathways that patients can take through the ED. When the Improvement Advisor would start work in the ED each morning, to support the implementation of the process, she would find that staff members during the nightshift had been playing “snakes and ladders” and “naughts and crosses” on the Kanban board. The Improvement Advisor was not able to measure performance against the new process, because staff refused to consistently adopt it. The Head of the ED (a doctor), mindful of needing the support of the doctors, produced statistical reports to undermine the legitimation of the new process, which had not had a chance to be properly established. In frustration, senior management decided to start again, and hire a new consultancy firm that claimed to be expert not only in solving functional problems through process improvement, but in staff consultation and engagement.YOUR TEAM is the new consultancy team who is expert in both elements of problem-solving. Expressed differently, YOU are the new consultants who are expert in looking at organisational problems through a functionalist AND interpretivist / social relativist lens.Drawing on your reflections, above, develop a consultation process to underpin and inform this new process improvement project. Represent this consultation process in diagrammatic form, as a process model. (Do NOT develop a process model depicting the flow of patients through the ED. Your process model is to reflect your proposed consultation process). This part of your report might be titled, Proposed consultation process, informed by interpretivism / social relativism (approximately 200 words).

Accurately diagnosing depressive disorders can be challenging given their periodic and, at times, cyclic nature. Some of these disorders occur in response to stressors and, depending on the cultural history of the client, may affect their decision to seek treatment. Bipolar disorders can also be difficult to properly diagnose. While clients with a bipolar or related disorder will likely have to contend with the disorder indefinitely, many find that the use of medication and evidence-based treatments have favorable outcomes.
TO PREPARE:

Review this week’s Learning Resources. Consider the insights they provide about assessing and diagnosing mood disorders.
Download the Comprehensive Psychiatric Evaluation Template, which you will use to complete this Assignment. Also review the Comprehensive Psychiatric Evaluation Exemplar to see an example of a completed evaluation document.
By Day 1 of this week, select a specific video case study to use for this Assignment from the Video Case Selections choices in the Learning Resources. View your assigned video case and review the additional data for the case in the “Case History Reports” (ATTACHED BELOW) document, keeping the requirements of the evaluation template in mind.
Consider what history would be necessary to collect from this patient.
Consider what interview questions you would need to ask this patient.
Identify at least three possible differential diagnoses for the patient.

Complete and submit your Comprehensive Psychiatric Evaluation, including your differential diagnosis and critical-thinking process to formulate a primary diagnosis. Incorporate the following into your responses in the template:

Subjective: What details did the patient provide regarding their chief complaint and symptomology to derive your differential diagnosis? What is the duration and severity of their symptoms? How are their symptoms impacting their functioning in life?
Objective: What observations did you make during the psychiatric assessment??
Assessment: Discuss the patient’s mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses with supporting evidence, listed in order from highest priority to lowest priority. Compare the DSM-5 diagnostic criteria for each differential diagnosis and explain what DSM-5 criteria rules out the differential diagnosis to find an accurate diagnosis. Explain the critical-thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case.
Reflection notes: What would you do differently with this client if you could conduct the session over??Also include in your reflection a discussion related to legal/ethical considerations (demonstrate critical thinking beyond confidentiality and consent for treatment!), health promotion and disease prevention taking into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).
ATTACHED IS THE VIDEO CASE STUDY AND CASE HISTORY REPORT IS LISTED BELOW
https://video-alexanderstreet-com.ezp.waldenulibra…
Name: Mrs. Leslie Tilman
Gender: female
Age: 32 years old
T- 97.6 P- 97 R 22 149/98 Ht 5’3 Wt 245lbs
Background: Recently had her first child two months ago. Currently married; stay at home
mother after working in retail for 5 years. Grew up with both parents, one sister in Omaha, NE.
Completed education through bachelor’s level, studying physics. Previous employment included
research science as well as high school substitute teaching for 5 years prior to birth. No
previous suicidal gestures; has uncle who committed suicide via GSW. She denied
drugs/alcohol; uncle was opioid abuser. Hx of HTN-prescribed labetalol 100mg twice daily,
admits to missing doses due to forgetting. No legal hx. Allergies: codeine
Symptom Media. (Producer). (2016). Training title 8 [Video]. https://video-alexanderstreetcom.ezp.waldenulibrar…
Please note that the video cases may not have all the necessary information needed for your evaluation. Supplementary case histories are provided. Rather than write “not provided” in your evaluations, be sure to use the fact sheets to fill in gaps. For any information still missing, explain what information is needed and why it is important.Select one of the videos under this week’s resources to use for your Assignment this week. Then, access the document “Case History Reports” and review the additional data about the patient in the specific video number you selected.Complete and submit your Comprehensive Psychiatric Evaluation, including your differential diagnosis and critical-thinking process to formulate a primary diagnosis. Incorporate the following into your responses in the template:

Subjective: What details did the patient provide regarding their chief complaint and symptomology to derive your differential diagnosis? What is the duration and severity of their symptoms? How are their symptoms impacting their functioning in life?
Objective: What observations did you make during the psychiatric assessment??
Assessment: Discuss the patient’s mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses with supporting evidence, listed in order from highest priority to lowest priority. Compare the DSM-5 diagnostic criteria for each differential diagnosis and explain what DSM-5 criteria rules out the differential diagnosis to find an accurate diagnosis. Explain the critical-thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case.
Reflection notes: What would you do differently with this client if you could conduct the session over??Also include in your reflection a discussion related to legal/ethical considerations (demonstrate critical thinking beyond confidentiality and consent for treatment!), health promotion and disease prevention taking into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).

Create a 2-5 page annotated outline that include the sections to be analyzed, ethical decision making aspects of the topic, main points of the recommendation, and credible evidence you plan to use for supporting the analysis and recommendations.IntroductionWhile everyone has their own process for writing, creating an outline is often an important early step in the process in all types of writing, even for the most seasoned writers. By creating an outline, you draft a plan that organizes your thoughts, helps you see gaps in your thought process, and enables you to decide where in your paper you will address particular issues.An annotated outline is a document that organizes the main sections to be included in your paper. The annotations are based on thinking through your approach to the paper and developing enough detail that anyone who reads the outline can follow your thought process.The purpose of this assessment is as follows:To build an annotated outline that shows the key sections of your analysis, the ethical considerations, and the leadership and collaboration aspects that you intend to include in your capstone project. With this outline, faculty can understand the organization and purpose of your paper; upon approval, you may move forward to writing the capstone project (Assessment 4).To help you manage your work because you will need to start researching now (if you have not already) in order to create your annotated outline.To demonstrate that you know how to cite in APA format by including some quotations or paraphrases from researched sources. The sources you include in the outline may or may not be used in your actual paper.To demonstrate your ability to create a well-organized document, suitable for academic or business, that meets established criteria.Assessment DescriptionFor this assessment, create an annotated outline that provides a framework of your capstone project. Begin by reviewing the MBA Capstone Project Description [PDF]. Your annotated outline must state the name of your chosen organization and must include the following items:Identify the main sections to be developed in the paper and tie them to the project objectives.In your key sections, you should use at least four main headings; these sections make up the body of your outline.Each heading must have at least two sub-points to develop the detail required.Include a description of each major point.Identify where each supporting reference will be integrated.Include at least one reference to support each major point of the paper.Incorporate relevant quotes or paraphrases from a source that you might use for support, with an APA in-text citation.Identify main points that address ethical aspects associated with your chosen business.Ethical considerations/aspects should also be one of the headings of your outline.Use the program outcomes to help determine the areas of ethics that you might want to cover.Include at least one reference to elaborate on how you intend to cover ethics in your project.Identify main points that address leadership and collaboration aspects associated with your chosen business.Leadership and collaboration considerations/aspects should also be one of the headings of your outline.Review the program outcomes to determine the areas of leadership and collaboration that you should consider. Include at least one reference to elaborate on how you intend to cover leadership and collaboration in your project.Identify main points of your recommendations. Your recommendations should also be one of the headings of your outline.Identify credible evidence to support an analysis.For the evidence you provide, include key points to clarify why it matters and how it will inform the analysis.Your annotated outline should have these sections:An executive summary.An introduction.The body of your outline should be comprised of at least four main headings with additional subheadings and points. (Never use the word “Body” as a heading or subheading.) A conclusion.References. Use APA style and formatting for all the sources you use in the annotated outline.Submission RequirementsStyle: This outline should be written in academic format; refer to the corresponding MBA Academic and Professional Document Guidelines. It should be double spaced, use subheadings, and be well organized and well written.Communication: Ensure written communication is free of errors that detract from the overall message and quality.APA guidelines: Format your paper according to current APA style and formatting.Resources: Use at least four resources from credible resources.Length: Your outline should be 2–5 pages.Font and font size: Use 12 point, Times New Roman.It is highly recommended that you submit your outline to Smarthinking (linked in the MBA Program Resources) to request feedback on ideas and organization (that is, global issues). Smarthinking can be instrumental in helping you get a solid, flowing outline and foundation to your capstone.EvaluationBy successfully completing this assessment, you will demonstrate your proficiency in the following course competencies through corresponding scoring guide criteria:Competency 1: Apply foundational knowledge and an understanding of business systems, processes, and technology within and across core disciplines.Identify the main sections to be developed in the paper and tie them to the project objectives.Competency 2: Integrate information across disciplines and from differing perspectives.Identify where each supporting reference will be integratedCompetency 3: Think critically and analytically to provide evidence-based solutions to business challenges and opportunities.Identify main points of recommendations.Competency 5: Lead and collaborate in virtual, global, and culturally diverse environments.Identify main points that address leadership and collaboration aspects associated with the chosen business.Competency 6: Integrate principles of ethics and integrity into business decisions.Identify main points that address ethical aspects associated with the chosen business.Competency 7: Communicate clearly and effectively in a business environment.Cite sources and references in proper APA format.