EvidenceAppraisal Worksheet and PICO

WorksheetFor PICO

Worksheet for PICO

PICO question- Refers to a framework used to develop an evidence-based practice to assist in providing an answer to a particular health or clinical problem. Additionally, PICO questions act as direction for a clinical research that seeks to build up literature research strategies aimed at getting an answer to individual health challenge. Typically, a properly formulate question needs to include fours parts known as PICO which assists in identifying the population, patient or problem(P), intervention(I) and then provide an outcome(O).

Elements definition

P- (Population, problem or Patient): – This refers to subjects sample that researcher wishes to recruit for a particular study.

I- (Intervention): Is a treatment given to subjects used in a particular study.

C- (Comparison): Relates to a tool that helps in identifying what the researcher plans to use as a controlled group to compare with an individual treatment intervention. In addition, comparison group is typically referred as controlled group in many research designs. Furthermore controlled group help in providing standard results which will assist in controlling the experimental results to avoid getting an extreme outcome in any study.

O- (Preferred outcome): Refers to the planned results on measurement that help in examining the effectiveness of a particular intervention. Validated and familiar tools for measuring outcome relevant to typical chiropractic population of the patient including Roland-Morris Questionnaire or Neck Disability Index. Although tools for measuring multitude outcome are available for various medical populations, all these apparatus have weakness, and strengths and no single tool can be used to provide the desired result.

State the practice problem or issue

Pressure ulcer patients need to be frequently turned when admitted to the hospital bed. However, in most case, it is usually impossible to attend them due to an inadequate number of nurses compared to the usual large number of patients admitted to health centers. As results of imbalance nurse-patients ratio, this sheet will analyze critically use of Kinnear bed to turn pressure ulcer patient and compare with manual turning in performing the same function so as to determine which method is most effective in healing patients within a short period.

What is the practice area?

  • Clinical area

How was the practice issue identified?

  • 1. Unsatisfactory patient outcomes-

  • 2. Significant financial concerns

  • 3. Clinical practice issue is a concern

How evidence was gathered?

  • Literature search

  • 2. Experts options

  • 3. Patient Preferences

  • 4. Clinical Expertise

  • 5. Financial Analysis

Search terms:

  1. Pressure ulcers patients

  2. kinnear beds

  3. cost of treatment

  4. patient-nurse ratio

  5. turning of patients

  6. treatment period

Databases to search:

National Institute of Health (NIH).

National Institute of Nursing.

Agency for Health Research and Quality.

Agency for health career search and quality (AHRQ).

Search Strategies:

The research will be conducted by visiting bedridden patients at Bedford VA Hospital and practically inspecting the time taken by nurses to turn all patients. Later patients who are handled electronically by use of Kinnear bed will also be inspected, and two treatment processes will be compared putting in consideration time taken by patients to heal. Literature reviews will also be conducted to get data concerning treatment of pressure ulcers. The database where information concerning patients-nurse ratio is available will be useful in making an important conclusion for this research.

Worksheetfor Evidence Appraisal



Aim:To identify evidence that supports an intervention which would bringchange the results.

Evidence Appraisal Worksheet

PICO Question: Is the use of kinnear beds more effective in reducing bedsore when compared with manual turning?

APA Reference for Article

Type of Source

Strength of Research

Research’s Briefly Description


Lazzarini, P. A., Hurn, S. E., Kuys, S. S., Kamp, M. C., Ng, V., Thomas, C., … &amp Reed, L. (2016). Direct inpatient burden caused by foot-related conditions: a multisite point-prevalence study.&nbspBMJ open,&nbsp6(6), e010811.

Peer-reviewed article.

The article provides data of foot-related inpatients collected from at least five hospitals different. It shows the challenges patients face when they are hospitalized. In this research, 733 participants took part meaning the sample size was large enough to provide a real picture of inpatient experience under hospital beds and could be generalized.

Information found in this article is essential in solving challenges experienced by hospital management when turning pressure ulcers patients. Such is because the material helps the hospital management to recognize the challenges of handling inpatient manually hence making them to appreciate any form of electronic turning.

* Study results – It is evident from the study that 8 out of 13 patients were not attended on time by hospital nurses. Furthermore, the patients stated that they had to be attended in turns to due to lack of enough nurse.

This information can be used in this research to prove that hospitalized patients need electronic attendance hence making Kinnear bed very useful in turning pressure ulcers patients.

* Source’s recommendation- It recommends that strategies need to be put in place to investigate and intervene in the burden caused by in patients with conditions that requires many nurses` attendance.


Bardou, M., Quenot, J. P., &amp Barkun, A. (2015). Stress-related mucosal disease in the critically ill patient.&nbspNature Reviews Gastroenterology &amp Hepatology,&nbsp12(2), 98-107.

Peer-reviewed article.

This article provides information concerning how critically sick patients have remained an issue in clinical management. The article shows how the patients hospitalized in intensive care unit need continues attention from nurses. Data of research done on patients from fours hospital are provided showing these patients need to spend up to 90% of their time with nurses.

Information from this article clearly proves the importance of close watch of patients and also burden associated with caring of hospitalized inpatient. Such information proves the need for computerized equipment which will reduce the workload on the nurses

*Results of the study- It is clearly that up to 40% of all patients in critical condition die due to lack of nurse’s continuous attention. Use of Kinnear bed will significantly reduce death on pressure ulcer patients since they will no longer require the attention of nurses.

*Source’s recommendation- the article recommends that equipment to be invented that can attend in patients without being operated by health workers.


Khuma, Nancy (2009).Analysis, Modeling&amp Improving patients Discharge process in a Regional Hospital.

Peer-reviewed article.

The article is about how to reduce the cost of treatment by shortening hospital stay duration and readmission. The research was conducted on 347 inpatients and 220 experts meaning valid information was obtained. Additionally, all other factors which reduce the length of that inpatient will stay in hospital were also considered in the article.

Information from the article shows that with proper care, patient stay in hospital is significantly reduced. Use of Kinnear beds will provide better care to pressure ulcers patient hence enabling them to recover within shorter period unlike when they are turned manually.

Results of the study- This research found out that ineffective treatment increases the hospital stay for inpatients with up to 3 months. Furthermore, patient’s hospitalization period also depend greatly on the technical and organizational support for health workers.

*Source’s recommendation-There is a need to improve patient discharge from health center using better treatment equipment.


Lena&nbspGunningberg,&nbspChristina&nbspLindholm &amp&nbspMarianne&nbspCarlsson (2005) Reduced incidence of pressure ulcers in patients with hip fractures 13 (5):399–407.

Peer-reviewed article.

The article used 101 pressure ulcers patients to assess the effect of the use of mattress with reduced pressure on their healing process. The results were compared with those using regular beds and to draw a generalization.

Information from this article shows that when pressure ulcers patients are improper treated take longer to recover. Kinnear beds will provide proper treatment for these patients hence helping them to recover faster.

*Results of the study- It shows that when pressure ulcer patients are not adequately treated, their hospitalization period increase by 55% of average stays.

*Article’s recommendation- It recommends proper care for ulcers patients to facilitate quicker recovery. Kinnear beds provide such recommended better care for ulcer patients.