NR 439 Week 2 PICOT Question Worksheet Example Example

Course	NR 439 RN Evidence-Based Practice
Week	2
Paper type	PICOT question worksheet
Length	About 1,100 words, 7 pages
Format	APA 7 student paper
School	Chamberlain University
Program	RN-to-BSN
Updated	October 2026

Free sample paper for NR 439 Week 2

Clinically Indicated Versus Scheduled Replacement of Peripheral Intravenous Catheters: A PICOT Question Worksheet

Student Name

College of Nursing, Chamberlain University

NR 439: RN Evidence-Based Practice

Instructor Name

Month Day, Year

What this page is doingThe title names both arms of the comparison and the document type, so the grader knows before page two that this is a worksheet built on one question about one device. APA 7 student format: title, author, college and university, course, instructor and date, with no running head. No hospital or patient is named anywhere in the paper.

Clinically Indicated Versus Scheduled Replacement of Peripheral Intravenous Catheters: A PICOT Question Worksheet

The Practice Problem

On a composite 30-bed adult medical-surgical unit, unit policy requires every peripheral intravenous catheter to be removed and replaced at 96 hours whether or not it is working, and the night shift carries most of that workload because the 96-hour mark tends to fall during the night for patients admitted in the afternoon. In a two-week audit of 118 catheters, 41 reached the 96-hour mark while still flushing, free of redness and in use. Each of those 41 was removed and a new one inserted, and 9 of the replacements needed more than one attempt. Patients with difficult venous access, most often older adults and patients on long antibiotic courses, described the scheduled restart as the worst part of their stay.

The problem, stated plainly, is that the unit replaces working catheters on a clock, and the clock is not obviously tied to any outcome the unit measures. Guidance from the Infusion Nurses Society now recommends removal when a catheter is no longer needed or when a complication appears rather than on a fixed schedule (Gorski et al., 2021), which makes the local policy look like a leftover from older guidance. Whether changing it would raise phlebitis or bloodstream infection rates is the question nurses on the unit raise when the idea comes up, and it deserves a searchable answer rather than an opinion either way.

The question also sits squarely inside nursing practice. Nurses insert most peripheral catheters on this unit, assess the site every shift, and decide when a site has failed, so a change from scheduled to clinically indicated replacement would be carried almost entirely by nursing judgment and nursing documentation. That makes it a fair topic for an evidence-based practice course: the evidence would be applied by the same people who raised the question, and no new equipment or order set is needed to test it.

What this page is doingThe problem statement carries a denominator and a count: 41 of 118 catheters were replaced while still working, and 9 replacements took more than one attempt. That is what makes the problem real to a grader instead of a complaint. It also names the objection staff would raise, which tells the reader exactly what outcome the PICOT has to measure.

PICOT Elements

P (Population): Adult inpatients aged 18 years or older admitted to an acute medical-surgical unit with a peripheral intravenous catheter expected to stay in place for longer than 72 hours.

I (Intervention): Clinically indicated replacement, meaning the catheter is removed only when therapy ends or when a nurse assessing the site at least every shift documents phlebitis, infiltration, occlusion, dislodgement or local infection.

C (Comparison): Current unit practice, which is routine replacement of every peripheral intravenous catheter at 96 hours after insertion regardless of site condition, with a new catheter inserted at a different site.

O (Outcome): Phlebitis per 100 catheters, measured with the unit's visual infusion phlebitis score at each shift assessment, and catheter-related bloodstream infection per 1,000 catheter days as recorded by infection prevention; the number of insertion attempts per patient is a secondary outcome.

T (Time): From the first catheter insertion on admission through discharge or 14 days, whichever comes first.

What this page is doingEvery box reads as search vocabulary. The comparison names what current practice is on this unit, the 96-hour clock, rather than writing standard care. The outcome names both what changes and how it is counted, with a scoring tool and a denominator, which is the box graders check first.

Why Each Element Was Worded This Way

The population is limited to catheters expected to stay longer than 72 hours because a catheter removed on the second day never reaches either schedule, so including those patients would dilute any difference between the two approaches. Age alone would not change the answer here, but expected dwell time would, which is why dwell time is written into the population and age is only the adult threshold.

The intervention is written at the level of a protocol. Clinically indicated replacement can be delivered badly if nobody looks at the site, so the box includes the assessment frequency and lists the five findings that trigger removal. Two nurses on different shifts reading that box would make the same decision about the same catheter, which is the test a protocol-level intervention has to pass. The comparison is equally specific: 96 hours, every catheter, new site. A search that pairs clinically indicated replacement with routine replacement will find trials that used 72 hours or 96 hours as the routine arm, and naming the unit's own interval makes it easier to judge later whether a study compared the same thing.

Phlebitis is the outcome nurses on the unit worry about, so it leads, but phlebitis is scored inconsistently from one nurse to the next and a study using a different scale may not be comparable. Catheter-related bloodstream infection is rarer and harder to move, yet it is the harm that would matter most if the change went wrong, so it is included even though the unit will see few events. Insertion attempts are listed as secondary because they are the patient-centered reason for the question, and they are easy to count from the documentation already in place. The time frame follows the clinical course of a hospital stay rather than the length of this course, since a phlebitis outcome measured over four days would miss catheters that fail late.

What this page is doingThis section explains the choices, which is where the worksheet shows understanding instead of form-filling. The population is narrowed on the attribute that changes the answer, the intervention passes a two-nurse test, and the outcome paragraph admits a measurement weakness in the leading outcome and says why the rarer outcome stays anyway.

The Assembled PICOT Question

In adult medical-surgical inpatients with a peripheral intravenous catheter expected to remain longer than 72 hours (P), how does clinically indicated replacement based on shift site assessment (I), compared with routine replacement every 96 hours (C), affect phlebitis per 100 catheters, catheter-related bloodstream infection per 1,000 catheter days and insertion attempts per patient (O) from admission through discharge or 14 days (T)?

The question uses the exact phrases from the boxes above, so it can be split back into search terms without rewriting. It is a therapy question, which points the search toward randomized controlled trials and systematic reviews of trials as the strongest designs for an answer (Melnyk & Fineout-Overholt, 2023). A preliminary check confirms that the question is answerable: a Cochrane review has pooled trials comparing the two approaches (Webster et al., 2019), so the search next week has a clear anchor and a clear standard for what counts as direct evidence.

What this page is doingThe final question is one readable sentence built from the box wording, with the letters marked so a grader can trace each element. Naming the question type and the design it calls for shows the writer knows what next week's search is looking for, and the closing check proves the question can be answered at all.

Search Terms Drawn From the Question

Population terms: adult inpatients; hospitalized adults; medical-surgical; peripheral intravenous catheter; peripheral venous catheter; PIVC.

Intervention terms: clinically indicated replacement; replacement when clinically indicated; site assessment.

Comparison terms: routine replacement; scheduled replacement; resite; 72 hours; 96 hours.

Outcome terms: phlebitis; infiltration; catheter-related bloodstream infection; CRBSI; insertion attempts.

Planned limits: English language, 2015 to present for primary studies with no date limit on systematic reviews, adult populations, peer-reviewed sources. Stillwell et al. (2010) recommend keeping synonyms for each element grouped this way so they can be combined with OR inside an element and AND between elements.

What this page is doingCarrying the question straight into search vocabulary shows the worksheet is usable, which is the point of a PICOT exercise. Synonyms are grouped by element and the planned limits are stated with the one exception reasoned, so the Week 3 search can start from this page without any rewording.

References

Gorski, L. A., Hadaway, L., Hagle, M. E., Broadhurst, D., Clare, S., Kleidon, T., Meyer, B. M., Nickel, B., Rowley, S., Sharpe, E., & Alexander, M. (2021). Infusion therapy standards of practice, 8th edition. Journal of Infusion Nursing, 44(1S), S1-S224. https://doi.org/10.1097/NAN.0000000000000396

Melnyk, B. M., & Fineout-Overholt, E. (2023). Evidence-based practice in nursing and healthcare: A guide to best practice (5th ed.). Wolters Kluwer.

Stillwell, S. B., Fineout-Overholt, E., Melnyk, B. M., & Williamson, K. M. (2010). Evidence-based practice, step by step: Asking the clinical question: A key step in evidence-based practice. American Journal of Nursing, 110(3), 58-61. https://doi.org/10.1097/01.NAJ.0000368959.11129.79

Webster, J., Osborne, S., Rickard, C. M., & Marsh, N. (2019). Clinically-indicated replacement versus routine replacement of peripheral venous catheters. Cochrane Database of Systematic Reviews, 2019(1), Article CD007798. https://doi.org/10.1002/14651858.CD007798.pub5

The Chamberlain NR 439 Week 2 instructions

The Week 2 worksheet has you develop a PICOT question from a practice problem. Typical parts are the practice problem, the five PICOT boxes, the assembled question, its question type and often search terms, with APA references. State the problem with a denominator and a count from your unit. Write each element in words you could search. Describe the comparison as what your unit actually does now, not "standard care." Name outcomes you can measure, and say how. Explain why you worded each element as you did. Assemble the question in one readable sentence with the letters marked. Name the question type and the design it calls for, then turn the elements into search terms.

How the NR 439 Week 2 example is put together

The problem section describes the 96-hour policy, the night shift workload and the local count of working catheters removed. It cites the Infusion Nurses Society standards and notes that nurses own this decision. The PICOT section defines the population as adults with catheters expected to stay more than 72 hours, the intervention as removal for clinical signs with site checks every shift, the comparison as routine 96-hour replacement, outcomes as phlebitis per 100 catheters and bloodstream infection per 1,000 catheter days, and time as admission through discharge or 14 days. The rationale section explains each choice. The assembled question follows, identified as a therapy question pointing to randomized trials. Search terms and limits close the worksheet.

NR 439 Week 2 rubric: what full points look like

PICOT worksheet rubrics in NR 439 generally award points for a clear practice problem, accurate PICOT elements, a well-formed question, identification of question type, appropriate search terms and APA. The comparison box is where most worksheets lose points, and this one earns them by naming the 96-hour clock as current practice. The problem row is credited because it carries a count and denominator. Elements score when each is searchable and measurable, including the phlebitis scale used. The rationale section shows understanding rather than form-filling. The assembled question earns points for being one sentence that splits back into terms. Naming the therapy type and turning elements into grouped synonyms with limits demonstrates the worksheet is usable.

NR 439 Week 2 help from the desk

Worksheets lose marks first on the comparison, filled in as "no intervention" or "standard care" with nothing about what standard care is. Next is an outcome no one could measure, such as "better patient outcomes." Students also write populations so broad that every study fits, leave out the time element without explaining why, or assemble a question that cannot be split back into search terms. The T is optional in some questions, but say so if you drop it. Qualitative questions use a different format, often PICo. If your search returns nothing, the population or intervention is usually too narrow. Send your practice problem and an NR 439 PICOT worksheet can be drafted from it with you.

Get a NR 439 Week 2 example written to your instructions

Send the Week 2 worksheet from your classroom along with the practice problem you have in mind, and a custom example is filled into your own boxes and returned inside 24 to 48 hours. The first one is free. The problem you choose remains your decision to make.

More NR 439 papers and RN-to-BSN samples

NR 439 Week 2 questions, answered

Does every question need the T?

Check your section, since some accept PICO where a timeframe makes no sense. Where T is required, it should describe how long the outcome needs to be followed rather than when your assignment is due. A timeframe pulled from the course calendar is the version instructors mark, because it shows the letter was filled in without being understood.

Can my question be qualitative?

Often yes, and some sections require one. A qualitative question drops the comparison and asks about experience or meaning instead of effect, which changes the whole worksheet. Say which type your assignment wants when you send it, because a comparative question rewritten as qualitative afterward rarely survives the edit intact.

What if nothing comes back when I search my question?

That usually means one element is too narrow rather than that no evidence exists. The population qualifiers are the commonest culprit. Broadening one box at a time, and recording what you changed, is also good material for the search assignment in the week that follows, so keep the versions you discarded.

Where can I find a free NR 439 Week 2 sample paper?

This page has the complete Week 2 PICOT worksheet on peripheral IV replacement, with the problem count, each element, the reasoning, the assembled question, search terms and four references.

How is the comparison written in the NR 439 Week 2 worksheet?

As the unit's current practice: routine replacement of every peripheral IV catheter at 96 hours after insertion regardless of site condition, rather than the vague phrase standard care.