by Bryan Hamilton

The paragraph or two that follows the title on the first page of your text is assumed to be your introduction. Your introduction follows the title of your paper (note that it is not in bold). You should start your introduction with a powerful statement or two to stimulate interest. You should identify the purpose of your paper and provide a preview of what the paper will include. Remember that formal papers are in third person so no I, me, we.

Significance of the Practice Problem
Start this section with identification of the practice problem. This section should also answer the question "why is this important?" You should address the significance to the patient/client (e.g., pain, suffering, quality of life, impact on income potential, etc.), the family, health care system (e.g., impact on cost or delivery systems), and society (e.g., cost of care, need for health care policy). Discuss the number of patients affected in the US and include the financial impact if at all possible. You might discuss length of stay, readmission, home health care requirements, and mortality. Also, you should address any quality, safety, legal, and ethical implications. This discussion must be substantiated by citations from professional literature.

PICOT Question
This section should include your PICOT question but also should provide thorough descriptions of your population, intervention, comparison intervention, outcome, and timing (if appropriate to your question). This section contains, in essence, your operational definitions of the variables in the question. If you use definitions from the literature be sure to cite them.

Theoretical (Conceptual) Framework
This section should include the theoretical (conceptual framework) which supports your project. Describe a theory or model to serve as the foundation for your project. This may be a nursing theory or a theory from another discipline if pertinent and applicable.

Synthesis of the Literature
Synthesize at least 10 research studies and/or systematic reviews, not summary articles. This is all about the evidence rather than someone else's opinion of the evidence. Do not use secondary sources; you need to get the article, read it, and make your own decision about quality and applicability to your question even if you did find out about the study in a systematic review. The studies in this section must relate directly to your PICOT question. Address the similarities, differences, and controversies.

Practice Recommendations
So, using available evidence, what is the answer to your question? This section is for you to summarize the strength of the body of evidence (quality, quantity, and consistency), make a summary statement, and give a recommendation for practice change. This section should include the recommendation for practice based on the evidence. Perhaps you have found that one subset of your population does fair better with the intervention but the rest of the patients do just as well with the standard practice that you used as your comparison. You might want to design an algorithm and include it in as a figure. Perhaps you found substantiation for usual practice and you recommend reinforcement and education regarding this best practice.

Project Mission, Vision, Objectives
This section should include the mission, vision, and objectives of your project. Describe the setting for your project and discuss the congruence between your project's mission and vision statements and the mission and vision of the organization where the project will be conducted. Include discussion of short-term and long-term objectives of the project.

Project Plan
This section should begin with a description of your change model and why it was selected as the model for this specific change. You should learn about the model from a primary source (i.e., do not cite a textbook). The model that you select should be appropriate to the change that you are recommending (i.e., individual change or organizational change). You may use a change model or an EBP model which describes the process of implementing an EBP change. Use that model to describe the practice change that you recommend even if that is reinforcement and education regarding the status quo. Your change process should be specific to your setting. You can make each step of the model a level 2 heading (title case and flush left) and then describe how you would implement that step of the change in your selected setting. Your change process must be specific to your question and the answer that you found through your literature review and your setting. It should be a well thought-out process using the model as a guide. Describe the setting for your project. Include discussion of stakeholders, barriers, facilitators, risks, unintended consequences, and your SWOT analysis. Include your activities in the form of a schedule or a Gantt chart. You should address the time frame for the change process and the evaluation keeping in mind that this project needs to be achievable within your last two practicum courses. Include resources required for your project and a budget. Include your role in the project and the leadership qualities and skills that will be utilized for successful completion of the project. Discuss how you will protect human rights and ensure privacy of health information.

Evaluation and Data Analysis
This section must include how you are going to evaluate the planned change project including formative and summative criteria for evaluation and time points for the evaluation. Remember that you must evaluate the outcome(s) identified in your PICOT question. Describe and include any tool(s) that are to be used in your project evaluation and discuss the reliability and validity of the tool(s). Discuss planned analysis of your evaluation data.

Dissemination of Project Results
This section should include your plan for sharing the results of your project within the institution and within the professional community. Discuss who would be invited to the presentation of results at the institution and your plan for how you will present the information. Also, discuss your plans for presentation at regional or national meetings and/or publication. If publication is planned, discuss what journal you will submit your manuscript to and why.

The conclusion should start with a statement regarding the intention of the paper and your achievement toward that intention. Also, it should briefly say what was included in the paper. Remember that the introduction is a preview and this section should contain a summary.

Remember that this is a reference list rather than a bibliography. A bibliography is everything you read to prepare the paper but a reference list contains your citations only. If there is not a citation for a reference, it should not be here. Make sure that your references and your citations throughout the paper are in APA format. You can go from an A paper to a B paper on APA errors alone.