Capstone Project Milestone #1 PICO and Evidence Appraisal Worksheets

CapstoneProject: Milestone #1: PICO and Evidence Appraisal Worksheets

CapstoneProject: Milestone #1: PICO and Evidence Appraisal Worksheets

Thispaper seeks to introduce the concept of antenatal screening ofvitamin D among the pregnant women. Antenatal screening is a practicethat is still lacking in the nursing and healthcare fraternity. Thelack is mainly informed by the few pieces of research that have beendone in the area (Hoffmann &amp Buchan, 2013).

Incoming up with the different specific questions to guide the search,first, the search is narrowed down, and some relevant literature arereviewed. In reviewing the literature, PICO framework was quiteessential. This framework helps in answering the several questionsthat exist within the medical literature that prove to bechallenging. When providing questions to the answers through theframework, there are some questions in place that are dissected indifferent categories and then restructured. The framework is made upof four main parts. For this paper, PICO is defined as follows:

Population:The pregnant women that in the antenatal period

Intervention:Giving Vitamin D screening when booked in

Comparator:Recommending vitamin D supplements, but currently there is no policyin place for comparison

Outcome:Better outcomes for both babies and their mothers

Question:Does YYY hospital offer screening of Vitamin D to all women at thebooking-in visit for antenatal, reviewing the results and offering ofthe supplementation considered appropriate?

Thesearch process began by concentrating on vitamin D screening on allpregnant women during the antenatal period (Hyppönen &amp Boucher,2010). This led to fewer results displayed that were not veryappropriate for the study. After more studies, the best strategiesfor the search was applied, and this led to an expanded criterionthat included general themes like vitamin D supplements,woman-centered care and informed decision making (Hyppönen &ampBoucher, 2010).

Duringthis search, some of the key words generated included food hygiene,lifestyle hygiene, smoking cessation, implications of recreationaldrug use alcohol consumption in pregnancy antenatal screeninghaemoglobinopathies screening Down`s syndrome screening risks andbenefits of the screening tests. Alternative spellings andcombinations of above words were identified and listed.

Thesearch strategy used to gather information for this paper was asystematic review of various database websites. The databasessearched included ProQuest, CINAHL, TRIP, MEDLINE, PUBMED NationalGuideline Clearing House, JBI, the Cochrane Library and GoogleScholar. The search also entailed the Published hospital guidelines(Hannes&amp Macaitis, 2012).

TheBoolean operators AND/OR were used. Phrases such as Vitamin D,Vitamin D screening, vitamin D deficiency, pregnancy, pregnant,antenatal screening, vitamin D screening in pregnancy, Caucasian,Western, Australia, hypovitaminosis D were enclosed in quotes. Anattempt was made at truncation and using the asterisk (*) wildcardcharacter (Hannes&amp Macaitis, 2012). MeSH Trees and the thesaurus were used for terms such as antenatalscreening, Caucasian and pregnancy. The date range searched was2005-2015. Reference lists of articles were also searched forrelevant articles.

Thereare challenges, which exist in this given clinical setting that havebeen noted. There is need to revise the recommended level of vitaminD that is taken in by pregnant women. Also, there is the need for anagreement in regards to the optimal serum concentrations for pregnantwomen and the required levels of supplementation needed to achievethe levels (Dror &ampAllen, 2010).


Dror,D. K., &amp Allen, L. H. (2010). Vitamin D inadequacy in pregnancy:biology, outcomes, and interventions. NutritionReviews,68(8),465-477.

Hannes,K., &amp Macaitis, K. (2012). A move to more systematic andtransparent approaches in qualitative evidence synthesis: update on areview of published papers. QualitativeResearch,12(4),402-442.

Hoffmann,T., &amp Buchan, H. (2013). Clinical practice guidelines.

Hyppönen,E., &amp Boucher, B. J. (2010). Avoidance of vitamin D deficiency inpregnancy in the United Kingdom: the case for a unified approach inNational policy. Britishjournal of Nutrition,104(03),309-314.