Three rejected drafts and a final question on chlorhexidine bathing for patients with central lines, each PICOT element on its own line, make up this MN504 Unit 2 worksheet. Searches like "mn 504 unit 2 assignment example", "mn504 unit 2 sample" and "mn504 unit 2 example" land here.
PICOT Question Worksheet: Daily Chlorhexidine Bathing and Central Line Infections on an Oncology Unit
[Student Name]
Purdue University Global
MN504: Evidence-Based Practice
Unit 2 Assignment
[Instructor Name]
[Date]
Composite unit written as a model document. No real hospital or patient is described.
Clinical Trigger and Question Type
Trigger: two central line-associated bloodstream infections in one quarter on a 30-bed adult oncology unit, both in patients with implanted ports receiving chemotherapy. Staff belief: "Chlorhexidine bathing prevents infection."
The belief is not a question. It states a conclusion, names no population, compares nothing and gives no way to measure whether it is true. A database cannot search a belief; it can only search the elements of a question. The question this trigger raises is an intervention, or therapy, question, because it asks whether doing something, bathing with chlorhexidine, changes an outcome compared with what the unit does now. Intervention questions are best answered by randomized trials and systematic reviews of them, which will shape the search in Unit 3 (Melnyk & Fineout-Overholt, 2023).
Three Drafts, Three Faults
Draft 1: "Does chlorhexidine bathing reduce infection in cancer patients?" Fault: the population is too broad and the outcome too vague. Cancer patients include outpatients and people with no central line, and infection includes pneumonia and urinary tract infection, which bathing is not expected to affect.
Draft 2: "In oncology inpatients, does daily chlorhexidine bathing reduce bloodstream infections?" Fault: there is no comparison, and the population still admits patients without a central venous catheter, who cannot develop a central line-associated infection and so cannot have the outcome.
Draft 3: "In adult oncology inpatients with central lines, does daily chlorhexidine bathing compared with usual care reduce central line infections within six months?" Fault: usual care is undefined, and a well-built PICOT names each element specifically enough to be searched (Riva et al., 2012). Usual care on one unit is not usual care on another, and a reader cannot tell what the intervention is being compared against.
Element Grid
P, population: adults aged 18 and older with a central venous catheter, including implanted ports, on a 30-bed inpatient oncology unit. Justification: only patients with a central line can develop the outcome, and pediatric bathing guidance differs from adult guidance, so children are excluded.
I, intervention: once-daily bathing with 2% chlorhexidine gluconate cloths. Justification: 2% cloths are the product and concentration used in the major trials (Climo et al., 2013), and naming them makes the intervention searchable and reproducible.
C, comparison: soap-and-water basin bathing. Justification: this is what nurses on this unit currently do, so it is the real alternative. Writing usual care would hide the comparison.
O, outcome: the unit's central line infection rate, counted per 1,000 catheter days. Expressing the outcome as a rate per 1,000 catheter days, the convention used in infection surveillance, keeps a month with more central lines from looking worse simply because more patients were at risk.
T, time: six months. Justification: central line infections are rare events on a unit this size, so a shorter period would likely show nothing; six months is long enough to observe a change and short enough to review within one budget year.
Held Back
Skin reaction to chlorhexidine is worth tracking as a secondary outcome during any practice change. It is deliberately left out of the question, because adding a second outcome would produce a question no single study answers and would dilute the search.
Assembled Question
In adults with a central venous catheter on an inpatient oncology unit (P), does once-daily bathing with 2% chlorhexidine gluconate cloths (I), compared with soap-and-water basin bathing (C), lower central line bloodstream infection rates, counted per 1,000 catheter days (O), over six months (T)?
References
Climo, M. W., Yokoe, D. S., Warren, D. K., Perl, T. M., Bolon, M., Herwaldt, L. A., Weinstein, R. A., Sepkowitz, K. A., Jernigan, J. A., Sanogo, K., & Wong, E. S. (2013). Effect of daily chlorhexidine bathing on hospital-acquired infection. New England Journal of Medicine, 368(6), 533-542. https://doi.org/10.1056/NEJMoa1113849
Melnyk, B. M., & Fineout-Overholt, E. (2023). Evidence-based practice in nursing and healthcare: A guide to best practice (5th ed.). Wolters Kluwer.
Riva, J. J., Malik, K. M. P., Burnie, S. J., Endicott, A. R., & Busse, J. W. (2012). What is your research question? An introduction to the PICOT format for clinicians. Journal of the Canadian Chiropractic Association, 56(3), 167-171.
How this MN504 Unit 2 example is structured
Every element is justified by the unit rather than by the literature, which has not been searched yet. Population is narrowed to patients with a central venous catheter because only they can develop the outcome, and to adults because pediatric bathing guidance differs. The comparison is written as what nurses on this unit do, a basin bath with soap and water, since usual care on one unit is not usual care on another. The outcome is expressed as a rate per 1,000 central line days, the convention in surveillance reporting, so that a month with more lines does not look worse. Six months is chosen as long enough to see a rare event and short enough to review within one budget year. Skin reaction is recorded as a secondary outcome worth tracking, then deliberately left out of the question to keep it searchable.
Get an MN504 Unit 2 example written to your instructions
Paste the practice problem you started with, however loose, along with the worksheet template or instructions and the rubric for Unit 2. The sample returns drafts built from it, the fault in each, and a final PICOT with every element defined for your own unit. Free for the first custom sample; expect it in 24-48h. The paper above is an original model document written by our desk, not a submitted student paper and not an official Purdue University Global document.
MN504 Unit 2 questions, answered
Does every PICOT question need a comparison?
For intervention questions, nearly always, because the point is whether one approach beats another. The comparison can be current practice, but it should say what current practice is. Some question types, such as meaning or prognosis, may not need a formal comparison, and many worksheets then use a PICo or similar format. Following the format the prompt names matters more than forcing every letter.
What does the T in PICOT stand for?
Time: most often the follow-up window for the outcome, such as six months of infection surveillance or thirty days after discharge. Some texts treat it as the duration of the intervention instead, and a few drop it for questions where time is irrelevant. The worksheet should state which meaning it uses, because the choice changes how studies are screened later.
Can I change my PICOT question after this unit?
Often, yes, and later units sometimes expect it. A search may show the population is too narrow to have been studied, or that the outcome most trials report differs from the one first chosen. Revising the question in light of the search is ordinary practice; the useful habit is recording what changed and why, so the final paper can explain it.