NURS 350 The Clinical Issue and Research Questions Using PICOT

PICO (alternately known as PICOT) is a mnemonic used to describe the four elements of a good clinical question. It stands for:

P–Patient/Problem
I–Intervention
C–Comparison
O–Outcome

according to NURS 350 The Clinical Issue and Research Questions Using PICOT Many people find that it helps them clarify their question, which in turn makes it easier to find an answer. 

Use PICO to generate terms – these you’ll use in your literature search for the current best evidence.   Once you have your PICO terms, you can then use them to re-write your question.  (Note, you can do this in reverse order if that works for you.)

Example:

Often we start with a vague question such as, “How effective is CPR, really?”  But, what do we mean by CPR?  And how do we define effective?  PICO is a technique to help us – or force us – to answer these questions.   Note that you may not end up with a description for each element of PICO. 

P –  our question above doesn’t address a specific problem other than the assumption of a person who is not breathing. So, ask yourself questions such as, am I interested in a specific age cohort? (Adults, children, aged); a specific population (hospitalized, community dwelling); health cohort (healthy, diabetic, etc.)   

I – our question above doesn’t have a stated intervention, but we might have one in mind such as ‘hands-only’

C – Is there another method of CPR that we want to compare the hands-only to?  Many research studies do not go head to head with a comparison.  In this example we might want to compare to the standard, hands plus breathing

O – Again, we need to ask, what do we mean by ‘effective’?  Mortality is one option with the benefit that it’s easily measured. 

Our PICO statement would look like:

From our PICO, we can write up a clearer and more specific question, such as:

In community dwelling adults, how effective is hands-only CPR versus hands plus breathing CPR at preventing mortality?

NURS 350 The Clinical Issue and Research Questions Using PICOT states that Registered nurses (RNs) start their research queries with an evidence-based practice framework derived from a well-constructed PICOT query, whether they’re finishing advanced courses in nursing school or working in a professional clinical setting.

The acronym PICOT stands for patient, intervention, comparison, outcome, and (occasionally) time, which are all parts of a clinical research issue. The PICOT process starts with a case scenario and a question designed to elicit a response.

In EBSCO Health’s whitepaper, “7 Steps To The Perfect Pico Search,” Kathy A. Jensen, MHA, RN, wrote, “The question needs to identify the patient or population we intend to study, the intervention or treatment we plan to use, the comparison of one intervention to another (if applicable), and the outcome we anticipate.” “Researchers will be in a better position to search the literature for evidence that will support their initial PICO inquiry once a well-structured query has been created.”

Learning how to design a complete PICOT question is critical to nurse manager abilities for RNs enrolled in a doctor of nursing practice (DNP) program, including an online DNP program. PICOT question examples are studied by DNP students to establish the best method for designing a question and finding an answer.

Understanding the PICOT Methodology
according to NURS 350 The Clinical Issue and Research Questions Using PICOT, the PICOT procedure usually starts with a broad clinical question. Each step in the process aids in the creation of a well-structured inquiry. Researchers can next look for evidence that will help them answer the question.

The following are the components of a PICOT question:

the letter p (Patient, population or problem)
Who or what is the patient, demographic, or issue that has to be addressed?

I’d like to express my gratitude to (Intervention)
What is the proposed intervention (action or treatment)?

The letter C (Comparison or control)
What further measures should be taken into account?

a (Outcome or objective)
What is the desired or anticipated outcome or goal?

The letter T (Time frame)
How much time would it take to get the desired result?

According to the world-renowned Centre for Evidence-Based Medicine at the University of Oxford, using the PICOT approach helps produce a careful and deliberate query that makes the search for evidence easier.

“The well-formed question makes it very simple to elicit and combine the necessary terms needed to describe your demand for information in the query language of whichever searching service is accessible to you,” according to the University of Oxford author. “After you’ve created your question using the PICO framework, consider what kind of question you’re asking and, as a result, what kind of study will provide the greatest answer.”