pico research question in nursing

PICOT Question Examples for Nursing Research

Are you looking for examples of nursing PICOT questions to inspire your creativity as you research for a perfect nursing topic for your paper? You came to the right place.

We have a comprehensive guide on how to write a good PICO Question for your case study, research paper, white paper, term paper, project, or capstone paper. Therefore, we will not go into the details in this post. A good PICOT question possesses the following qualities:

• A clinical-based question addresses the nursing research areas or topics.
• It is specific, concise, and clear.
• Patient, problem, or population.
• Intervention.
• Comparison.
• Includes medical, clinical, and nursing terms where necessary.
• It is not ambiguous.

For more information, read our comprehensive PICOT Question guide . You can use these questions to inspire your PICOT choice for your evidence-based papers , reports, or nursing research papers.

If you are stuck with assignments and want some help, we offer the best nursing research assignment help online. We have expert nursing writers who can formulate an excellent clinical, research, and PICOT question for you. They can also write dissertations, white papers, theses, reports, and capstones. Do not hesitate to place an order.

List of 180 Plus Best PICOT Questions to Get Inspiration From

Here is a list of nursing PICO questions to inspire you when developing yours. Some PICOT questions might be suitable for BSN and MSN but not DNP. If you are writing a change project for your DNP, try to focus on PICOT questions that align to process changes. 

• Among healthy newborn infants in low- and middle-income countries (P), does early skin-to-skin contact of the baby with the mother in the first hour of life (I) compared with drying and wrapping (C) have an impact on neonatal mortality, hypothermia or initiation/exclusivity/ duration of breastfeeding (O)?
• Is it necessary to test blood glucose levels 4 times daily for a patient suffering from Type 1 diabetes?
• Does raising the head of the bed of a mechanically ventilated patient reduce the chances of pneumonia?
• Does music therapy is an effective mode of PACU pain management for patients who are slowly coming out from their anesthesia?
• For all neonates (P), should vitamin K prophylaxis (I) be given for the prevention of vitamin K deficiency bleeding (O)?
• For young infants (0-2 months) with suspected sepsis managed in health facilities (P), should third generation cephalosporin monotherapy (I) replace currently recommended ampicillin-gentamicin combination (C) as first line empiric treatment for preventing death and sequelae (O)?
• In low-birth-weight/pre-term neonates in health facilities (P), is skin-to-skin contact immediately after birth (I) more effective than conventional care (C) in preventing hypothermia (O)?
• In children aged 2–59 months (P), what is the most effective antibiotic therapy (I, C) for severe pneumonia (O)?
• Is skin-to-skin contact of the infant with the mother a more assured way of ensuring neonatal mortality compared to drying and wrapping?
• Are oral contraceptives effective in stopping pregnancy for women above 30 years?
• Is spironolactone a better drug for reducing the blood pressure of teenagers when compared to clonidine?
• What is the usefulness of an LP/spinal tap after the beginning of antivirals for a pediatric population suffering from fever?
• In children aged 2–59 months in developing countries (P), which parenteral antibiotic or combination of antibiotics (I), at what dose and duration, is effective for the treatment of suspected bacterial meningitis in hospital in reducing mortality and sequelae (O)?
• Does the habit of washing hands third-generation workers decrease the events of infections in hospitals?
• Is the intake of zinc pills more effective than Vitamin C for preventing cold during winter for middle-aged women?
• In children with acute severe malnutrition (P), are antibiotics (I) effective in preventing death and sequelae (O)?
• Among, children with lower respiratory tract infection (P), what are the best cut off oxygen saturation levels (D), at different altitudes that will determine hypoxaemia requiring oxygen therapy (O)?
• In infants and children in low-resource settings (P), what is the most appropriate method (D) of detecting hypoxaemia in hospitals (O)?
• In children with shock (P), what is the most appropriate choice of intravenous fluid therapy (I) to prevent death and sequelae (O)?
• In fully conscious children with hypoglycaemia (P) what is the effectiveness of administering sublingual sugar (I)?
• Is using toys as distractions during giving needle vaccinations to toddlers an effective pain response management?
• What is the result of a higher amount of potassium intake among children with low blood pressure?
• Is cup feeding an infant better than feeding through tubes in a NICU setup?
• Does the intervention of flushing the heroin via lines a more effective way of treating patients with CVLs/PICCs?
• Is the use of intravenous fluid intervention a better remedy for infants under fatal conditions?
• Do bedside shift reports help in the overall patient care for nurses?
• Is home visitation a better way of dealing with teen pregnancy when compared to regular school visits in rural areas?
• Is fentanyl more effective than morphine in dealing with the pain of adults over the age of 50 years?
• What are the health outcomes of having a high amount of potassium for adults over the age of 21 years?
• Does the use of continuous feed during emesis a more effective way of intervention when compared to the process of stopping the feed for a short period?
• Does controlling the amount of sublingual sugar help completely conscious children suffering from hypoglycemia?
• Is the lithotomy position an ideal position for giving birth to women in labor?
• Does group therapy help patients with schizophrenia to help their conversational skills?
• What are the probable after-effects, in the form of bruises and other injuries, of heparin injection therapy for COPD patients?
• Would standardized discharge medication education improve home medication adherence in adults age 65 and older compared to-standardized discharge medication education?
• In patients with psychiatric disorders is medication non-compliance a greater risk compared with adults experiencing chronic illness?
• Is the use of beta-blockers for lowering blood pressure for adult men over the age of 70 years effective?
• Nasal swab or nasal aspirate? Which one is more effective for children suffering from seasonal flu?
• What are the effects of adding beta-blockers for lowering blood pressure for adult men over the age of 70 years?
• Does the process of stopping lipids for 4 hours an effective measure of obtaining the desired TG level for patients who are about to receive TPN?
• Is medical intervention a proper way of dealing with childhood obesity among school-going children?
• Can nurse-led presentations of mental health associated with bullying help in combating such tendencies in public schools?
• What are the impacts of managing Prevacid before a pH probe study for pediatric patients with GERD?
• What are the measurable effects of extending ICU stays and antibiotic consumption amongst children with sepsis?
• Does the use of infrared skin thermometers justified when compared to the tympanic thermometers for a pediatric population?
• What are the roles of a pre-surgery cardiac nurse in order to prevent depression among patients awaiting cardiac operation?
• Does the increase in the habit of smoking marijuana among Dutch students increase the chances of depression?
• What is the direct connection between VAP and NGT?
• Is psychological intervention for people suffering from dementia a more effective measure than giving them a placebo?
• Are alarm sensors effective in preventing accidents in hospitals for patients over the age of 65 years?
• Is the sudden change of temperature harmful for patients who are neurologically devastated?
• Is it necessary to test blood glucose levels, 4 times a day, for a patient suffering from Type 1 diabetes?
• Is the use of MDI derive better results, when compared to regular nebulizers, for pediatric patients suffering from asthma?
• What are the effects of IVF bolus in controlling the amount of Magnesium Sulfate for patients who are suffering from asthma?
• Is the process of stopping lipids for 4 hours an effective measure of obtaining the desired TG level for patients who are about to receive TPN?
• What are the standards of vital signs for a pediatric population?
• Is daily blood pressure monitoring help in addressing the triggers of hypertension among males over 65 years?
• Does receiving phone tweets lower blood sugar levels for people suffering from Type 1 diabetes?
• Are males over the age of 30 years who have smoked for more than 1 year exposed to a greater risk of esophageal cancer when compared to the same age group of men who have no history of smoking?
• Does the increase in the use of mosquito nets in Uganda help in the reduction of malaria among the infants?
• Does the increase in the intake of oral contraceptives increase the chances of breast cancer among 20-30 years old women in the UK?
• In postpartum women with postnatal depression (P), does group therapy (I) compared to individual therapy (C) improve maternal-infant bonding (O) after eight weeks (T)?
• In patients with chronic pain (P), does mindfulness-based cognitive therapy (I) compared to pharmacotherapy (C) improve quality of life (O) after 12 weeks (T)?
• In patients with type 2 diabetes (P), does continuous glucose monitoring (I) compared to self-monitoring of blood glucose (C) improve glycemic control (O) over a period of three months (T)?
• In patients with chronic kidney disease (P), does a vegetarian diet (I) compared to a regular diet (C) slow the decline in renal function (O) after one year (T)?
• In pediatric patients with acute otitis media (P), does delayed antibiotic prescribing (I) compared to immediate antibiotic prescribing (C) reduce antibiotic use (O) within one week (T)?
• In older adults with dementia (P), does pet therapy (I) compared to no pet therapy (C) decrease agitation (O) after three months (T)?
• In patients with chronic heart failure (P), does telemonitoring of vital signs (I) compared to standard care (C) reduce hospital readmissions (O) within six months (T)?
• In patients with anxiety disorders (P), does exposure therapy (I) compared to cognitive therapy (C) reduce anxiety symptoms (O) after 12 weeks (T)?
• In postpartum women with breastfeeding difficulties (P), does lactation consultation (I) compared to standard care (C) increase breastfeeding rates (O) after four weeks (T)?
• In patients with chronic obstructive pulmonary disease (P), does long-acting bronchodilator therapy (I) compared to short-acting bronchodilator therapy (C) improve lung function (O) after three months (T)?
• In patients with major depressive disorder (P), does bright light therapy (I) compared to placebo (C) reduce depressive symptoms (O) after six weeks (T)?
• In patients with diabetes (P), does telemedicine-based diabetes management (I) compared to standard care (C) improve glycemic control (O) over a period of six months (T)?
• In patients with chronic kidney disease (P), does a low-phosphorus diet (I) compared to a regular diet (C) decrease serum phosphate levels (O) after one year (T)?
• In pediatric patients with acute gastroenteritis (P), does probiotic supplementation (I) compared to placebo (C) reduce the duration of diarrhea (O) within 48 hours (T)?
• In patients with chronic pain (P), does acupuncture (I) compared to sham acupuncture (C) reduce pain intensity (O) after eight weeks (T)?
• In older adults at risk of falls (P), does a home modification program (I) compared to no intervention (C) reduce the incidence of falls (O) over a period of six months (T)?
• In patients with schizophrenia (P), does cognitive remediation therapy (I) compared to standard therapy (C) improve cognitive function (O) after one year (T)?
• In patients with chronic kidney disease (P), does angiotensin-converting enzyme inhibitors (I) compared to angiotensin receptor blockers (C) slow the progression of renal disease (O) over a period of two years (T)?
• In postoperative patients (P), does chlorhexidine bathing (I) compared to regular bathing (C) reduce the risk of surgical site infections (O) within 30 days (T)?
• In patients with type 2 diabetes (P), does a low-carbohydrate, high-fat diet (I) compared to a low-fat diet (C) improve glycemic control (O) over a period of six months (T)?
• In patients with chronic obstructive pulmonary disease (P), does pulmonary rehabilitation combined with telemonitoring (I) compared to standard pulmonary rehabilitation (C) improve exercise capacity (O) after three months (T)?
• In patients with heart failure (P), does a nurse-led heart failure clinic (I) compared to usual care (C) improve self-care behaviors (O) after six months (T)?
• In postpartum women with postnatal depression (P), does telephone-based counseling (I) compared to face-to-face counseling (C) reduce depressive symptoms (O) after eight weeks (T)?
• In patients with chronic migraine (P), does prophylactic treatment with topiramate (I) compared to amitriptyline (C) reduce the frequency of migraines (O) after three months (T)?
• In pediatric patients with acute otitis media (P), does watchful waiting (I) compared to immediate antibiotic treatment (C) reduce the duration of symptoms (O) within seven days (T)?
• In older adults with dementia (P), does reminiscence therapy (I) compared to usual care (C) improve cognitive function (O) after three months (T)?
• In patients with chronic heart failure (P), does telemonitoring combined with a medication reminder system (I) compared to telemonitoring alone (C) reduce hospital readmissions (O) within six months (T)?
• In patients with asthma (P), does self-management education (I) compared to standard care (C) reduce asthma exacerbations (O) over a period of one year (T)?
• In postoperative patients (P), does the use of wound dressings with antimicrobial properties (I) compared to standard dressings (C) reduce the incidence of surgical site infections (O) within 30 days (T)?
• In patients with chronic kidney disease (P), does mindfulness-based stress reduction (I) compared to usual care (C) improve psychological well-being (O) over a period of three months (T)?
• In adult patients with chronic pain (P), does biofeedback therapy (I) compared to relaxation techniques (C) reduce pain intensity (O) after eight weeks (T)?
• In patients with type 2 diabetes (P), does a low-glycemic index diet (I) compared to a high-glycemic-index diet (C) improve glycemic control (O) over a period of six months (T)?
• In patients with chronic obstructive pulmonary disease (P), does regular physical activity (I) compared to no physical activity (C) improve health-related quality of life (O) after three months (T)?
• In patients with major depressive disorder (P), does mindfulness-based cognitive therapy (I) compared to antidepressant medication (C) reduce depressive symptoms (O) after eight weeks (T)?
• In postpartum women (P), does perineal warm compresses (I) compared to standard perineal care (C) reduce perineal pain (O) after vaginal delivery (T)?
• In patients with chronic kidney disease (P), does a low-protein, low-phosphorus diet (I) compared to a low-protein diet alone (C) slow the progression of renal disease(O) after two years (T)?
• In pediatric patients with attention-deficit/hyperactivity disorder (P), does mindfulness-based interventions (I) compared to medication alone (C) improve attention and behavior (O) after six months (T)?
• In patients with chronic pain (P), does cognitive-behavioral therapy (I) compared to physical therapy (C) reduce pain interference (O) after 12 weeks (T)?
• In elderly patients with osteoarthritis (P), does aquatic exercise (I) compared to land-based exercise (C) improve joint flexibility and reduce pain (O) after eight weeks (T)?
• In patients with multiple sclerosis (P), does high-intensity interval training (I) compared to moderate-intensity continuous training (C) improve physical function (O) after three months (T)?
• In postoperative patients (P), does preoperative carbohydrate loading (I) compared to fasting (C) reduce postoperative insulin resistance (O) within 24 hours (T)?
• In patients with chronic obstructive pulmonary disease (P), does home-based tele-rehabilitation (I) compared to center-based rehabilitation (C) improve exercise capacity (O) after six months (T)?
• In patients with rheumatoid arthritis (P), does tai chi (I) compared to pharmacological treatment (C) reduce joint pain and improve physical function (O) after six months (T)?
• In postpartum women with postpartum hemorrhage (P), does early administration of tranexamic acid (I) compared to standard administration (C) reduce blood loss (O) within two hours (T)?
• In patients with hypertension (P), does mindfulness meditation (I) compared to relaxation techniques (C) reduce blood pressure (O) after eight weeks (T)?
• In elderly patients with hip fractures (P), does multidisciplinary geriatric care (I) compared to standard care (C) improve functional outcomes (O) after three months (T)?
• In patients with chronic kidney disease (P), does aerobic exercise (I) compared to resistance exercise (C) improve renal function (O) after six months (T)?
• In patients with major depressive disorder (P), does add-on treatment with omega-3 fatty acids (I) compared to placebo (C) reduce depressive symptoms (O) after 12 weeks (T)?
• In postoperative patients (P), does preoperative education using multimedia materials (I) compared to standard education (C) improve patient satisfaction (O) after surgery (T)?
• In patients with type 2 diabetes (P), does a plant-based diet (I) compared to a standard diet (C) improve glycemic control (O) after three months (T)?
• In patients with chronic obstructive pulmonary disease (P), does high-flow oxygen therapy (I) compared to standard oxygen therapy (C) improve exercise tolerance (O) after three months (T)?
• In patients with heart failure (P), does nurse-led telephone follow-up (I) compared to standard care (C) reduce hospital readmissions (O) within six months (T)?
• In postpartum women with postnatal depression (P), does online cognitive-behavioral therapy (I) compared to face-to-face therapy (C) reduce depressive symptoms (O) after eight weeks (T)?
• In patients with chronic migraine (P), does mindfulness-based stress reduction (I) compared to medication alone (C) reduce the frequency and severity of migraines (O) after three months (T)?
• In older adults with delirium (P), does structured music intervention (I) compared to standard care (C) reduce the duration of delirium episodes (O) during hospitalization (T)?
• In patients with chronic low back pain (P), does yoga (I) compared to physical therapy (C) reduce pain intensity (O) after six weeks (T)?
• In pediatric patients with acute otitis media (P), does watchful waiting with pain management (I) compared to immediate antibiotic treatment (C) reduce the need for antibiotics (O) within one week (T)?
• In patients with schizophrenia (P), does family psychoeducation (I) compared to standard treatment (C) improve medication adherence (O) over a period of six months (T)?
• In patients with chronic kidney disease (P), does a low-phosphorus diet (I) compared to a regular diet (C) slow the progression of renal disease (O) after one year (T)?
• In postoperative patients (P), does wound irrigation with saline solution (I) compared to povidone-iodine solution (C) reduce the incidence of surgical site infections (O) within 30 days (T)?
• In patients with type 1 diabetes (P), does continuous subcutaneous insulin infusion (I) compared to multiple daily injections (C) improve glycemic control (O) over a period of six months (T)?
• In postoperative patients (P), does the use of prophylactic antibiotics (I) compared to no antibiotics (C) reduce the incidence of surgical site infections (O) within 30 days (T)?
• In patients with chronic obstructive pulmonary disease (P), does smoking cessation counseling (I) compared to no counseling (C) decrease the frequency of exacerbations (O) over a period of six months (T)?
• In patients with diabetes (P), does a multidisciplinary team approach (I) compared to standard care (C) improve self-management behaviors (O) over a period of one year (T)?
• In pregnant women with gestational hypertension (P), does bed rest (I) compared to regular activity (C) reduce the risk of developing preeclampsia (O) before delivery (T)?
• In patients with chronic kidney disease (P), does angiotensin-converting enzyme inhibitors (I) compared to placebo (C) slow the progression of renal disease (O) over a period of two years (T)?
• In older adults with hip fractures (P), does early surgical intervention (I) compared to delayed surgery (C) improve functional outcomes (O) after six months (T)?
• In patients with major depressive disorder (P), does exercise (I) compared to antidepressant medication (C) reduce depressive symptoms (O) after eight weeks (T)?
• In children with autism spectrum disorder (P), does applied behavior analysis (I) compared to standard therapy (C) improve social communication skills (O) over a period of one year (T)?
• In postoperative patients (P), does the use of incentive spirometry (I) compared to no spirometry (C) decrease the incidence of postoperative pulmonary complications (O) within seven days (T)?
• In patients with hypertension (P), does a combination of diet modification and exercise (I) compared to medication alone (C) lower blood pressure (O) after six months (T)?
• In patients with chronic obstructive pulmonary disease (P), does home oxygen therapy (I) compared to no oxygen therapy (C) improve exercise capacity (O) after threemonths (T)?
• In patients with heart failure (P), does a multidisciplinary heart failure management program (I) compared to standard care (C) reduce hospital readmissions (O) within six months (T)?
• In postpartum women with postnatal depression (P), does mindfulness meditation (I) compared to relaxation techniques (C) reduce depressive symptoms (O) after eight weeks (T)?
• In patients with chronic kidney disease (P), does a low-sodium diet (I) compared to a regular diet (C) lower blood pressure (O) after six months (T)?
• In pediatric patients with attention-deficit/hyperactivity disorder (P), does neurofeedback training (I) compared to medication (C) improve attention and behavior (O) after six months (T)?
• In patients with chronic pain (P), does transcranial direct current stimulation (I) compared to sham stimulation (C) reduce pain intensity (O) after eight weeks (T)?
• In older adults with osteoporosis (P), does a structured exercise program (I) compared to no exercise (C) improve bone mineral density (O) after six months (T)?
• In patients with type 2 diabetes (P), does a low-carbohydrate, high-protein diet (I) compared to a standard diet (C) improve glycemic control (O) over a period of six months (T)?
• In patients with chronic obstructive pulmonary disease (P), does mindfulness-based stress reduction (I) compared to usual care (C) improve dyspnea symptoms (O) after three months (T)?
• In postpartum women with postnatal depression (P), does online peer support (I) compared to individual therapy (C) reduce depressive symptoms (O) after eight weeks (T)?
• In patients with chronic kidney disease (P), does resistance training (I) compared to aerobic training (C) improve muscle strength (O) after six months (T)?
• In pediatric patients with asthma (P), does a written asthma action plan (I) compared to verbal instructions (C) reduce emergency department visits (O) within six months (T)?
• In patients with chronic pain (P), does yoga (I) compared to pharmacological treatment (C) reduce pain interference (O) after eight weeks (T)?
• In older adults at risk of falls (P), does a multifactorial falls prevention program (I) compared to no intervention (C) reduce the rate of falls (O) over a period of six months (T)?
• In patients with schizophrenia (P), does cognitive-behavioral therapy (I) compared to medication alone (C) reduce positive symptom severity (O) after six months (T)?
• In postpartum women with breastfeeding difficulties (P), does breast massage (I) compared to no massage (C) improve milk flow (O) after four weeks (T)?
• In patients with chronic obstructive pulmonary disease (P), does long-term oxygen therapy (I) compared to short-term oxygen therapy (C) improve survival rates (O) after one year (T)?
• In patients with major depressive disorder (P), does repetitive transcranial magnetic stimulation (I) compared to sham treatment (C) reduce depressive symptoms (O) after six weeks (T)?
• In patients with diabetes (P), does a digital health app (I) compared to standard care (C) improve medication adherence (O) over a period of six months (T)?
• In patients with chronic kidney disease (P), does a low-potassium diet (I) compared to a regular diet (C) lower serum potassium levels (O) after one year (T)?
• In pediatric patients with acute gastroenteritis (P), does oral rehydration solution (I) compared to intravenous fluid therapy (C) reduce hospital admissions (O) within 48 hours (T)?
• In patients with chronic pain (P), does hypnotherapy (I) compared to no hypnotherapy (C) reduce pain intensity (O) after eight weeks (T)?
• In older adults at risk of falls (P), does a tai chi program (I) compared to no exercise program (C) improve balance and stability (O) after six months (T)?
• In patients with chronic heart failure (P), does a home-based self-care intervention (I) compared to standard care (C) reduce hospital readmissions (O) within six months (T)?
• In patients with anxiety disorders (P), does acceptance and commitment therapy (I) compared to cognitive-behavioral therapy (C) reduce anxiety symptoms (O) after 12 weeks (T)?
• In postpartum women with breastfeeding difficulties (P), does the use of nipple shields (I) compared to no nipple shields (C) improve breastfeeding success (O) after four weeks (T)?
• In patients with chronic obstructive pulmonary disease (P), does a comprehensive self-management program (I) compared to usual care (C) improve health-related quality of life (O) after three months (T)?
• In patients with major depressive disorder (P), does internet-based cognitive-behavioral therapy (I) compared to face-to-face therapy (C) reduce depressive symptoms (O) after eight weeks (T)?
• Does the increase in the habit of smoking marijuana among Dutch students increase the likelihood of depression?
• Does the use of pain relief medication during surgery provide more effective pain reduction compared to the same medication given post-surgery?
• Does the increase in the intake of oral contraceptives increase the risk of breast cancer among women aged 20-30 in the UK?
• Does the habit of washing hands among healthcare workers decrease the rate of infections in hospitals?
• Does the use of modern syringes help in reducing needle injuries among healthcare workers in America?
• Does encouraging male work colleagues to talk about sexual harassment decrease the rate of depression in the workplace?
• Does bullying in boarding schools in Scotland increase the likelihood of domestic violence within a 20-year timeframe?
• Does breastfeeding among toddlers in urban United States decrease their chances of obesity as pre-schoolers?
• Does the increase in the intake of antidepressants among urban women aged 30 years and older affect their maternal health?
• Does forming work groups to discuss domestic violence among the rural population of the United States reduce stress and depression among women?
• Does the increased use of mosquito nets in Uganda help in reducing malaria cases among infants?
• Can colon cancer be more effectively detected when colonoscopy is supported by an occult blood test compared to colonoscopy alone?
• Does regular usage of low-dose aspirin effectively reduce the risk of heart attacks and stroke for women above the age of 80 years?
• Is yoga an effective medical therapy for reducing lymphedema in patients recovering from neck cancer?
• Does daily blood pressure monitoring help in addressing the triggers of hypertension among males over 65 years?
• Does a regular 30-minute exercise regimen effectively reduce the risk of heart disease in adults over 65 years?
• Does prolonged exposure to chemotherapy increase the risk of cardiovascular diseases among teenagers suffering from cancer?
• Does breastfeeding among toddlers in the urban United States decrease their chances of obesity as pre-schoolers?
• Are first-time mothers giving birth to premature babies more prone to postpartum depression compared to second or third-time mothers in the same condition?
• For women under the age of 50 years, is a yearly mammogram more effective in preventing breast cancer compared to a mammogram done every 3 years?
• After being diagnosed with blood sugar levels, is a four-times-a-day blood glucose monitoring process more effective in controlling the onset of Type 1 diabetes?

Related: How to write an abstract poster presentation.

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• What is EBP?

Background vs. Foreground

Pico examples, asking different types of questions, pico resources & worksheet.

• Evidence Appraisal
• Clinical Tools and Databases
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Evidence based practice requires that clinicians make use of the best research they can find to help them in decision-making. To find that research efficiently, the clinician must ask a well-designed clinical question with all the elements that will lead to finding relevant research literature.

The first step in doing this is to determine the type of question: background or foreground. The type of question helps to determine the resource to access to answer the question.

Background questions ask for general knowledge about a condition or thing.

• Broaden the scope - "The Forest"
• Provides basics for a a greater grasp of concepts
• Typically found in textbooks, guidelines, point-of-care monographs, encyclopedias, or topic reviews
• A question root (who, what, when, etc.) with a verb
• A disorder, test, treatment, or other aspect of healthcare

The background question is usually asked because of the need for basic information. It is not normally asked because of a need to make a clinical decision about a specific patient.

Foreground questions ask for specific knowledge to inform clinical decisions or actions.

• Focused in scope - "The Trees"
• Requires a grasp of basic concepts to fully comprehend
• Typically found in journals and conference proceedings
• Have 3 or 4 essential components (see PICO below)

PICO is a mnemonic used to describe the four elements of a good clinical foreground question:

P = Population/Patient/Problem - How would I describe the problem or a group of patients similar to mine?

I = Intervention - What main intervention, prognostic factor or exposure am I considering?

C = Comparison - Is there an alternative to compare with the intervention?

O = Outcome - What do I hope to accomplish, measure, improve or affect?

 Fill in the blanks with information from your clinical scenario: THERAPY In_______________, what is the effect of ________________on _______________ compared with _________________?

PREVENTION For ___________ does the use of _________________ reduce the future risk of ____________ compared with ______________? DIAGNOSIS OR DIAGNOSTIC TEST Are (Is) ________________ more accurate in diagnosing _______________ compared with ____________? PROGNOSIS Does ____________ influence ______________ in patients who have _____________? ETIOLOGY Are ______________ who have _______________ at ______________ risk for/of ____________ compared with _____________ with/without______________? MEANING How do _______________ diagnosed with _______________ perceive __________________? Melnyk, B. M., & Fineout-Overholt, E. (2011). Evidence-based practice in nursing & healthcare: A guide to best practice . Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins.

• PubMed PICO Tool
• TRIP Database PICO Builder
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Evidence Based Nursing Practice

• PICO(T) and Clinical Questions
• Literature Review
• Study Design and Methodology
• Documenting EBP
• Additional Sources & Assistance
• MUHC Evidence Based Practice Model

PICO Templates

For an intervention/therapy:

In _______(P), what is the effect of _______(I) on ______(O) compared with _______(C) within ________ (T)?

For etiology:

Are ____ (P) who have _______ (I) at ___ (increased/decreased) risk for/of_______ (O) compared with ______ (P) with/without ______ (C) over _____ (T)?

Diagnosis or diagnostic test:

Are (is) _________ (I) more accurate in diagnosing ________ (P) compared with ______ (C) for _______ (O)?

Prevention:

For ________ (P) does the use of ______ (I) reduce the future risk of ________ (O) compared with _________ (C)?

Prognosis/Predictions

Does __________ (I) influence ________ (O) in patients who have _______ (P) over ______ (T)?

How do ________ (P) diagnosed with _______ (I) perceive ______ (O) during _____ (T)?

Based on Melnyk B., & Fineout-Overholt E. (2010). Evidence-based practice in nursing & healthcare. New York: Lippincott Williams & Wilkins .

Using PICO to Formulate Clinical Questions

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

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.)

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?

More information on formulating PICO questions

Now that we've clarified what we want to know, it will be much easier to find an answer.

Breaking Down Your PICO into a Search Strategy

We can use our PICO statement to list terms to search on.  Under each letter, we'll list all the possible terms we might use in our search. 

P - Community Dwelling:  It is much easier to search on 'hospitalized' than non-hospitalized subjects.  So I would leave these terms for last. It might turn out that I don't need to use them as my other terms from the I, C, or O of PICO might be enough.

community dwelling  OR out-of-hospital

P - adults: I would use the limits in MEDLINE or CINAHL for All Adults.  Could also consider the following depending upon the population you need:

adult OR adults OR aged OR elderly OR young adult

CPR  -  cardiopulmonary resuscitation

I - Hands-only

 hands-only OR compression-only OR chest compression OR compression OR Heart Massage

C - Hands plus breathing Breathing is a tougher term to match.

breathing OR mouth to mouth OR conventional OR traditional

O - Mortality:  If your outcomes terms are general, they may not as useful in the literature search.  They will still be useful in your evaluation of the studies.

mortality OR death OR Survival

Putting it together - a search statement from the above might look like this:

cardiopulmonary resuscitation AND (hands-only OR compression-only OR chest compression OR compression OR Heart Massage) AND (breathing OR mouth to mouth OR conventional OR traditional)

Note that the above strategy is only using terms from the I and the C of PICO.  Depending upon the results, you may need to narrow your search by adding in terms from the P or the O.  

An easy way to keep track of your search strategy is to use a table. This keeps the different parts of your PICO question and their various keywords and subject terms together. This document shows you how to use the tables and provides a few options to organize your table. Use whichever works best for you!  Search Strategy Tables to Break your PICO into Concepts .

PICO and Qualitative Questions

A qualitative PICO question focuses on in-depth perspectives and experiences.  It does not try to solve a problem by analyzing numbers, but rather to enrich understanding through words.  Therefore, the emphasis in qualitative PICO questions is on fully representing the information gathered, rather than primarily emphasizing ways the information can be broken down and expressed through measurable units (though measurability can also play an important role). 

A strength of a qualitative PICO question is that it can investigate what patient satisfaction looks like, for example, instead of only reporting that 25% of patients who took a survey reported that they are satisfied. 

When working with qualitative questions, an alternative to using PICO in searching for sources is the SPIDER search tool.  SPIDER is an acronym that breaks down like this:

P=Phenomena of Interest

E=Evaluation

R=Research Type

Cooke, A., Smith, D., & Booth, A. (2012). Beyond PICO: The SPIDER tool for qualitative evidence synthesis . Qualitative Health Research, 22 (10), 1435-1443. doi:10.1177/1049732312452938

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Nursing research guide.

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What is PICO?

PICO is a formula used to develop a researchable clinical question. 

The purpose of a PICO question is to help breakdown a research question into smaller parts, making the evaluation of evidence more straightforward.

Note: Not every question will have a time frame or a comparison. Outcomes should be a measure of clinical well being/quality of life.

Forming Focused Question with PICO: Case Study

Case: patient education.

• You are a nurse working in a busy inpatient medical surgical unit. The patients on your unit are admitted for a wide variety of conditions: renal, GI, dermatologic, etc.
• All patients admitted that are chronic smokers are given brief counseling by an RN and a self-help brochure about smoking cessation, but no follow up counseling after that.
• You hear your coworkers complaining that they feel like they are wasting their time because they think the patients will resume smoking after discharge.
• You decide you want to find out if this minimal contact intervention works in the long term.

P: Consider when choosing your Patient/Problem/Population

• What are the most important characteristics?
• Relevant demographic factors
• The setting

I: Consider for your Intervention

• What is the main intervention, treatment, diagnostic test, procedure, or exposure?
• Think of dosage, frequency, duration, and mode of delivery

C: Consider for your Comparison

• Inactive control intervention: Placebo, standard care, no treatment
• Active control intervention: A different drug, dose, or kind of therapy

O: Consider for your Outcome

• Be specific and make it measurable
• It can be something objective or subjective

PICO: Putting It Together

Your full PICO question is:

"Among hospitalized chronic smokers, does a brief educational nursing intervention lead to long term smoking cessation [when compared with no intervention]?"

PICO Question Examples

• Infection Control
• Labor & Delivery

Patients on coronary artery bypass graft (CABG) waiting lists often experience anxiety and depression and your nurse manager wants to know if it would be a good idea to reach out to these patients with presurgical home visits and follow-up calls from a specialist cardiac nurse.

P: patients on CABG waiting lists I: program consisting of presurgical home visit and follow-up calls form a specialist cardiac nurse C: no intervention O: decreased patient anxiety and depression  

For patients on CABG waiting lists, does an intervention program consisting of presurgical home visits and follow-up calls from a specialist cardiac nurse lead to decreased patient anxiety and depression [when compared with no intervention]?

You work in the Big City Hospital ICU. Your mechanically ventilated patients sometimes contract nosocomial pneumonia, which leads to costly complications. You want to know if raising the head of the bed lowers the chance of the patient contracting pneumonia compared to letting the patient lie flat on their back.

P: mechanically ventilated ICU patients I: semi-fowlers position C: supine position O: lower incidence of nosocomial pneumonia In mechanically ventilated ICU patients, does positioning the patient in semi-fowlers result in a lower incidence of nosocomial pneumonia when compared to the supine position?

In the past few years, your hospital has installed antibacterial foam dispensers on all the nursing units. You’ve had nurses asking you if the foam is just as effective as washing their hands with water and soap.

P: hospital nurses I: using antibacterial foam C: hand washing with soap and water O: decreased bacteria count In hospital nurses, does antibacterial foam decrease bacteria count on hands as much as hand washing with soap and water?

You’re a new nurse on a labor and delivery unit. You’ve noticed that most women give birth in the lithotomy position at the encouragement of their doctors. However, you’re sure you heard in nursing school that other positions are less likely to lead to deliveries with forceps or a vacuum...or did you? You want to find some literature to back up your claim.

P: laboring women delivering in a hospital I: positions other than the lithotomy position C: lithotomy position O: decreased incidence of assisted deliveries In laboring women delivering in the hospital, do positions other than lithotomy position lead to a decreased incidence of assisted deliveries?

You’re the nurse manager of a NICU unit. One concern of parents of infants receiving tube feedings is being able to successfully breastfeed their child upon discharge. One of your staff nurses asks if it would be helpful to give the infants cup feedings instead of tube feedings during their NICU stay.

P: Infants in the NICU I: cup feeding throughout the hospital stay C: tube feedings throughout the hospital stay O: greater reported success with breastfeeding post-discharge In infants in the NICU, will cup feeding throughout the hospital stay lead to greater success with breastfeeding post-discharge when compared to tube feedings?

You work with patients with advanced cancer and have been taught to suggest pain diaries for your patients as a form of pain management. You’ve been wondering for a while now if these diaries actually improve pain control or make pain worse by making patients more aware of their pain.

P: patients with advanced cancer I: keeping a pain journal C: no intervention O: lower reported pain scores In patients with advanced cancer, does keeping a pain journal result in lower reported pain scores when compared to no intervention?

You work in a pediatrician’s office and give patients their routine vaccinations. The younger children are often fearful of needles, and some of the RNs use toys to distract the patients. You want to know if this technique actually has an effect on the children's pain response.

P: young children I: distraction techniques during immunization C: no intervention O: lower pain scores rated by the Faces pain scale In young children, do distraction techniques during immunization administration using toys result in lower pain scores when compared to no intervention?

You work on an inpatient psychiatric unit. One of your patients with chronic schizophrenia, Joe, normally mumbles to himself, but will occasionally speak to others when residents play games together. Noticing this, you say to a coworker that maybe social skills group training sessions would bring out Joe’s conversational skills. Your coworker shakes her head and says "I don’t think so. Joe is in and out of this hospital, he’s a lost cause."

P: Inpatient chronic schizophrenia patients I: social skills group training sessions C: standard care O: increased conversational skills as evidenced by greater number of interactions with peers In inpatient chronic schizophrenia patients, do social skills group training sessions increase conversational skills when compared to standard care?

A diabetic patient from a nursing home has recently been admitted with a stage III pressure ulcers on his heels. The unit nurses have called you in for a wound consult. You have to choose between standard moist wound therapy and using a wound vac.

P: elderly diabetic with stage III foot ulcers I: negative pressure wound therapy C: standard moist wound therapy O: improved wound healing as measured by pressure ulcer grading system guidelines In elderly diabetic patients with stage III foot ulcers, does negative pressure wound therapy lead to improved wound healing when compared to standard moist wound therapy?

The main concern for most of your patients coming out of anesthesia in your PACU is pain. You want to explore nursing interventions you can use on top of medication administration to decrease pain. One coworker mentions trying to make the PACU feel less clinical by playing soft music to relax patients.

P: PACU patients I: soft music as an adjunct to standard care C: standard care alone O: lower reported pain scores In PACU patients, will playing soft music in the PACU as an adjunct to standard care result in lower reported pain scores when compared to standard care alone?

Example Sources:

• UNC-Chapel Hill Health Sciences Library PICO Examples
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PICO- What's in a queston?

The PICOT question format is a consistent "formula" for developing answerable, researchable questions.

Note: Not every question will have an intervention (as in a meaning question) or time (when it is implied in another part of the question) component.

PICO(T) Templates

Template for Asking PICOT Questions

For an intervention/therapy:

In _______(P), what is the effect of _______(I) on ______(O) compared with _______(C) within ________ (T)?

For etiology:

Are ____ (P) who have _______ (I) at ___ (Increased/decreased) risk for/of_______ (O) compared with ______ (P) with/without ______ (C) over _____ (T)?

Diagnosis or diagnostic test:

Are (is) _________ (I) more accurate in diagnosing ________ (P) compared with ______ (C) for _______ (O)?

Prevention:

For ________ (P) does the use of ______ (I) reduce the future risk of ________ (O) compared with _________ (C)?

Prognosis/Predictions

Does __________ (I) influence ________ (O) in patients who have _______ (P) over ______ (T)?

How do ________ (P) diagnosed with _______ (I) perceive ______ (O) during _____ (T)?

Melnyk B., & Fineout-Overholt E. (2010). Evidence-based practice in nursing & healthcare. New York: Lippincott Williams & Wilkins.

Develop your Research Question

The PICO(T) Question

A clinical question that is composed using the PICO or PICOT format will help you to focus your search and help you to develop your research skills which are essential in finding the best available evidence.

The most common PICO(T) elements are:

P - Population

• How you would describe a group of people with a similar problem or complaint.

I - Intervention

• How you plan to treat, medicate, diagnose and/or observe the patient's care.

C - Comparison (if applicable)

• The main intervention alternative you are considering (i.e. placebo, alternative therapy, different drug, surgery).

O - Outcome

• The result from proposed treatment that is measurable, including improvement of symptoms,no symptoms, or complications.

(T) - Time (if applicable)

• The time frame of treatment and/or measurable outcome.

In order be successful in using Evidence Based Practice (EBP) you will need to learn how to develop well-composed clinical questions.  By formatting your research question in a PICO(T) format you can gather evidence relevant to your patient's problem.   Well-composed PICO(T) questions generally contain up to four components each represented in the acronym  " PICO(T)"  P=Patient or Population and Problem; I=Intervention or Indicator; C=Comparison or Control (not part of all questions); O=Outcome; T=Time or Type.

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• PICO(T) Questions

What is a PICO(T) Question?

Pico(t) question templates, ideas for your pico(t) question, tips for building a pico(t) question, example: pico(t) question and search strategy.

• Pre-Appraised Sources of Evidence
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Asking questions is at the heart of evidence-based practice.

If nurses never asked questions about how to improve patient care based on scientific research evidence, then no beneficial changes or advancements in nursing practice would occur. Cultivating a spirit of inquiry is essential for evidence-based practice implementation.

The  PICO(T) model  is used widely in evidence-based practice to construct a focused, well-built, and searchable clinical question. This page provides you with the following content to guide you in developing a PICO(T) question of your own:

Evidence-based practice (EBP) is a systematic approach to patient care decision-making based on current, best available research evidence. 

The first step in EBP involves re-phrasing a clinical patient care issue in the form of a focused, searchable, and answerable question . 

PICO(T)  is a basic template for creating a well-built clinical question for evidence-based inquiry.

P - Patient/Population/Problem

I - Intervention/Variable of Interest

C - Comparison (can be "standard care" or "usual care", or the opposite of I - "no meditation," "no exposure to smoke", etc.)

O - Outcome(s)

In _____ (P), what is the effect of _____ (I), compared with _____ (C), on _____ (O) within _____ (T)?

There are several templates for developing a PICO(T) question, depending on the nature of your clinical problem.

See the Template for Asking PICO(T) Questions document for examples. 

Identifying a clinical problem that can be translated into a PICO(T) question takes some brainstorming, research, and planning.

The following recommendations can help in triggering ideas for your PICO(T) question:

Problem-Focused or Practice-Focused Triggers:

• Patient cases you have encountered
• Clinical scenarios you have observed
• Quality improvement data
• Other internal data specific to your organization

Knowledge-Focused Triggers:

• Conduct a search of the research literature to identify problems or practice recommendations
• Identify interventions that have been proven effective by previous studies
• Clinical practice guidelines recommendations

Titler, M. G., Kleiber, C., Steelman, V. J., Rakel, B. A., Budreau, G., Everett, L. Q., et al. (2001). The Iowa model of evidence-based practice to promote quality care.  Critical Care Nursing Clinics of North America ,  13 (4), 497-509.

Need some inspiration for PICO(T) questions?

Helpful web resources for PICO(T) question ideas can be accessed below: 

• PICO Questions [from University of Kansas Medical Center] This site provides examples by patient care setting under the "PICO Question Examples" section
• Johns Hopkins - EBP Exemplar Library Explore this database of EBP projects completed by clinicians. Many of these projects include good examples of PICOT questions.
• UToledo DNP Student EBP Projects Access and read the full-text of UToledo DNP students' EBP projects. The PICOT questions utilized in these projects may provide you with inspiration and ideas for your own PICOT.
• Ohio State DNP Final Projects Access and read the full-text of OSU DNP students' EBP projects. The PICOT questions utilized in these projects may provide you with inspiration and ideas for your own PICOT.

PICO(T) Question Example: 

"In adult cancer patients experiencing fatigue (P), what is the effect of meditation (I), compared with standard care (C), on quality of life (O) within 6 months (T)?" 

Building a Database Search Strategy for the PICO(T) Question: 

• A well-built PICO(T) question forms the basis of a database search strategy for finding research literature.
• Concepts from the PICO(T) question are used to construct a comprehensive database search strategy with search terms describing each relevant component of the PICO(T). 
• Relevant elements of your PICO(T) question can be used to develop an initial list of keywords (including synonyms) to use in a database search. The most important parts of a PICO(T) question for searching are the P, I, and O. 
• After developing a list of search terms, you can then begin brainstorming your search strategy for combining terms with OR or AND (this is called Boolean logic ), and using other techniques such as truncation (i.e. a keyword search for  letharg* will also find articles with the term lethargic or lethargy ) or quotes (i.e. a keyword search for "guided imagery" will find articles with that exact phrase)
• VIDEO TUTORIAL:   PICO(T) Question & CINAHL Search Tutorial ( this video, originally created for DNP students, but applicable to all nursing students, demonstrates how to perform a database search for evidence to support a PICOT question using the CINAHL database as an example )

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Nursing Research Guide: Using PICO(T)

• Quick Access
• Intro to EBP
• Clinical Question Types
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The "Silent T" in PICO(T)

Two additional important elements of the well-built clinical question to consider are

• the type of foreground question
• the type of study (methodology)

This information can be helpful in focusing the question and determining the most appropriate type of evidence.

Foreground questions can be further divided into questions that relate to therapy, diagnosis, prognosis, etiology/harm.

• Therapy: Questions of treatment in order to achieve some outcome. May include drugs, surgical intervention, change in diet, counseling, etc.
• Diagnosis:  Questions of identification of a disorder in a patient presenting with specific symptoms.
• Prognosis:  Questions of progression of a disease or likelihood of a disease occurring.
• Etiology/Harm:  Questions of negative impact from an intervention or other exposure.

Knowing the type of foreground question can help you select the best study design to answer your question. You always want to look for the study design that will yield the highest level of evidence. Consult the pyramid on the Study Designs tab (click the image to enlarge it) and the definitions below.

Formulating a Well Built Clinical Question

According to the Centre for Evidence Based Medicine (CEBM) , "one of the fundamental skills required for practising EBM is the asking of well-built clinical questions. To benefit patients and clinicians, such questions need to be both directly relevant to patients' problems and phrased in ways that direct your search to relevant and precise answers."

A well-built clinical foreground question should have 4 - 5 components. The PICO(T) model is a helpful tool that assists you in organizing and focusing your foreground question into a searchable query. Dividing into the PICO elements helps identify search terms/concepts to use in your search of the literature.

P = Patient, Problem, Population (How would you describe a group of patients similar to yours? What are the most important characteristics of the patient?)

I = Intervention, Diagnostic Test, Prognostic Factor, Exposure (What main intervention are you considering? What do you want to do with this patient?)

C = Comparison (Can be no treatment or placebo.) (What is the main alternative to compare with the intervention? Are you trying to decide between two drugs, a drug and no medication or placebo, or two diagnostic tests?)

O= Outcome (What are you trying to accomplish, measure, improve or affect? Outcomes may be disease-oriented or patient-oriented.)

T= Type  (What type of clinical question is this? See the adjacent box on the "Silent T" in PICO(T).

What is a PICO(T) Search

This 8.5 minute video tutorial, created in 2012 for first year medical students at the School of Medicine & Dentistry at URMC, is a short primer on the basic points of formulating clinical questions and searching for evidence to answer those questions.

Branch Librarian at URMC

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Do you want to know whether a Cochrane Review is relevant to you?  

Look for the PICO.  

PICO stands for four different potential components of a health question used in Cochrane Review research: 

• What are the characteristics of the patient or population (demographics, risk factors, pre-existing conditions, etc)? 
• What is the condition or disease of interest?
• What is the intervention under consideration for this patient or population? 
• What is the alternative to the intervention (e.g. placebo, different drug, surgery)? 
• What are the included outcomes (e.g. quality of life, change in clinical status, morbidity, adverse effects, complications)? 

These components give you the specific who, what, when, where and how, of an evidence-based health-care research question.  

The PICO model is widely used and taught in evidence-based health care as a strategy for defining Review criteria, formulating questions and search strategies, and for characterizing included studies or meta-analyses.  

There are three different sorts of PICOs within Cochrane Reviews: 

• Review PICOs - Used to decide which studies to include in a Review. You can find this documented in the Methods section of the Review 
• Comparison PICOs – One Review may have multiple comparisons, which group different parts of the Review PICO in different ways, to answer more specific questions.  
• Included Study PICOs – Each included study has its own PICO which may include additional PICO components, such as other outcomes, that the Review is not interested in. 

See more on using PICO in the Cochrane Handbook for Systematic Reviews of Interventions . 

Find out more about the Cochrane PICO linked data project .

How can I use PICO on the Cochrane Library? 

Pico summaries on cochrane reviews .

For Cochrane Intervention Reviews, we display included PICO terms below the Abstract.  

This gives an at-a-glance summary of Population, Intervention, Comparison, Outcome for the Review as annotated by Cochrane Community experts.  

With one click on a PICO term, users can see search results for Reviews with the same included PICO term. There is also prominent Help material giving clear guidance on using PICOs, linking to the relevant section of the Cochrane Handbook.  

On the Review Information pages, MeSH and PICOs are now grouped together for easy discoverability. 

Read more at Cochrane.org | Find Exactly the Evidence You Need: At-a-Glance PICO Summaries

PICO summaries on search results 

For Intervention Reviews, included PICOs are also displayed on search results.  

Get started with PICO Search on Wiley Customer Success Hub  

Browse by PICO 

You can browse Cochrane content using themed groups of included PICOs from the Cochrane Library and Biblioteca Cochrane homepages.  

Users can discover Cochrane content using themed groups of included PICOs curated and maintained by Cochrane experts. With one click, users can see all available search results for categories with included PICOs. 

In addition, there is clear contextual help for those new to PICOs, with clear guidance on using PICOs and links to the relevant section of the Cochrane Handbook. 

Search by PICO  

PICO search allows you to use those same terms to find Reviews most relevant to your PICO questions. 

For example, the term "Diabetes Mellitus" is cited in Cochrane Reviews in some cases as a Population term, and in other cases as an Outcome term. PICO search allows you to search on the PICO context that you are interested in. 

Read more on PICO search on Cochrane Library    

Read more on PICO Search help

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Evidence-Based Practice: Asking a Clinical Question (PICO)

• Asking a Clinical Question (PICO)
• Levels of Evidence
• Finding the Evidence
• Practice Guidelines
• Appraising the Evidence
• Integrating the Evidence
• Selected EBP Publications

What is PICO(T)

PICO(T) is a mnemonic that stands for:

PATIENT/PROBLEM/POPULATION

INTERVENTION

PICO Resources

• Asking Focused Questions Tips and strategies for asking focused clinical questions more... less... OCEBM
• Asking searchable, answerable clinical questions Fineout‐Overholt, Ellen, and Linda Johnston. "Teaching EBP: Asking searchable, answerable clinical questions." Worldviews on Evidence‐Based Nursing 2, no. 3 (2005): 157-160.
• Evidence-based practice, step by step: asking the clinical question: a key step in evidence-based practice. 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. AJN The American Journal of Nursing, 110(3), 58-61.
• The Well Built Clinical Question Clinical scenarios that walk you through how to turn them into clinical questions. more... less... WS Richardson, MC Wilson, J Nishikawa, RS Hayward. ACP Journal Club. Nov-Dec 1995;123;A12.
• Formulating Answerable Questions Practice answering clinical questions with guided scenarios and step by step instructions.

PICO for MSK Nursing Projects

Are you working on a evidence based project or N-CARE project? Use the PICO(T) format to frame your question.

• Population/ Patient Problem: Who is your patient? (Disease or Health status, age, race, sex) / What is the problem?
• Intervention: What do you plan to do for the patient? (Specific tests, therapies, medications)
• Comparison: What is the alternative to your plan? (ie. No treatment, different type of treatment, etc.)
• Outcome: What outcome do you seek? (Less symptoms, no symptoms, full health, etc.)
• Time:  What is the time frame? (This element is not always included.)

Your PICO(T) question will fall under one of these types:

• Therapy/Prevention

Need Help?  Get assistance from the library -  Literature/PICO Search form !

This easy-to-follow tutorial from the Librarians at the Bodleian Library at Oxford University, in partnership with the Centre for Evidence Based Medicine (CEBM), walks you through an example of turning a clinical research question into PICO format and using that to create search terms.

• << Previous: N-CARE
• Next: Levels of Evidence >>
• Last Updated: Apr 2, 2024 2:01 PM
• URL: https://libguides.mskcc.org/ebp

Nursing Research

• Getting Started
• PICO Questions & Levels of Evidence

Asking a PICO Question

Evaluating the evidence, primary & secondary sources.

• CINAHL Complete
• ScienceDirect
• Citation Searching
• Quantitative & Qualitative Research
• Literature Reviews
• Nursing Theory Resources
• Finding Health Statistics
• APA Style This link opens in a new window

Clinical and nursing practice questions can be broken down into the PICO(T) format, which breaks a question apart into searchable parts:

Population (P)  – what individual or group are we interested in studying? Intervention (I)  – what is the action (intervention, treatment, etc.) we are considering taking? Comparison (C)  – to what other action (intervention, treatment, etc.) are we comparing the considered action? Outcome (O)  – what do we anticipate as the outcome? Time (T)  – how long will it take to reach the outcome?

• Note:  not all PICO(T) questions require the "TIME" component 

Potential PICO(T) Question Formats

In__ [Population] __, how does __ [Intervention] __ compared to __ [Comparison] __ affect __ [Outcome] __ within __ [Time] __ ?

In__ [Population] __, how does __ [Intervention] __ compared to __ [Comparison] __ influence/predict __ [Outcome] __ over __ [Time] __ ?

In__ [Population] __, are/is __ [Intervention] __ compared with __ [Comparison] __ more accurate in diagnosing __ [Outcome] __?

Are __ [Population] __, who have  __ [Intervention] __ compared with those without __ [Comparison] __ at risk for/of  __ [Outcome] __ over __ [Time] __ ?  

Sample PICO Question

Scenario:   A committee decides to conduct a case study to determine whether postoperative gum chewing for abdominal surgery patients can prevent postoperative ileus (lack of intestinal movement).

• P – Patients recovering from abdominal surgery
• I –  Gum chewing
• C – Not chewing gum
• O – Impacts post-operative ileus

PICO Question:  “In patients recovering from abdominal surgery, is there evidence that suggests gum-chewing postoperatively, compared to not chewing gum, impacts postoperative ileus?”

Levels of evidence are assigned to studies based on the methodological quality of their design, validity, and applicability to patient care. The combination of these attributes gives the level of evidence for a study.  In nursing, the system for assigning levels of evidence is often from Melnyk & Fineout-Overholt's 2011 book,  Evidence-based Practice in Nursing and Healthcare: A Guide to Best Practice . 

Depending on their purpose, design, and mode of reporting or dissemination, health-related research studies can be ranked according to the strength of evidence they provide, with the sources of strongest evidence at the top, and the weakest at the bottom:

Secondary Sources: studies of studies

A secondary source summarizes or quotes content from primary sources.

Systematic Review

• Identifies, appraises, and synthesizes all empirical evidence that meets pre-specified eligibility criteria
• Methods section outlines a detailed search strategy used to identify and appraise articles
• May include a meta-analysis, but not required (see Meta-Analysis below)

Meta-Analysis

• A subset of systematic reviews: uses quantitative methods to combine the results of independent studies and synthesize the summaries and conclusions
• Methods section outlines a detailed search strategy used to identify and appraise articles; often surveys clinical trials
• Can be conducted independently, or as a part of a systematic review
• All meta-analyses are systematic reviews, but not all systematic reviews are meta-analyses

Evidence-Based Guideline

• Provides a brief summary of evidence for a general clinical question or condition
• Produced by professional health care organizations, practices, and agencies that systematically gather, appraise, and combine the evidence

Meta-Synthesis or Qualitative Synthesis (Systematic Review of Qualitative or Descriptive Studies)

• a systematic review of qualitative or descriptive studies, low strength level

Primary Sources: original studies

Primary sources are written by the person who originated or is responsible tor generating the ideas published. 

Randomized Controlled Trial

• Experiment where individuals are randomly assigned to an experimental or control group to test the value or efficiency of a treatment or intervention

Non-Randomized Controlled Clinical Trial (Quasi-Experimental)

• Involves one or more test treatments, at least one control treatment, specified outcome measures for evaluating the studied intervention, and a bias-free method for assigning patients to the test treatment

Case-Control or Case-Comparison Study (Non-Experimental)

• Individuals with a particular condition or disease (the cases) are selected for comparison with individuals who do not have the condition or disease (the controls)

Cohort Study (Non-Experimental)

• Identifies subsets (cohorts) of a defined population
• Cohorts may or may not be exposed to factors that researchers hypothesize will influence the probability that participants will have a particular disease or other outcome
• Researchers follow cohorts in an attempt to determine distinguishing characteristics
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Evidence-Based Practice in Nursing: PICO Questions

• What is Evidence-based Practice?
• Process Steps
• PICO Questions
• Searching the Literature
• Levels of Evidence
• Literature Appraisal
• Online Resources

Background and Foreground Questions

Ask background questions   and foreground questions.

• Typically found in textbooks, encyclopedia, or reviews.
• Not normally asked when clinical decisions are needed to be made about a patient.
• Typically found in journals and conference proceedings.
• Require a grasp of the basic concepts from background questions

Formulating a Clinical or PICO Question

How do I Formulate a Clinical, or PICO, Question?

Knowing how to form a PICO question is important for finding evidence. PICO questions focus the scope of your results and help develop keywords to search for evidence. Watch this video to learn more about why PICO questions are important. Also, visit our PICO Research Question Resource Guide to learn more about formulating a PICO question.

Inclusion and Exclusion

Think about inclusion and exclusion criteria to help you select and set boundaries for your searching.

• Certain types of studies.
• Certain geographic locations.
• Published within last 5 years.
• Comparison of certain treatments.
• Use of wrong types of studies.
• Published more than 5 years ago.
• Published in another language (depending on if you can read the language or are looking for articles only pertaining to the U.S.).
• << Previous: Process Steps
• Next: Searching the Literature >>
• Last Updated: Sep 12, 2023 10:51 AM
• URL: https://library.madonna.edu/evidencebasedpractice

• UNC Libraries
• HSL Subject Research
• Forming Focused Questions with PICO

Forming Focused Questions with PICO: About PICO

Created by health science librarians.

What does PICO stand for?

The pico framework, get help with your pico.

• PICO's Limitations
• PICO Examples
• Other Question Frameworks

Additional letters (for PICOT, PICOS, PICOTS, PICOTTS)

• T ype of study

This guide introduces the PICO question framework for evidence-based practice. It explores PICO’s history, purpose, and limitations. This guide also introduces other question frameworks and provides example questions from across many health professions.

PICO and Its History

PICO is an acronym used to remember the key components of a clinical question. Physicians first developed the PICO framework in evidence-based medicine as a way to address knowledge gaps during patient encounters. Questions could arise around a patient’s diagnosis, prognosis, and therapy, as well as around prevention strategies and patient education. Since then, PICO has become the most widely used question framework for evidence-based practice.

The Purpose of PICO

PICO is useful in academic and clinical settings. It can help you:

• form a question that focuses on the most important issue for a patient or a population
• identify key terms to use in a search for evidence
• select results that directly relate to the situation

PICO has some limitations. The framework privileges interventions, experimental research, and dominant voices.

PICO's Limitations

• Example PICO questions Use this worksheet from Sonoma State University to help you structure your PICO question. (Word doc)
• Asking the Well-Built Clinical Question This guide walks you through the steps of EBP from PICO development to appraisal. Developed by UNC and Duke.

Other guides and tools:

• Asking Focused Questions PICO guide from the Centre for Evidence-Based Medicine (CEBM)
• Formulating Answerable Questions Practice developing your PICO questions here.
• Next: PICO's Limitations >>
• Last Updated: May 14, 2024 12:49 PM
• URL: https://guides.lib.unc.edu/pico

• [email protected]

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PICO is required for creating clinical questions in evidence-based research in nursing. Evidence-based research papers constitute a major part of the nursing assignments . In such papers, you need to design your PICO research questions in accordance with the PICO framework. The framework is actually divided into four major elements. 

A good clinical question will address most, if not all, aspects of the PICO.  The following are the parameters defined by PICO (T) when it comes to designing of clinical questions: 

P: Patient, Problem, Population 

I: Intervention 

C: Comparison 

O: Outcome 

T: Time frame, Type of Question, Type of study (this additional parameter is not always present but nonetheless it helps in the determination of a perfect clinical question) 

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These elements will help you define the perfect clinical question for your evidence-based nursing report. You will be required to frame the entire nursing research paper based on this framework. Now if you need assistance with your PICO Research Questions or nursing research homework then do not hesitate to contact us. 

Helpwithassignment.com is the most reliable nursing research assignment help provider. We provide top quality help and assistance to nursing students all across the globe. If you are still worried about framing your perfect clinical question then do not hesitate to contact us expert nursing tutors today. Meanwhile, here is a list of 101 PICO Research Questions for you to get an idea:

101 PICO Research Questions

• Is using toys as distractions during giving needle vaccinations to toddlers an effective pain response management? 
• Do pain diaries work in pain management for cancer patients?
• Is the use of anti-bacterial foam dispensers a healthy choice for the nurses?
• Do bedside shift reports help in the overall patient care for nurses?
• Is the lithotomy position an ideal position for giving birth for women in labor? 
• Is cup feeding an infant is better than feeding through tubes in a NICU set up?
• Does raising the head of the bed of a mechanically ventilated patient reduce the chances of pneumonia? 
• Is home visitation a better way of dealing with teen pregnancy when compared to regular school visits in rural areas?
• What is the result of a higher amount of potassium intake amongst children with low blood pressure?
• Is spironolactone a better drug for reducing the blood pressure of teenagers when compared to clonidine?
• What are the health outcomes of having a high amount of potassium for adults over the age of 21 years?
• Do workout routines actually help patients who are suffering from hypertension?
• Does the intervention of flushing the heroine via lines a more effective way of treating patients with CVLs/PICCs? 
• Nasal swab or nasal aspirate? Which one is more effective for children suffering from seasonal flu? 
• Is the use of intravenous fluid intervention a better remedy for infants under fatal conditions?
• What is the most effective way of cutting down the oxygen saturation levels during oxygen therapy for children suffering from urinary tract infections?
• What is the best way of giving oxygen during the process of oxygenation for children between 2 and 3 months old?
• Does controlling the amount of sublingual sugar help completely conscious children suffering from hypoglycaemia?
• What are the best standards of beginning and ending oxygen therapy?
• Is a wound vac a better alternative compared to a standard moist whilst treating an ulcer for a patient suffering from blood pressure?
• Is negative therapy wound pressure a better therapy when compared to a standard moist for dealing with patients over the age of 60 years?
• Does group therapy help patients with schizophrenia to help their conversational skills?
• What are the probable after effects, in the form of bruises and other injuries, of herapin injection therapy for COPD patients?
• Does music therapy is an effective mode of PACU pain management for patients who are slowly coming out from their anesthesia? 
• Is the intake of zinc pills more effective than Vitamin C for preventing cold during winter for middle-aged women? 
• Is skin-to-skin contact of the infant with the mother a more assured way of ensuring neonatal mortality when compared to drying and wrapping?
• Do non-smoking adults have any risk of oeseophagal cancer?
• Is vitamin K prophylaxis effective in preventing Vitamin K deficiency caused during bleeding in a neonatal?
• What are the roles of a pre-surgery cardiac nurse in order to prevent depression amongst patients awaiting cardiac operation?
• Is medical intervention a proper way of dealing with childhood obesity among school-going children?
• Can nurse-led presentation of mental health associated with bullying help in combating such tendencies in public schools?
• What are the effects of adding beta-blockers for lowering blood pressure for adult men over the age of 70 years? 
• Does the habit of washing hands among healthcare workers decrease the events of infections in hospitals? 
• Is psychological intervention for people suffering from dementia a more effective measure than giving them placebo? 
• What are the measurable effects of extending ICU stays and antibiotic consumption amongst children with sepsis? 
• How is antenatal care effective for pregnant women under the age of 20 years?
• Is fentanyl more effective than morphine in dealing with the pain of adults over the age of 50 years?
• Is new regime exercises effective in preventing fatal heart diseases among women with a family history of cardiac disorder?
• Are alarm sensors effective in preventing accidents in hospitals for patients over the age of 65 years?
• Is using continuous feed during emesis a more effective way of intervention when compared to the process of stopping the feed for a short period of time?
• Is the process of stopping lipids for 4 hours an effective measure of obtaining the desired TG level for patients who are about to receive TPN?
• What is it difficult to detect any C difficile for children below the age of 5 years?
• Is the syringe pump more effective than a kangaroo pump in storing breast milk for pediatric patients?
• What is the usefulness of an LP/spinal tap after the beginning of antivirals for a pediatric population suffering from fever?
• Is an annual mammogram necessary for detecting breast cancer for women over the age of 40 years?
• Is it necessary to test blood glucose level, 4 times a day, for a patient suffering from Type 1 diabetes? 
• Are oral contraceptives effective in stopping pregnancy for women above 30 years?
• Are oral contraceptives more likely to cause blood clotting problems for women above the age of 40 years?
• What are the expected outcomes of pediatric patients with MRSA?
• Are inline suction catheters more effective when compared to regular catheters for reducing the risk of infection?
• What are the uses of insuflon port in herapin therapy for pediatric population?
• Is the process of flushing GT with Pedialyte a healthy measure for the prevention of NA depletion? 
• What are the ethical considerations for providing placebo medication for a pediatric population suffering from mental health issues?
• Is monitoring NJT placement by aspiration is a better method for NJT placement in case of infants?
• What is the average bill-level to offer hyperbili amongst newborn patients? 
• Does the use of MDI derive better results, when compared to regular nebulizers, for pediatric patients suffering from asthma?
• What are the reasons for getting an infant afebrile, for an entire day, before getting a VCUG? 
• Is the sudden change of temperature harmful for patients who are neurologically devastated? 
• What is the accuracy level of oral thermometers when compared to the tympanic thermometer for the pediatric population?
• What are the standards of vital signs for a pediatric population?
• Does psychological intervention help in the increase of self-confidence amongst patients who are suffering from chronic diseases?
• What are the impacts of managing Prevacid before a ph probe study for pediatric patients with GERD? 
• Are cold packs more effective than heat packs for IV infiltrates? 
• Is placing a toddler in a prone situation better in preventing any air leak, considering he/she is using chest tubes?
• What are the impacts of using  an intermittent straight catheter for children suffering from UTI? 
• What is the clinical relation between congenital central hypoventilation syndrome and Hirschsprung?
• Are there any advantages of utilizing TPA in the tubes as a thrombolytic therapy for patients with chest tubes?
• What is the effectiveness of RASKIN protocol for dealing with patients with migraine? 
• What is the significance of using three banks of lights for infants suffering from hyperbilirubinemia?
• Do bilirubin levels decrease faster when more banks of lights are being used for treating infants with hyperbilirubinemia?
• What are the effects of IVF bolus in controlling the amount of Magnesium Sulfate for patients who are suffering from asthma? 
• Are ethanol locks effective in preventing catheter-based infections amongst infants?
• What are the consequences of vaccination amongst children when compared to adults?
• Is the use of infrared skin thermometers justified when compared to the tympanic thermometers for a pediatric population?
• What are the basic protocols of AFB culture for diagnosing patients with tuberculosis?
• Infants suffering from SGS normally throws-up when Imodium is being introduced. What are the alternatives to this?
• Is the use of modern syringes help in the reduction of needle injuries among healthcare workers in America?
• Is the increase in the intake of anti-depressants among 30 years and older urban women affecting their maternal health? 
• What is the direct connection between VAP and NGT?
• Is sodium bicarb absorption better done through tubes when compared to swallowing it? 
• Is the increase of the use of mosquito net in Uganda helped in the reduction of malaria among the infants? 
• Does the increase in the habit of smoking marijuana among Dutch students increase the chances of depression? 
• Does the increase in the intake of oral contraceptives increase the chances of breast cancer among 20-30 years old women in the UK? 
• Is bullying in the boarding schools of Scotland increase the chances of domestic violence in a 20 years’ time frame?
• Does the use of pain relief medication during the process of the surgery reduce the pain more effectively when compared to the intake of the same medicine given post-surgery? 
• Do breastfeeding toddlers in the urban United States decrease their chances of obesity as pre-schoolers? 
•  Does encouraging male work colleagues to talk about sexual harassment decrease the rate of depression in the workplace? 
• Does forming workgroups to discuss domestic violence among the rural population of the United States decrease stress and depression among women? 
• Do peer-supported intervention programs help prevent school suicide rates among female students of New York?
• Is yoga an effective medical therapy in the reduction of lymphedema in patients who are recovering from neck cancer?
• Does receiving phone tweets lower blood sugar levels for people suffering from Type 1 diabetes? 
• Are males over the age of 30 years who have smoked for more than 1 year exposed to greater risk of esophageal cancer when compared to the same age group of men who has no history of smoking? 
• Do women, between the age of 25 and 40 years, who takes regular oral contraceptives are in greater risk of blood clots when compared to the women in the same age group who avoid oral contraceptives?
• For women under the age of 50 years is yearly mammogram more effective in the prevention of breast cancer when compared to the mammogram done every 3 years?
• Are cancer patients receiving aggressive protocols involving radiation and chemotherapy more vulnerable to cachexia when compared to the patients who are not receiving those treatments?
• Can colon cancer be more effectively determined when colonoscopy is supported by an occult blood test when compared to colonoscopy alone?
• Does a regular 30 minutes exercise regime effectively reduce the chances of heart diseases in adults over 65 years?
• Is daily blood pressure monitoring helps in addressing the triggers of hypertension among males over 65 years?
• After diagnosed with blood sugar levels does a 4 times a day blood glucose monitoring process more effective in controlling the advent of Type 1 diabetes?
• Does prolonged exposure to chemotherapy increase the chances of cardiovascular diseases among teenagers who are suffering from cancer?
• Do first-time mothers giving birth to premature babies are more prone to postpartum depression when compared to second or third-time mothers with the same condition?

These are a few examples of the PICO Research Questions which are based on the PICO parameters of population, problem, patient, intervention, comparison, and outcome. You should note that not all the question covers all the parameters of the PICO or PICOT but they most definitely define the outline of the nursing essay help or nursing thesis . If you need help with designing your clinical research question or need help with your nursing assignment , then do not hesitate to contact us today!

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Nursing Research: PICO Clinical Questions

• PICO Clinical Questions
• Levels of Evidence
• Nursing Databases

PICO is an acronym for the four elements that every well-designed clinical question must have when researching evidence-based practices. 

Creating an effective search strategy with pico, there are four key elements required for an effective pico question..

P: Population / Patient

• Who or What?  Patient, Population, Problem.
• How would you describe a group of patients similar to your group?
• What are the most important characteristics of the patient?  Primary problem; disease; co-existing conditions.
• Consider sex, age and/or race of a patient as this may be relevant to the diagnosis or treatment of a disease.

 I: Intervention / Indicator

• Intervention, prognostic factor or exposure - Drug, procedure, diagnostic test, exposure.
• Which main intervention, prognostic factor, exposure are you considering?
• What do you want to do for the patient? Prescribe a drug? Order a test? Order surgery?
• What factor might influence the prognosis of the patient? Age; co-existing problems.
• What exposure has the patient experienced? Asbestos; cigarette smoke.

  C: Comparator / Control

• What is the main alternative?  Comparison or intervention?
• What is the main alternative to compare with the intervention?
• Are you trying to decide between? Two drugs; a drug and no medication or placebo; two diagnostic tests.
• Your clinical question may not always need a specific comparison.

  O: Outcome

• What are you trying to accomplish, measure, improve, effect, achieve?
• What can you hope to accomplish measure, improve or affect?
• What are you trying to do for the patient? Relieve or eliminate the symptoms; reduce the number of adverse events; improve function or test scores.

Clinical problem: A patient asks if drinking carrot juice will reduce the likelihood of developing prostate cancer.

Answerable clinical question:

P - In males

I - Does drinking carrot juice

C - Compared to not drinking carrot juice

O - Reduce the incidence of prostate cancer

Created by Katrina Henderson at Griffith University

Shared under Creative Commons Attribution 4.0 International (CC BY 4.0) license

DiCesno, A., Bayley, L., & Haynes, B. (2009). Accessing pre-appraised evidence: fine-tuning the 5S model into a 6S model. Evidence Based Nursing, 12 (4). https://doi.org/10.1136/ebn.12.4.99-b

eHealth NSW. (2018). Clinical Information Access Portal (CIAP) EBP Learning Modules. https://www.ciap.health.nsw.gov.au/training/ebp-learning-modules/module1/index.html

Glossary of basic statistical terms

Null and alternative hypothesis.

The null and alternative hypotheses are two competing claims that researchers weigh evidence for and against using a statistical test:

• Null hypothesis: There’s no effect in the population.
• Alternative hypothesis: There’s an effect in the population.

(Scribbr, May 6, 2022. Learn more...)

Dependent and Independent Variables

In research, variables are any characteristics that can take on different values, such as height, age, temperature, or test scores. Researchers often manipulate or measure independent and dependent variables in studies to test cause-and-effect relationships.

• The independent variable is the cause. Its value is independent of other variables in your study.
• The dependent variable is the effect. Its value depends on changes in the independent variable.

(Scribbr, Dec. 2, 2022. Learn more...)

Subject variables

Subject variables are characteristics that vary across participants, and they can’t be manipulated by researchers. For example, gender identity, ethnicity, race, income, and education are all important subject variables that social researchers treat as independent variables.

P - In males (independent subject variable)

I - Does drinking carrot juice (independent variable)

C - Compared to not drinking carrot juice (independent variable)

O - Reduce the incidence of prostate cancer (dependent variable)

Bhandari, P. (2022, December 02). Independent vs. Dependent Variables | Definition & Examples. Scribbr. Retrieved April 18, 2023, from https://www.scribbr.com/methodology/independent-and-dependent-variables/

More information on statistical analysis can be found on the Scribbr website: The Beginner's Guide to Statistical Analysis | 5 Steps & Examples  on scribbr.com.

Video Tutorials - Researching Evidence Based Practices

Researching evidence based practices is key to nursing education. These video tutorials provide a step-by-step approach for doing nursing research at Bushnell University.   

• The PICO Question Part 1 of 3. Defining and developing a PICO Question. (4:30)
• Turning PICO Questions into Keywords Part 2 of 3. Using a PICO Question to develop keywords for searching the databases. (6:21)
• Searching CINAHL and MEDLINE Part 3 of 3. Navigating to and getting ready to search the databases. (5:41)
• Using CINAHL and MEDLINE effectively After navigating to the databases, how do you search them effectively? (12:41)
• FEEDBACK FORM Please provide feedback on each video tutorial that you view. The form takes about 2 minutes to complete. Thank you!

Search Strategies

• PICO Keyword Chart Making a PICO question into keywords for database searching with Boolean operators. (blank)

PICOT Research Question Generator

• PICOT Question Generator The PICOT Research Question Generator will help researchers create valid research questions using the PICOT framework. more... less... Created by Eric Heidel, PhD, PStat, Associate Professor of Biostatistics at theUniversity of Tennessee Graduate School of Medicine.
• Next: Levels of Evidence >>
• Last Updated: May 23, 2024 11:29 AM
• URL: https://bushnell.libguides.com/nursing

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NRS 302 - Nursing Research

Pico questions.

• Creating Search Strategies
• Finding Evidence
• APA Style (7th ed.)

PICO questions are a tool used to help you

• Assess your situation or problem. What does your patient need? What is their clinical problem or question?
• Construct a well-built question based on your assessment.
• Search the evidence.

Watch the video and review the examples below to help you develop a PICO question to guide your research proposal.

Download the PICO Question Generator worksheet for a guide:

• PICO Question Generator

Case Example

Rita is an RN who works in a nursing home. One of her patients complains of arthritic pain that is worsening. Her medication doesn't seem to be helping. Rita wonders whether massage therapy would present an effective means of treatment for her patient.

Before Rita can look for sources of literature on the subject, she needs to form a question that will:

• Address all the elements of the problem
• Yield relevant results

Constructing the Question using PICO

The PICO format helps you form an answerable questions that identifies the patient problem, the treatments or tests that are being considered, any alternative treatments or tests (if any), and the desired outcome of the treatment(s).

P = Patient or Problem: Who is your patient? What patient population do they belong to? Are there problems endemic to this population?

I = Intervention or Exposure: Which intervention or treatments are you going to research? What do you want for the patient (a prescription, a test, surgery, etc.)?

C = Comparison or Control: What is the main alternative to compare with the intervention? Is your patient already receiving an intervention? Or none at all (control)?

O = Outcome: What do you hope to accomplish, improve, or achieve? What are you trying to do for the patient?

Case Example Revisited

After assessing the problem and constructing a question using the PICO format, Rita comes up with the following question:

P = Geriatric patients with arthritic pain

I = Massage therapy

C = Patient's prescribed NSAID or similar anti-inflammatory drugs

O = Reduced arthritic pain

Complete clinical question: Do geriatric patients with arthritis who receive regular massage therapy have lessened arthritic pain compared to those that do not?

Another Example

Let's look at another example. You're working with an elderly client who is in a nursing home and experiencing social isolation. You're interested in exploring options to help them cope and connect with their loved ones. While doing some quick background research, you discover the potential for digital communication technology to have an impact on social isolation. Before you can proceed with this, you need to find evidence to support your decision, so forming a PICO question will help you effectively search for relevant literature.

Using what we know from our scenario, let's break it down:

• P:  nursing home residents (population) with social isolation (problem)
• I:  videoconference program with family (intervention to be explored)
• C:  normal family visitation at the nursing home (comparison to the new intervention)
• O:  lessened social isolation (our ideal outcome)

If we piece these components into a complete question, it might sound something like this:

Would a videoconference program (I) improve social isolation (O) amongst nursing home residents (P) compared with traditional visitation (C)?

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Framing different types of clinical questions.

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Using a structured question frame can help you clearly define the concepts or variables that make up the specific research question.  PICO(T) is the most common question frame used in health sciences research, where the question is composed of the:

• What is the problem to be addressed? What are the characteristics of the patient population, or disease of interest?  
• Think of this element as the  dependent variable
• What is the relevant treatment or exposure? What action or change would affect the patient/problem/population?
• Think of this element as the  independent variable
• What is the alternative to the intervention? (A different intervention? The usual standard of care? Not intervening at all?)
• Think of this element like a " control group "
• What are the relevant effects? 
• Think of this element as what is  measured  to show what the intervention has accomplished or improved
• In what time frame should the intervention achieve the outcome?
• What type of study would best address the PICO question?

For example:

"For  adolescents with type II diabetes (P)  does the use of telehealth consultations (I) compared to  in-person consultations   (C)  improve  blood sugar control (O) ?

Different types of clinical questions are suited to different syntaxes and phrasings, but all will clearly define the PICO elements.  The definitions and frames below may be helpful for organizing your question:

Intervention/Therapy

Questions addressing how a clinical issue, illness, or disability is treated.

"In__________________(P), how does__________________(I) compared to_________________(C) affect______________(O)?"

Questions that address the causes or origin of disease, the factors which produce or predispose toward a certain disease or disorder.

"Are_________________(P), who have_________________(I) compared with those without_________________(C) at_________________risk for/of_________________(O) over_________________(T)?" 

Questions addressing the act or process of identifying or determining the nature and cause of a disease or injury through evaluation.

In_________________(P) are/is_________________(I) compared with_________________(C) more accurate in diagnosing_________________(O)?

Prognosis/Prediction:

Questions addressing the prediction of the course of a disease.

In_________________(P), how does_________________(I) compared to_________________ (C) influence_________________(O)?

Questions addressing how one experiences a phenomenon or why we need to approach practice differently.

"How do_________________(P) with_________________(I) perceive_________________(O)?" 

Adapted from: Melnyk, B. M., & Fineout-Overholt, E. (2011). Evidence-based practice in nursing & healthcare: A guide to best practice. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins.

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Capstone and PICO Project Toolkit

• Starting a Project: Overview
• Developing a Research Question
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Defining the Question: Foreground & Background Questions

In order to most appropriately choose an information resource and craft a search strategy, it is necessary to consider what  kind  of question you are asking: a specific, narrow "foreground" question, or a broader background question that will help give context to your research?

Foreground Questions

A "foreground" question in health research is one that is relatively specific, and is usually best addressed by locating primary research evidence. 

Using a structured question framework can help you clearly define the concepts or variables that make up the specific research question. 

 Across most frameworks, you’ll often be considering:

• a who (who was studied - a population or sample)
• a what (what was done or examined - an intervention, an exposure, a policy, a program, a phenomenon)
• a how ([how] did the [what] affect the [who] - an outcome, an effect). 

PICO is the most common framework for developing a clinical research question, but multiple question frameworks exist.

PICO (Problem/Population, Intervention, Comparison, Outcome)

Appropriate for : clinical questions, often addressing the effect of an intervention/therapy/treatment

Example : For adolescents with type II diabetes (P) does the use of telehealth consultations (I) compared to in-person consultations  (C) improve blood sugar control  (O)?

Framing Different Types of Clinical Questions with PICO

Different types of clinical questions are suited to different syntaxes and phrasings, but all will clearly define the PICO elements.  The definitions and frames below may be helpful for organizing your question:

Intervention/Therapy

Questions addressing how a clinical issue, illness, or disability is treated.

"In__________________(P), how does__________________(I) compared to_________________(C) affect______________(O)?"

Questions that address the causes or origin of disease, the factors which produce or predispose toward a certain disease or disorder.

"Are_________________(P), who have_________________(I) compared with those without_________________(C) at_________________risk for/of_________________(O) over_________________(T)?" 

Questions addressing the act or process of identifying or determining the nature and cause of a disease or injury through evaluation.

In_________________(P) are/is_________________(I) compared with_________________(C) more accurate in diagnosing_________________(O)?

Prognosis/Prediction:

Questions addressing the prediction of the course of a disease.

In_________________(P), how does_________________(I) compared to_________________ (C) influence_________________(O)?

Questions addressing how one experiences a phenomenon or why we need to approach practice differently.

"How do_________________(P) with_________________(I) perceive_________________(O)?" 

Adapted from: Melnyk, B. M., & Fineout-Overholt, E. (2011). Evidence-based practice in nursing & healthcare: A guide to best practice. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins.

Beyond PICO: Other Types of Question Frameworks

PICO is a useful framework for clinical research questions, but may not be appropriate for all kinds of reviews.  Also consider:

PEO (Population, Exposure, Outcome)

Appropriate for : describing association between particular exposures/risk factors and outcomes

Example : How do  preparation programs (E) influence the development of teaching competence  (O) among novice nurse educators  (P)?

SPIDER (Sample, Phenomenon of Interest, Design, Evaluation, Research Type)

Appropriate for : questions of experience or perspectives (questions that may be addressed by qualitative or mixed methods research)

Example : What are the experiences and perspectives (E) of  undergraduate nursing students  (S)  in clinical placements within prison healthcare settings (PI)?

SPICE (Setting, Perspective, Intervention/phenomenon of Interest, Comparison, Evaluation)

Appropriate for : evaluating the outcomes of a service, project, or intervention

Example : What are the impacts and best practices for workplace (S) transition support programs (I) for the retention (E) of newly-hired, new graduate nurses (P)?

PCC (Problem/population, Concept, Context)

Appropriate for : broader (scoping) questions

Example : How do nursing schools  (Context) teach, measure, and maintain nursing students ' (P)  technological literacy  (Concept))throughout their educational programs?

Background Questions

To craft a strong and reasonable foreground research question, it is important to have a firm understanding of the concepts of interest.  As such, it is often necessary to ask background questions, which ask for more general, foundational knowledge about a disorder, disease, patient population, policy issue, etc. 

For example, consider the PICO question outlined above:

"For adolescents with type II diabetes does the use of telehealth consultations compared to in-person consultations  improve blood sugar control ?

To best make sense of the literature that might address this PICO question, you would also need a deep understanding of background questions like:

• What are the unique barriers or challenges related to blood sugar management in adolescents with TII diabetes?
• What are the measures of effective blood sugar control?
• What kinds of interventions would fall under the umbrella of 'telehealth'?
• What are the qualitative differences in patient experience in telehealth versus in-person interactions with healthcare providers?
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What is your research question? An introduction to the PICOT format for clinicians

John j. riva.

† Department of Family Medicine, McMaster University, Hamilton, Ontario.

Keshena M.P. Malik

¶ Graduate Student, Department of Rehabilitation Sciences, McMaster University, Hamilton, Ontario.

Stephen J. Burnie

‡ Canadian Memorial Chiropractic College, Toronto, Ontario.

Andrea R. Endicott

£ Senior Policy Analyst, Ontario Chiropractic Association, Toronto, Ontario.

Jason W. Busse

§ Institute for Work & Health, Toronto, Ontario.

* Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, Ontario.

Introduction

Clinicians often witness impressive treatment results in practice and may wish to pursue research to formally explore their anecdotal experiences. The potential to further new knowledge both within the profession and to the greater healthcare system is compelling. An obvious next step for a practitioner considering research is to connect with experienced researchers to convey their idea for a study, who may in turn ask, “What is your research question?” With limited understanding of how to respond, this interaction may result in the first and last experience these clinicians will have with the research community.

It has been estimated that between 1% and 7% of the chiropractic profession in Canada is engaged in research. 1 , 2 Arguably, this low engagement could be the result of practitioners’ perceived importance of research and levels of research literacy and capacity. However, increasing demands for evidence-based approaches across the health system puts pressure on all clinicians to base their decisions on the best available scientific evidence. Lack of clinician representation in research has the probable effect of limiting growth and new developments for the profession. Furthermore, lack of clinician involvement in research complicates the transfer of study findings into practical settings.

The Canadian Institutes of Health Research describes integrated knowledge translation as a process that involves collaboration between researchers and knowledge users at all stages of a research project. 3 This necessitates involvement of clinicians to help in forming a research question, interpreting the results, and moving research findings into practice. This shared effort between clinicians and researchers increases the likelihood that research initiatives will be relevant to practice. 3 Conversely, it has been reported that there is a growing communication gap between clinicians and academics in chiropractic. 4 Clinicians have important practice-related questions to ask, but many may lack the ability to map out their research strategy, specifically in communicating their question in a manner required to develop a research protocol.

David L. Sackett, Officer of the Order of Canada and the founding Chair of Canada’s first Department of Clinical Epidemiology & Biostatistics at McMaster University, highlights the importance of mapping one’s research strategy in exploration of the research question: “one-third of a trial’s time between the germ of your idea and its publication in the New England Journal of Medicine should be spent fighting about the research question.” (personal communication, November 30, 2011) We describe a randomized controlled trial (RCT) example to highlight how clinicians may use existing literature and the PICOT format to formulate a research question on treatment efficacy.

PICOT Defined

The PICOT format is a helpful approach for summarizing research questions that explore the effect of therapy: 5

• (P) – Population refers to the sample of subjects you wish to recruit for your study. There may be a fine balance between defining a sample that is most likely to respond to your intervention (e.g. no co-morbidity) and one that can be generalized to patients that are likely to be seen in actual practice.
• (I) – Intervention refers to the treatment that will be provided to subjects enrolled in your study.
• (C) – Comparison identifies what you plan on using as a reference group to compare with your treatment intervention. Many study designs refer to this as the control group. If an existing treatment is considered the ‘gold standard’, then this should be the comparison group.
• (O) – Outcome represents what result you plan on measuring to examine the effectiveness of your intervention. Familiar and validated outcome measurement tools relevant to common chiropractic patient populations may include the Neck Disability Index 6 or Roland-Morris Questionnaire. 7 There are, typically, a multitude of outcome tools available for different clinical populations, each having strengths and weaknesses.
• (T) – Time describes the duration for your data collection.

RCT Design Example Using PICOT

Dosage effects of spinal manipulative therapy for chronic neck pain.

Neck pain is second in frequency only to low back pain among musculoskeletal complaints reported in the general population and among those presenting to manual therapy providers. 8 , 9 Chronic neck pain (i.e. neck pain lasting longer than 90 days) is a common reason for presenting to a chiropractor’s office, and such patients often receive spinal manipulation or mobilization. 10 Recent systematic reviews of RCTs and prior observational studies have shown increases in cervical range of motion, 11 , 12 and decreases in self-rated neck pain 13 , 14 following cervical spine manipulation. In 2010, the Cochrane systematic review concluded, “Optimal technique and dose need to be determined.” 14

Despite evidence of benefit, there is a limited understanding of the optimal dose for neck manipulation; as such, frequency and duration of this treatment varies greatly between clinicians. Although patient characteristics and clinicians’ beliefs likely account for some of this variation, it seems likely that many cases of mechanical neck pain will require a minimal number of spinal manipulative therapy (SMT) treatments to derive benefit and that no further benefit will result after a certain upper threshold is reached. To properly examine the dose effects of manipulation for neck pain, it is necessary to consider three treatment factors:

• total number of manipulations

A factorial design RCT allows investigators to consider more than one treatment factor at a time and examine possible interactions between them. This trial design allows for determination of, not only, the effects of frequency and duration, but also whether it is more effective to provide a certain number of manipulations over shorter or longer durations (i.e. an interaction between the two factors). Considering a 3x4 factorial design, patients would attend 1, 2, or 3 sessions per week (i.e. the first ’factor’ of frequency) with manipulation provided over a duration of 2 weeks, 4 weeks, 6 weeks, or not at all (i.e. the second ‘factor’ of duration). To improve generalizability of findings, neck manipulation could be performed using standard rotary or lateral break diversified technique, which is the most common manually applied neck manipulation in chiropractic practice. Pain relief is a common concern among patients presenting with neck pain and detection of a resulting difference of 13 mm on the 100mm Visual Analog Scale (VAS) line is considered a clinically important change in intensity for patients with chronic pain. 15

Research Question: In adults with chronic neck pain, what is the minimum dose of manipulation necessary to produce a clinically important improvement in neck pain compared to supervised exercise at 6 weeks?

• (P) – Population: Adults 18 to 60 years of age, with a clinical diagnosis of chronic mechanical neck pain who have not received cervical SMT in the past year. Patients with non-mechanical neck pain or contraindications to cervical manipulation will be excluded.

Frequency and Duration of SMT

• (C) – Comparison: A standardized supervised exercise regimen would be used as an active control group. All subjects, regardless of group assignment, would perform a standardized exercise regime at each session over a period of 6 weeks. Using this strategy, we will be able to minimize the non-specific effects due to attending a clinic.
• (O) – Outcome: Changes in neck pain, measured using the 100mm VAS for pain.
• (T) – Time: The outcome would be measured weekly for 6 weeks.

Clinician input, assuming expertise in the ‘gold standard’ standard rotary or lateral break diversified technique and an ability to teach it, would be helpful during the planning of patient recruitment. Specifically, in leading training initiatives to calibrate each treating chiropractor to deliver his/her manipulation in a similar way (i.e. load, force, angle) and to assist in normalizing communication with study subjects. This standardization, through structured training sessions for those rendering treatment, will help ensure no additional interventions were inadvertently applied (i.e. education, extra advice).

Other Study Designs Amenable to PICOT

The PICOT format example described above represents a factorial RCT methodology that has been informed by the existing literature. While a well-conducted RCT is appropriate for answering many questions on treatment efficacy, they are typically costly, time-consuming and challenging to conduct. Not all research questions that clinicians wish answered are feasible using this research methodology and the use of a PICOT format is also applicable to other study designs.

The clinical research question being asked ideally determines the best research design for a study. A prospective or retrospective cohort design may be an easier methodology to administer in comparison to a RCT; but study results can by affected by confounding due to the comparison of non-randomized groups. Another methodology, used to look for associations between respondent characteristics and outcomes of interest, is a cross-sectional survey. This methodology is faster and less expensive to do in comparison to a RCT since it considers one time-point of individuals in various spectrums of the variables of interest. However, this design can also can be prone to recall problems by respondents who self-report information if investigators ask about events in the past. A case-control study is most appropriate when attempting to identify associations between patient characteristics and outcomes that take a long time to occur or are very rare. For example, the study by Cassidy et al. (2008) looking at risk of vertibrobasilar artery stroke following chiropractic care, whilst more complex in the design approach, used aspects of a case-control methodology. 16

While these study designs are common in clinical research today, they are not exhaustive of all designs available. Systematic reviews will be familiar to most as a study design aimed at summarizing bodies of studies; but other less familiar individual patient focus designs, such as N-of-1 RCT, 17 also exist which are amenable to the PICOT format depending on the research question that is being posed.

Many considerations need to be contemplated in the PICOT formulation: How detailed should the literature search be in breadth and quality level? What study design best fits the research question? Should the patient population include very similar types of patients or will there be more of a real-world wide variety of participants? Will the intervention be very specific and rendered by a clinical expert or will there be a combination of tailored interventions rendered by a non-clinician with a more general skill set? Will the comparison be against usual care (i.e. ‘gold standard’) or a sham placebo procedure? Will the outcomes measured be from validated instruments on a form or more from direct patient verbal communication and will these results be presented in a way most important to clinicians, patients or policy-makers? And if so, what amount of difference and how many patients would be required to both statistically and clinically conclude the intervention was effective? Will measurement of outcomes occur at multiple times or once at 5 days, 6 months or 10 years?

While these considerations are clearly complex and not inclusive of the entire process, to develop a strong research question framed in the PICOT format, it is an important basis to understand both the clinical area of investigation and the current literature that exists. As highlighted by the example above, it is necessary to review the type and quality of research that has already been performed in the area of interest to guide development of a question. When initially synthesizing the literature, some key entry questions to examine include:

• what are the important research questions in the field?
• what has been found?
• what areas need further exploration?
• would the proposed study fill a gap and better an understanding?

In our example design, the literature search identified existing knowledge in the respective area. A recent high-quality Cochrane review reported on previously completed RCTs in the area, strengths and weaknesses of these studies and offered direction as to gaps in current understanding that would benefit from further research exploration. 14 As research is a time consuming and often costly endeavour, building on the best available existing knowledge rather than “re-inventing the wheel” is favourable.

Only after a thorough literature synthesis and investigation into these answers should a research question be formulated – in some instances a systematic review methodology may actually align best with the PICOT framework for your research question. Turning an idea into a good research question requires it to be feasible, interesting, novel, ethical and relevant. 18 This feasibility refers to, not only, resources (time and money), but also to whether there is agreement on the meaning of the research question and to whether everything that needs to be measured can be measured by the study design. The question should be of interest to many in the clinical area to drive both team momentum for the project and dissemination of the results. Generating new knowledge in large existing gaps of healthcare provides the opportunity to help large volumes of patients who previously may have had poorer clinical outcomes. Practically, ethical considerations have to be accounted for in related study designs to ensure subjects are not harmed by the study. Finally, reflection is required on how well the study design will apply to the real world.

A strong research question should always pass the ‘so what?’ test. Who will the research help? What is the benefit? There should be a definitive and strong rationale for the purpose of the research. A well-thought-out focused research question leads directly into hypotheses; the predictions about the nature and direction of the relationship between the variables under study. Hence, the question acts as the foundation of the study.

The importance of moving from studies to empirically supported treatments to evidence-based practices may very well rest on whether or not a clinician views the research as relevant to their daily practice. It is common for clinicians to express frustration that researchers are not asking questions that are of most relevance to practice. Similarly, researchers often find that clinicians have difficulty distilling the important concepts they would like investigated in a way that can be feasibly researched.

To support both clinical and academic interests, an important clinical research question should therefore be one that is developed in conjunction with a diverse team. This expertise should align with the best research methodology available and propose a project feasible to complete through study that will adequately answer the research question asked. In Canada, the Canadian Chiropractic Research Foundation has reported that there are currently 12 university-based research chairs, 15 PhD candidates and 14 Masters students. 19 An opportunity exists to engage these researchers, as well as those from chiropractic schools, in helping to formulate important clinical research questions.

Clinicians interested in research pursuits, related to patient care, should consider the use of a literature search and the PICOT format when engaging clinical researchers. This approach will provide clinicians and researchers an initial basis for mutual understanding, communication and direction to help answer clinical study questions of most relevance.

• Clinicians should frame practice-based research questions in the PICOT format
• Look to existing literature for guidance in the formulation of a research question
• Clinicians have an important role in contributing to the integrated knowledge translation of research studies
• Framing of a research question offers a common language between clinician and researcher discourse

Funding: No funds were received for the preparation of this manuscript. Dr. Busse is funded by a New Investigator Award from the Canadian Institutes of Health Research and Canadian Chiropractic Research Foundation. Dr. Riva is funded by an award from the NCMIC Foundation. Drs. Burnie, Busse, Malik and Riva are members of the McMaster Chiropractic Working Group, which receives in-kind support from the Canadian Chiropractic Association.

Competing Interests: None.

PICO Question Generator

PICO Question Generator can help you come up with a PICO question quickly and effectively! All you need to do is to take 4 simple steps:

• Fill in all the necessary fields.
• Use hints if something is not clear to you.
• Click the “Generate” button.
• Check the result.

🔤 What Is the PICO Question Generator?

📚 pico question types, ✍️ how to develop a pico question, 👩‍⚕️ nursing pico question examples, ✨ pico research question generator: benefits, ❓ pico generator research: faq, 🔗 references.

PICO Question Generator is a perfect online tool for nursing students that can make healthcare research smoother and easier! With the help of our generator, you can come up with a PICO question within a couple of seconds and absolutely for free!

What is a PICO question? It is an effective way to formulate questions that arise in clinical practice. In other words, it is a complex query that assists medical students in conducting evidence-based research and learning more about a subject or problem.

A PICO question, sometimes written as a PICOT question, comprises several elements:

• P – Population, patient, problem.
• I – Intervention.
• C – Comparison or control.
• O – Outcome or objective.
• T – Time frame (optional component).

There are 5 key types of PICO questions. Look at the table below to learn more about them!

If you are looking for a practical guide on formulating a PICO question, this section is for you! Follow the steps below, and the result will not keep you waiting!

• Determine the population or problem. Identify the characteristics of a patient group or the condition of interest.
• Identify the intervention. Choose the exposure or treatment that would affect the patient or problem.
• Specify the alternative intervention. Determine an alternative to your selected intervention. It can be either a different treatment, usual care, or an absence of intervention.
• State the expected outcome. Think of the expected result as something that you and the patient are most concerned about. The outcome should be measurable ; otherwise, you won’t be able to determine whether the treatment works.
• Combine all elements into a question. Finally, put all components together to formulate a complex and concise PICO question.

We have prepared 3 practical examples of what PICO questions should look like. Check them out below!

📄 Example 1: PICO Question for Depression

📄 Example 2: PICO Question for Diabetes

📄 Example 3: PICO Question for Women’s Health

Our PICO Question Generator has so many bonuses for its users!

❓ What Does PICO Question Stand for?

PICO(T) question stands for:

• T – Time frame.

❓ How to Formulate a PICO Question?

• Identify a group of people, patients, or issues.
• Define the intervention.
• Find an alternative intervention.
• Describe the expected outcome.
• Combine all the components in a PICO question.

❓ What Is a Good PICO Question for Nursing?

A good PICO question should meet the following criteria:

• Be specific.
• Include key terms and avoid unnecessary words.
• Aim to find the best practice.
• Find something new in terms of diagnosis, etiology, or therapy.

Updated: Aug 30th, 2023

• Nursing 472: Picking a PICO | Southern Illinois University Edwardsville
• PICOT Research Question | Physiopedia
• Nursing - Graduate: PICOT & Evidence Based Practice | Grand Valley State University
• NRS 302 - Nursing Research | Aultman Health Sciences Library
• PICO(T): Definitions and Examples | Claude Moore Health Sciences Library

The PICOT Question

• Why Does PICOT Matter?
• What is PICOT?
• PICOT Practice
• PICOT & Research
• Additional Resources

What Is It?

PICOT is a clinical search strategy that assists in the decision-making process in evidence-based practice (EBP). It is a specific, foreground question composed of elements that form an acronym. The P stands for patient/population/problem, the I stands for intervention or exposure, the C stands for comparison (standard of care, another intervention, or control/placebo group), and the O stands for outcome (which should be something measurable if possible). Though optional ,  T for time can also be included as an element of your question if your topic or research allows.

What Does It Mean?

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Nursing PICOT Question Examples for BSN, MSN, and DNP nursing students

• November 29, 2023

If you’re a nursing student or researcher, you know the importance of formulating strong PICOT questions for nursing research. These questions, based on the PICO framework, help guide your research and ensure evidence-based practice in the field. To help you get started, we’ve compiled a list of nursing PICOT question examples for BSN, MSN, and DNP students.

Key Takeaways:

• Nursing PICOT questions are essential in nursing research, providing a framework for addressing specific clinical issues.
• The PICO framework (Patient/Problem, Intervention, Comparison, Outcome, Time frame) guides the formulation of PICOT questions.
• Examples of PICOT questions can be tailored to different nursing specialties, such as BSN, MSN, DNP, or health administration.
• These examples include questions related to nursing change projects, evidence-based nursing papers, and advanced nursing practice.
• Using PICOT questions in nursing research promotes evidence-based practice and improves patient outcomes.

Practical Nursing PICOT Question Topics Writing Help

If you need assistance in writing PICOT questions for your nursing research, there are resources available to help you. NursingWriters.net is a nursing writing service that empowers busy nurses to excel in BSN, MSN, and DNP programs by providing expert information and guidance on the different writing and comprehension challenges that they may have. They offer practical nursing PICOT question topics writing help, providing templates and examples that can guide you in formulating your own PICOT questions.

Writing PICOT questions can be a complex task, as they require a strong understanding of the PICO framework and the specific research areas you are addressing. By seeking assistance from nursing writing services like NursingWriters.net, you can save time and ensure that your PICOT questions are well-formulated and aligned with evidence-based practice.

NursingWriters.net understands the unique needs of nursing students and researchers and provides tailored support to help you develop high-quality PICOT questions. Whether you are a BSN, MSN, or DNP nursing student, their resources can help you enhance your research skills and contribute to the advancement of evidence-based practice in nursing.

Benefits of using NursingWriters.net for nursing PICOT questions:

• Expert guidance from experienced nursing professionals
• Access to templates and examples for various research areas
• Assistance in formulating well-structured PICOT questions
• Alignment with evidence-based practice
• Enhancement of research skills and critical thinking abilities

By utilizing the practical nursing PICOT question topics writing help offered by NursingWriters.net, you can streamline your research process and ensure that your PICOT questions are of the highest quality. With their support, you can confidently embark on your nursing research journey and contribute to the advancement of healthcare through evidence-based practice.

Table: Benefits of Using NursingWriters.net for Nursing PICOT Questions

Examples of Nursing Change Project PICOT Questions

When working on a nursing change project, it is important to develop PICOT questions that address specific research areas. These questions help guide the research process and ensure that the project focuses on relevant clinical issues. Here are some examples of PICOT questions related to nursing change projects:

PICOT Question 1

In nurses working in the ICU (P), how does implementing regular hand hygiene training (I) compared to no training (C) affect hospital-acquired infections rates (O)?

PICOT Question 2

Among postpartum women (P), does immediate skin-to-skin contact with the baby (I) compared to delayed skin-to-skin contact (C) result in higher breastfeeding rates (O)?

In the first PICOT question, the focus is on the implementation of regular hand hygiene training for nurses in the ICU and its impact on hospital-acquired infections. The second PICOT question explores the effect of immediate skin-to-skin contact on breastfeeding rates among postpartum women. These examples demonstrate how PICOT questions can be used to address specific areas of nursing change projects.

By formulating PICOT questions that are well-aligned with the goals of the nursing change project, researchers can effectively investigate the impact of interventions and make evidence-based recommendations for improving patient outcomes. These questions provide a structured framework for research and help guide the design, implementation, and analysis of nursing change projects.

Examples of Evidence-Based Nursing Paper PICOT Questions

When conducting evidence-based nursing research, formulating well-crafted PICOT questions is essential. These questions guide the research process and help in addressing specific clinical issues. Here are some examples of evidence-based nursing paper PICOT questions:

Among pediatric patients with asthma (P), does regular use of inhalers (I) compared to no inhaler use (C) result in fewer hospital readmissions (O)?

In elderly patients with chronic pain (P), does the use of acupuncture (I) compared to traditional pain medications (C) result in improved pain management (O)?

These PICOT questions address specific patient populations and interventions, comparing the effectiveness of different approaches. By answering these questions through research, nurses can contribute to evidence-based practice and improve patient outcomes.

As shown in the table above, each PICOT question includes the specific patient/population (P), intervention (I), comparison (C), outcome (O), and time frame (if applicable). These elements provide a clear structure for research studies and help researchers focus on important clinical questions.

Examples of Health Administration Capstone PICOT Questions

Health administration capstone projects require nursing students to address specific healthcare management issues and develop well-defined PICOT questions. These questions guide the research process and help students analyze the impact of interventions on patient outcomes and healthcare delivery. Here are some examples of PICOT questions for health administration capstone projects:

In a hospital setting (P), does implementing electronic health records (I) compared to paper-based records (C) result in improved patient outcomes (O)?

Among healthcare professionals in a primary care setting (P), does implementing a teamwork training program (I) compared to no training (C) result in increased patient satisfaction (O)?

These PICOT questions provide a framework for researching key healthcare administration issues and evaluating the effectiveness of interventions. By exploring the impact of electronic health records and teamwork training programs on patient outcomes and satisfaction, nursing students can contribute to evidence-based practice and enhance healthcare management.

Examples of Nursing PICOT Questions for DNP Students

DNP students, as advanced nursing practitioners, are tasked with developing PICOT questions that address the complexities of advanced nursing practice and patient outcomes. These questions serve as the foundation for evidence-based research and innovation in the nursing field. Here are some examples of PICOT questions that DNP students can explore:

Evaluating Nurse-Led Diabetes Management Programs

In this study, DNP students can investigate the effectiveness of a nurse-led diabetes management program compared to standard care in improving glycemic control among patients with diabetes. This research aims to contribute to the development of comprehensive care strategies for individuals with diabetes.

Exploring Antihypertensive Medications in Pregnant Women with Hypertension

This research focuses on determining the impact of antihypertensive medications compared to no medication use in pregnant women with hypertension. By examining the effects on maternal and fetal outcomes, DNP students can contribute to the development of evidence-based care guidelines for this specific patient population.

As DNP students engage in research and scholarly work, these examples of PICOT questions provide a starting point for their investigations. By addressing important clinical issues and measuring patient outcomes, DNP students can contribute to the advancement of nursing practice and improve the quality of care provided to patients.

Examples of PICOT Questions in Nursing Research

PICOT questions are commonly used in nursing research to guide the formulation of research questions and the design of studies. These questions follow the PICO framework, which stands for Patient/Problem, Intervention, Comparison, Outcome, and Time frame. By using the PICO framework, researchers can ensure that their studies are grounded in evidence-based practice and address specific clinical issues.

Here are some examples of PICOT questions that can be used in nursing research:

In elderly patients with dementia (P), does music therapy (I) compared to no therapy (C) result in reduced agitation and improved mood (O)?

This PICOT question focuses on the use of music therapy as an intervention for elderly patients with dementia. The question seeks to determine whether music therapy is effective in reducing agitation and improving mood compared to no therapy.

Among healthcare workers (P), does regular handwashing (I) compared to using hand sanitizer (C) result in lower rates of healthcare-associated infections (O)?

This PICOT question explores the effectiveness of regular handwashing compared to using hand sanitizer in healthcare workers. The question aims to determine whether handwashing reduces the rates of healthcare-associated infections.

These examples demonstrate how PICOT questions can be used to guide nursing research and address specific clinical issues. By formulating well-designed PICOT questions, nurses can contribute to evidence-based practice and improve patient outcomes.

Examples of PICOT Questions for Nursing Research Papers

In nursing research, developing well-formulated PICOT (Patient/Problem, Intervention, Comparison, Outcome, and Time frame) questions is crucial for conducting meaningful studies and advancing evidence-based practice. Here, we provide some examples of PICOT questions that can guide nursing research papers:

Table: Examples of PICOT Questions for Nursing Research Papers

These examples demonstrate how PICOT questions can focus research efforts and guide the investigation of specific nursing topics. By formulating well-structured PICOT questions, nursing researchers can explore various interventions, comparisons, and outcomes to generate valuable insights for evidence-based nursing practice.

Framing Different Types of Clinical Questions in Nursing

Framing clinical questions is an essential component of nursing research, as it helps guide the investigation process and formulates specific research objectives. The PICO framework is a valuable tool that can be used to develop different types of clinical questions in nursing. These questions address various aspects of patient care, intervention effectiveness, etiology, diagnosis, prognosis, and prediction.

When formulating intervention/therapy questions, researchers can inquire about the effectiveness of specific interventions in addressing certain patient populations or conditions. For example, in patients with diabetes, does regular exercise result in lower blood glucose levels compared to no exercise? This type of question enables researchers to explore the impact of interventions on patient outcomes and develop evidence-based practice guidelines.

Etiology questions aim to identify risk factors or causes of specific conditions or diseases. For instance, researchers may compare smoking habits between pregnant women who delivered prematurely and those who did not to determine if smoking increases the risk of preterm birth. By understanding the underlying causes of health issues, healthcare professionals can develop preventive strategies and interventions to improve patient outcomes.

Diagnosis questions focus on differentiating between various conditions or diseases and determining the most accurate diagnostic methods. An example of a diagnosis question could be comparing the accuracy of an electrocardiogram versus a physical examination in diagnosing myocardial infarction in patients presenting with chest pain. This type of question helps researchers and healthcare providers determine the most effective diagnostic approaches for timely and accurate diagnoses.

The PICO framework is a valuable tool for framing different types of clinical questions in nursing research. It allows researchers to address specific aspects of patient care, intervention effectiveness, etiology, diagnosis, prognosis, and prediction.

Prognosis/prediction questions assess the likelihood of specific outcomes based on different factors or interventions. For example, in patients with heart failure, does medication adherence influence hospital readmission rates? This type of question helps predict patient outcomes and supports healthcare professionals in developing patient-centered care plans.

By utilizing the PICO framework, nursing researchers can address various research questions and contribute to evidence-based practice in the field. Whether investigating intervention effectiveness, exploring etiological factors, diagnosing conditions accurately, or predicting patient outcomes, framing different types of clinical questions is crucial for advancing nursing knowledge and improving patient care.

Advantages of Using PICOT Questions in Nursing Research

PICOT questions are a valuable tool in nursing research, providing several advantages that contribute to the overall success of a study. By following the PICO framework, researchers can ensure that their studies are grounded in evidence-based practice, leading to improved patient outcomes and quality of care.

One of the primary advantages of using PICOT questions is the clear focus they provide. These questions help researchers narrow down their research objectives and address specific aspects of a clinical issue. By clearly defining the patient or problem, intervention, comparison, outcome, and time frame, researchers can design studies that are tailored to answer specific research questions.

Another advantage of using PICOT questions is the promotion of evidence-based practice. By following the PICO framework, researchers ensure that their studies are based on the best available evidence. This helps bridge the gap between research and practice, allowing nurses to provide care that is supported by high-quality evidence and ultimately leads to improved patient outcomes.

Furthermore, using PICOT questions in nursing research contributes to the overall advancement of the nursing profession. By conducting research studies that address specific clinical issues, nurses can contribute to the body of knowledge in the field. This research can help inform future practice guidelines and policies, leading to better care for patients.

In conclusion, developing well-formulated PICOT questions is essential for nursing students and researchers. These questions serve as a framework for conducting research, addressing specific clinical issues, and ultimately improving patient care. By using the PICO framework, nursing students can enhance their research skills and contribute to evidence-based practice in the field of nursing.

NursingWriters.net is a nursing writing service that understands the challenges faced by busy nurses in BSN, MSN, and DNP programs. We provide expert information and guidance on various writing and comprehension challenges, including nursing PICOT questions. Our aim is to empower nurses to excel in their academic pursuits and make a positive impact in their professional practice.

Whether you need assistance with formulating your own nursing PICOT questions or require practical examples for inspiration, our team of experienced writers can provide the support you need. Visit NursingWriters.net today to access our resources and take your nursing research to the next level.

What is the PICO framework for nursing PICOT questions?

The PICO framework stands for Patient/Problem, Intervention, Comparison, Outcome, and Time frame. It is a structure used to formulate nursing research questions.

Where can I find nursing writing services for help with PICOT question topics?

You can find nursing writing services, such as dnpcapstoneproject.com, that offer practical nursing PICOT question topics writing help. They provide templates and examples to guide you in formulating your own PICOT questions.

Can you give examples of PICOT questions for nursing change projects?

Sure! Here are a couple of examples: – In nurses working in the ICU (P), how does implementing regular hand hygiene training (I) compared to no training (C) affect hospital-acquired infections rates (O)? – Among postpartum women (P), does immediate skin-to-skin contact with the baby (I) compared to delayed skin-to-skin contact (C) result in higher breastfeeding rates (O)?

How can PICOT questions be used in evidence-based nursing papers?

PICOT questions play a crucial role in guiding the research process in evidence-based nursing papers. Here are a few examples: – Among pediatric patients with asthma (P), does regular use of inhalers (I) compared to no inhaler use (C) result in fewer hospital readmissions (O)? – In elderly patients with chronic pain (P), does the use of acupuncture (I) compared to traditional pain medications (C) result in improved pain management (O)?

What are examples of PICOT questions for health administration capstone projects?

For health administration capstone projects, you can consider these examples: – In a hospital setting (P), does implementing electronic health records (I) compared to paper-based records (C) result in improved patient outcomes (O)? – Among healthcare professionals in a primary care setting (P), does implementing a teamwork training program (I) compared to no training (C) result in increased patient satisfaction (O)?

Can you provide examples of PICOT questions for DNP students?

Here are some examples of PICOT questions for DNP students: – In patients with diabetes (P), does a nurse-led diabetes management program (I) compared to standard care (C) result in improved glycemic control (O)? – Among pregnant women with hypertension (P), does the use of antihypertensive medications (I) compared to no medication use (C) result in better maternal and fetal outcomes (O)?

How are PICOT questions used in nursing research?

PICOT questions are commonly used in nursing research to guide the formulation of research questions and the design of studies. Here are a couple of examples: – In elderly patients with dementia (P), does music therapy (I) compared to no therapy (C) result in reduced agitation and improved mood (O)? – Among healthcare workers (P), does regular handwashing (I) compared to using hand sanitizer (C) result in lower rates of healthcare-associated infections (O)?

What are examples of PICOT questions for nursing research papers?

Here are a few examples of PICOT questions that can be used in nursing research papers: – In postoperative patients (P), does the use of multimodal pain management (I) compared to traditional pain management (C) result in reduced opioid use and faster recovery (O)? – Among hospitalized children (P), does the presence of parents during pediatric procedures (I) compared to no parent presence (C) result in reduced anxiety and improved patient cooperation (O)?

What are different types of clinical questions that can be framed using the PICO framework?

The PICO framework can be used to frame different types of clinical questions in nursing research. Here are some examples: – Intervention/Therapy: In patients with diabetes (P), does regular exercise (I) compared to no exercise (C) result in lower blood glucose levels (O)? – Etiology: Are women who smoke during pregnancy (P) compared to non-smoking women (C) at higher risk for preterm birth (O)? – Diagnosis: In patients with chest pain (P), is an electrocardiogram (I) compared to a physical examination (C) more accurate in diagnosing myocardial infarction (O)? – Prognosis/Prediction: In patients with heart failure (P), how does adherence to medication (I) compared to non-adherence (C) influence hospital readmission rates (O)?

What are the advantages of using PICOT questions in nursing research?

Using PICOT questions in nursing research offers several advantages, including: – Clear focus: PICOT questions provide a clear focus for research, allowing the researcher to address specific aspects of a clinical issue. – Evidence-based practice: By using the PICO framework, researchers can ensure that their studies are grounded in evidence-based practice. – Improved patient outcomes: By addressing specific clinical issues through research, PICOT questions can contribute to improved patient outcomes and quality of care.

How important is the development of well-formulated PICOT questions in nursing research?

Developing well-formulated PICOT questions is essential for nursing students and researchers. These questions provide a framework for conducting research, addressing specific clinical issues, and improving patient care. By using the PICO framework, nursing students can enhance their research skills and contribute to evidence-based practice in the field.

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Research Nurse

• Madison, Wisconsin
• SCHOOL OF MEDICINE AND PUBLIC HEALTH/DEPARTMENT OF MEDICINE
• Health and Wellness Services
• Staff-Full Time
• Staff-Part Time
• Opening at: Jun 18 2024 at 11:30 CDT
• Closing at: Jul 2 2024 at 23:55 CDT

Job Summary:

The Division of Cardiovascular Medicine within the Department of Medicine at the University of Wisconsin - Madison, School of Medicine and Public Health conducts federally funded NIH or industry sponsored clinical research involving drugs, devices, biologic agents, imaging and breakthrough technologies to improve patient care and outcomes. This position involves coordinating these clinical trials within the division, providing nursing care for research participants and managing the research protocols in collaboration with clinical research coordinators and physician investigators. Typical work schedule is Monday through Friday with very rare time on weekends, evenings or holidays. Find more information on Research within the Division of Cardiovascular Medicine here: https://www.medicine.wisc.edu/cardiovascular-medicine/research-division-cardiovascular-medicine  

Responsibilities:

• 5% Secures and schedules logistics for clinical research projects according to the research plan
• 20% Assists in the recruitment and screening of subjects for clinical studies by conducting physical health assessments
• 10% Provides professional nursing care to patients according to established protocols
• 5% Provides appropriate treatment plan direction and information to study participants
• 10% Serves as main point of contact and liaison to project participants, investigators, research sponsors, and the research team delivering study information in accordance with established research project standards and protocols
• 20% Collects, verifies, and enters data into database and analyzes clinical information data
• 5% Serves a primary point of contact for emergent study participant situations related to adverse effects or complications of the study
• 5% May provide expertise, training, and guidance to the community, peers, and/or students
• 10% Initiate and maintain clinical research regulatory compliance for assigned protocols including but not limited to the IRB approval and regulatory documents per FDA, HHS and GCP guidelines
• 5% Prepare research participant information/consent/authorization
• 5% Assist with development of a comprehensive budget for each clinical research protocol

Institutional Statement on Diversity:

Diversity is a source of strength, creativity, and innovation for UW-Madison. We value the contributions of each person and respect the profound ways their identity, culture, background, experience, status, abilities, and opinion enrich the university community. We commit ourselves to the pursuit of excellence in teaching, research, outreach, and diversity as inextricably linked goals. The University of Wisconsin-Madison fulfills its public mission by creating a welcoming and inclusive community for people from every background - people who as students, faculty, and staff serve Wisconsin and the world. For more information on diversity and inclusion on campus, please visit: Diversity and Inclusion

Preferred Bachelor's Degree Preferred focus in Nursing or other closely related field. Candidates with an Associate's Degree in Nursing are welcome to apply.

Qualifications:

-Previous nursing experience required -Experience in cardiovascular nursing or emergency/urgent care nursing is preferred -Experience in clinical trials, knowledge of good clinical practice, understanding of federal research regulations is preferred

License/Certification:

Preferred BCLS - Basic Life Support Required RN - Registered Nurse - State Licensure And/Or Compact State Licensure

Full or Part Time: 80% - 100% It is anticipated this position requires work be performed in-person, onsite, at a designated campus work location.

Appointment Type, Duration:

Ongoing/Renewable

Minimum $60,000 ANNUAL (12 months) Depending on Qualifications The starting salary for the position is $60,000 but is negotiable based on experience and qualifications. Employees in this position can expect to receive benefits such as generous vacation, holidays, and sick leave; competitive insurances and savings accounts; retirement benefits. Benefits information can be found at ( https://hr.wisc.edu/benefits/ ). SMPH Academic Staff Benefits flyer: ( https://uwmadison.box.com/s/r50myohfvfd15bqltljn0g4laubuz7t0 )

Additional Information:

This position has been identified as a position of trust with access to vulnerable populations. The selected candidate will be required to pass an initial caregiver check to be eligible for employment under the Wisconsin Caregiver Law and every four years. University sponsorship is not available for this position, including transfers of sponsorship. The selected applicant will be responsible for ensuring their continuous eligibility to work in the United States (i.e. a citizen or national of the United States, a lawful permanent resident, a foreign national authorized to work in the United States without the need of an employer sponsorship) on or before the effective date of appointment. This position is an ongoing position that will require continuous work eligibility. UW-Madison is not an E-Verify employer, and therefore, is not eligible to employ F1 STEM OPT Extension participants. If you are selected for this position you must provide proof of work authorization and eligibility to work.

How to Apply:

To apply for this position, please click on the "Apply Now" button. You will be asked to upload a current resume/CV and a cover letter briefly describing your qualifications and experience. You will also be asked to provide contact information for three (3) references, including your current/most recent supervisor during the application process. References will not be contacted without prior notice.

Karen Olson [email protected] 608-263-1544 Relay Access (WTRS): 7-1-1. See RELAY_SERVICE for further information.

Official Title:

Research Nurse(HS042)

Department(s):

A53-MEDICAL SCHOOL/MEDICINE/CARDIOLOGY

Employment Class:

Academic Staff-Renewable

Job Number:

The university of wisconsin-madison is an equal opportunity and affirmative action employer..

You will be redirected to the application to launch your career momentarily. Thank you!

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