PICOT is an approach for developing a nursing question in a format allowing users to approach different nursing research questions with a benefit of evidence-based practice. It eliminates the potential to assume various inappropriate and including it in the research as it is likely to skew the results to the extent of making them dysfunctional.
PICOT Question Meaning
PICOT is an acronym standing for the following:
P-Population or patient problem: It describes the patient in terms of health status, sex, age and race etc.
I-Intervention: These are the plans for attempting to address the health issues of the patient. These actions include specific tests, medications and therapies.
C-Comparison: Compares alternatives to the plan such as a different type of treatment or an alternative to treating a patient
O-Outcome- Stands for expected results after an intervention. It might be reducing symptoms, eliminating symptoms or attaining full health
T-The 'T' stands for the time it takes for an intervention to achieve the desired outcome or observation of the patients. Time is optional as you can decide to concentrate on PICO only.
A PICOT question falls within one of the intervention:
- Therapy or prevention
PICO question examples for falls
- Considering the EBO project deals with the PICOT question in the patients who are hospitalized on the orthopedic unit (P), the effect of a mal-factorial method with the best intervention (I) is also used, when to compared with the usual care (C) on the rate of falls, the fall injury and patient and staff compliance (O) throughout three months (T) is considered.
- In older adults age 65 and above living in a gated community (P), does exercising at least 3 hours a week (I) compared to having a sedentary lifestyle (C) reduce the incidence and improving the prevention of falls (O) in one year?
- In geriatric patients above the age of 65 years living in long-term care facilities (P), what is the effect of exercise and vitamin D supplementation (I) compared to the lack of exercise and vitamin supplementation (C) on improving muscle stability and balance (O) over the course of four months (T)?
For adult hospitalized patient, (P) does patient education on prevention of falls during admission (I) compared with the normal nursing care (C) reduces the risks of patients falls(O) within 2 months? (T)
1.In a children's ward(P),does hourly rounding(I),compared to daily rounding(C) minimize patient falls(O) within a period of 3 months(T)?
Does high blood pressure(I) increase sugar levels(O)in pregnant women(P) during the last three months of pregnancy(T) as compared to the first three months(C)?
Are old people(P) who have Asthma(I) at more risk of contracting corona virus easily(O) as compared to those without Asthma(C) within the first 72 hours of exposure(T)?
Examples PICO Questions
Patients on coronary artery bypass graft (CABG) waiting lists frequently experience anxiety and depression, and your nurse manager is wondering 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 in order to reduce their anxiety and depression.
Patients on CABG waiting lists are referred to as P.
A presurgical home visit and follow-up phone calls from a cardiac nurse specialist are included in Phase I of the program.
O: decreased patient anxiety and depression as a result of the intervention C: no intervention
Does an intervention program comprising of presurgical home visits and follow-up calls from a specialist cardiac nurse lead to a reduction in patient anxiety and depression [when compared to no intervention] in patients on CABG waiting lists?
You are employed as an intensive care unit (ICU) nurse in a large city hospital. Your mechanically ventilated patients may get nosocomial pneumonia, which can lead to serious problems that are expensive to treat. You're interested in finding out if elevating the head of the bed reduces the likelihood of a patient acquiring pneumonia as compared to allowing the patient to lie on their back.
P: patients in intensive care units who are mechanically ventilated
I: the situation of semi-fowlers
C: supine position
O:The incidence of nosocomial pneumonia has decreased.
When compared to the supine position, does putting the patient in semi-fowlers result in a lower incidence of nosocomial pneumonia in mechanically ventilated intensive care unit patients?
Scenario for Infection Prevention and Control:
Your hospital has placed antibacterial foam dispensers on all of its nursing units over the course of the last few years. Nurses have approached you and inquired as to whether the foam is as effective as cleaning their hands with water and soap.
P: nurses working in a hospital
I: scrubbing hands with antibacterial soap
C: hand cleaning with soap and water
O: a reduction in the number of bacteria
Is antibacterial foam as effective as hand washing with soap and water in reducing the bacteria count on the hands of hospital staff members?
Scenario for Labor and Delivery:
You've just started as a new nurse on a labor and delivery ward. You've probably seen that the majority of women give birth in the lithotomy position, which is encouraged by their physicians. However, you're certain that you learned in nursing school that alternative postures are less likely to result in the use of forceps or a vacuum during deliveries... or did you hear that? You're looking for some supporting documentation for your claim.
P: ladies in labor who are giving birth in a hospital
Positions other than the lithotomy position I: positions other than the lithotomy position C: lithotomy position
The incidence of assisted deliveries has dropped. O:
Do positions other than the lithotomy position in laboring women delivering in the hospital result in a lower rate of assisted births than the lithotomy position?
You work as a nurse manager at a neonatal intensive care unit. One of the main concerns of parents of newborns who are receiving tube feedings is whether or not they will be able to properly nurse their kid once they are discharged. One of your staff nurses inquires as to whether it would be beneficial to give the infants cup feedings rather than tube feedings while they are in the NICU.
P: Neonatal intensive care unit (NICU) patients
I: cup feeding for the duration of the hospitalization
C: tube feedings for the duration of the hospitalization
O: more women have reported success with nursing after being discharged
Is it more likely that infants who receive cup feedings during their hospital stay will have greater success with nursing after discharge when compared to those who receive tube feedings?
As a pain management specialist, you work with cancer patients who have advanced disease and have been instructed to recommend pain diaries to them as a kind of pain treatment. You've been debating whether or not these journals genuinely help patients manage their pain, or whether they actually make it worse by making them more conscious of their discomfort.
P: patients with cancer that has progressed.
I: maintaining a pain journal
C: refraining from intervention
O: reduced reported levels of discomfort
Is it true that keeping a pain journal in patients with advanced cancer results in reduced reported pain scores as compared to not keeping a pain journal?
You work in a pediatrician's office, where you administer immunizations to patients on a regular basis. Younger children are frequently afraid of needles, and some registered nurses utilize toys to distract the youngsters from their fears. You're interested in learning whether or not this strategy has any influence on the children's pain response.
P: children under the age of five
I: distraction tactics during immunization
C: no intervention
O: reduced pain levels as measured by the Faces pain scale I: distraction techniques during immunization
Is it true that utilizing toys to distract children during vaccine administration results in reduced pain levels as compared to no intervention in the case of young children?
You are employed as a psychiatric inpatient unit. Joe, one of your chronic schizophrenia patients, generally mumbles to himself, but he will occasionally speak to others when the residents play games together, according to the staff. Noticing this, you suggest to a coworker that Joe's conversational abilities might be improved through participation in social skills group training sessions. Your coworker sighs and shakes her head, saying "No, I don't believe so. Joe is in and out of this hospital on a regular basis; he's a hopeless case."
Patients with persistent schizophrenia admitted to a psychiatric hospital
I: Social skills group training sessions are being offered.
C: conventional medical treatment As shown by the increased frequency of interactions with peers,
O: improved conversational abilities
When compared to normal care, do social skills group training sessions in an inpatient chronic schizophrenia setting improve conversational abilities in patients with schizophrenia?
Scenario for Wound Care:
A diabetic patient from a nursing home was recently admitted to the hospital with stage III pressure ulcers on his heels, which were caused by diabetes. You've been summoned to the unit for a wound consultation by the unit nurses. A decision must be made between traditional moist wound care and the use of a wound vacuum.
P: a diabetic who is elderly and has stage III foot ulcers.
I: Wound therapy with negative pressure.
C: moist wound therapy as prescribed by the manufacturer.
Pressure ulcer grading system criteria indicate that wound healing has improved.
When compared to traditional moist wound therapy, does negative pressure wound therapy result in enhanced wound healing in senior diabetic patients with stage III foot ulcers?
Pain is the primary worry for the majority of your patients who are recovering from anesthesia in your PACU. You want to learn about nursing interventions that you can use in addition to medication delivery to help you manage your pain. One employee describes attempting to make the PACU feel less clinical by playing gentle music to relax patients in order to make them feel more comfortable.
PACU patients are referred to as P.
I: the use of gentle music as a supplement to routine medical care
C: just standard medical care
O: reduced reported levels of discomfort
Is it possible that playing gentle music in the PACU as an adjunct to standard care will result in lower reported pain scores in PACU patients as compared to standard care alone in this population?
Picot Question Ideas
A PICOT question format idea should be a consistent formula to develop researchable and answerable questions. The process of finding and evaluating evidence will be more straightforward when you create a good PICOT question. PICOT questions should bring multiple concepts that relate to a research topic or a specific clinical situation together. For simple formulation you can have a PICOT question in these two categories:
Qualitative questions:Aim at gaining an understanding or discover the meaning of phenomena.These questions ask about the experience of a person or population regarding certain circumstances or situations.
Quantitative questions:these are questions that compare two or more individuals sometimes groups based on different outcomes with an aim at discovering the cause and effect relationships. The results of quantitative questions are associated with interventions or exposures.Forming a question using the PICO framework requires deeper thinking about the type of question to ask. It should either focus on therapy, diagnosis, prognosis, etiology or prevention to give the question a particular domain.
PICO Question Examples
It will be a time-consuming and difficult venture to identify the most appropriate resources and find relevant evidence without a well-focused question. PICO helps to form a question and facilitate quick and wider literature search.PICO framework helps to identify the main elements of a question and simplify writing a question statement. These are some examples of PICO questions that fit to the framework.
Does hand washing by healthcare providers reduce transmission of hospital-acquired infections? The question first into PICO elements
C-Alternative to hand washing such as wearing a mask or gloves
Do turning bedridden patients reduce the risk of pressure ulcers than pressure mattresses?
P-Pressure ulcers in bedridden patients
I-Turning a patient
O-Prevent pressure ulcers
How do pregnant women diagnosed with obesity prefer dietary changes or workout to reduce weight during pregnancy and six weeks postpartum?
P-women diagnosed with diabetes
PICO (T) questions should have four concepts or components that help in making a clinical decision. A PICOT question should compare interventions or actions by healthcare professionals as they care for patients. The purpose is to identify and decide on the most beneficial intervention. Most of the PICO questions address diagnosis and interventions.