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Development of PICO(T) Question and PICO(T) Template essay assignment
What is the effectiveness of early ambulation, compared to bedrest, on decreasing post-op DVTs n adult patients with total hip replacements.
Your PICO question must address questions related to nursing and improving patient outcomes. Questions that are outside the scope of nursing practice are not acceptable. Examples of not acceptable PICO’s for this course: comparison of drug efficacy, diagnostic procedures and surgical procedures that do not directly related to nursing and improved patient outcomes. Remember, your PICO must be within the scope of nursing practice at a BS level.
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Limit the scope of your PICO question to aid in identifying key words, assisting in searching, and helping identify the “keeper” studies.
Recognize there are many Hierarchies of Evidence, Levels of Evidence schematics, and Grading of Evidence. The important point is that you cite the source you are using. For this course, we recommend the information in the AJN “Steps” series to avoid confusion.
Use the template provided in the readings to develop your question. Most questions will be of a quantitative nature. Qualitative questions (the meaning or experience of…) i.e. much more difficult to complete in five weeks.
Question Templates for Asking PICO Questions (Melnyk B. & Fineout-Overholt E. (2011). Evidence-based practice in nursing & healthcare. New York: Lippincott Williams & Wilkins)
Question Templates for Asking PICO Questions (Melnyk B. & Fineout-Overholt E. (2005).
Evidence-based practice in nursing & healthcare. New York: Lippincott Williams & Wilkins)
P: Population/disease ( i.e. age, gender, ethnicity, with a certain disorder)
I: Intervention or Variable of Interest (exposure to a disease, risk behavior, prognostic factor) C: Comparison: (could be compared to current standard practice)
O: Outcome: (risk of disease, accuracy of a diagnosis, rate of occurrence of adverse outcome)
(T): over what period of time, ( ie, within 6 months). This is an optional component.
PICO Template:
For an intervention/effect/therapy:
In (P), what is the effectiveness of (I) compared with (C)? on the (O) within (T)
For etiology:
Are (P) who have (I) at (Increased/decreased) risk for/of (O) compared with (P) with/without (C)?
Diagnosis or diagnostic test: (Must be within the scope of RN-BS practice)
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:
Does (I) influence (O) in patients who have (P)?
Meaning:
How do (P) diagnosed with (I) experience (O)?
Examples of Evidence-Based PICO Questions
Intervention/Effect/Therapy PICO Question: An example: In adult patients with total hip replacements (Patient population) how effective is early ambulation (Intervention of interest) compared to bedrest (Comparison intervention) on decreasing post-op DVTs (Outcome)?
Note: The question may also be stated as What is the effectiveness of early ambulation, compared to bedrest, on decreasing post-op DVTs n adult patients with total hip replacements.
Meaning PICO Question: How do pregnant women (P) newly diagnosed with diabetes
(I) experience reporting their blood sugar levels (O) to their healthcare providers?