Question

PICOT is utilized by the health care community to identify and study a nursing or medical practice problem. Consequently, PICOT examples that may provide insight into the use of the PICOT process, may not be relevant to nursing practice as they are based on a medical practice problem.

Describe the difference between a nursing practice problem and a medical practice problem. Provide one example of each. Discuss why is it important to ensure your PICOT is based on a nursing practice problem.

Answer 1

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.)

Example:

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

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

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

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

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

Our PICO statement would look like:

P - community dwelling adults

I - hands only CPR

C - hands plus breathing CPR

O - mortality