To make your case, start with a PICOT question
Ilia M. Echevarria MS, MSN, RN, CCRN, CHES, NEA-BC
Susan Walker DrNP, RN-BC

February 2014 
Volume 44  Number 2
Pages 18 - 19
  PDF Version Available!

AT THE MONTHLY staff meeting, Steve's nurse manager Janis is reviewing sternal wound infection metrics for the unit. Because cardiac surgical site infections have increased, she's discussing possible reasons and solutions. Recalling an article he'd read recently, Steve suggests using chlorhexidine bath wipes to reduce surgical site infections.Janis says, "The wipes are just too expensive. We can't commit to purchasing the wipes when we aren't even sure they'd work." Other staff members have heard conflicting information about chlorhexidine wipes and believe they're not recommended for cardiac patients.Feeling strongly about the benefits of chlorhexidine wipes, Steve asks Janis to trial the product. She says that if he can produce literature supporting his argument, she'll consider purchasing the wipes for a trial. Steve hasn't done a literature search since he was in nursing school and isn't sure how to begin.What's the optimum way to find the best evidence? This article will help nurses get started by forming a clinical or researchable question with an evidence-based practice framework: A well-constructed PICOT question helps find the best evidence available to influence practice.1 PICOT is an acronym for five key components to a clinical research question. (See PICOT, point by point.) The question should be formulated before starting a literature search.Finding the best possible evidence requires nurses to formulate a clinical question systematically.2 First, they need to consider the two types of questions. * Background questions are broad ones commonly answered in textbooks. These questions typically begin with what or when. For example, "What are the signs and symptoms of digoxin toxicity?" When answered, background questions enhance general knowledge. Background questions serve as a foundation for foreground questions. * Foreground questions are specific to a clinical issue. When these questions are answered, they provide evidence for clinical decision making.1

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