Searching for proof: Creating and using an actionable PICO question
Clare Hastings PhD, RN, FAAN
Cheryl A. Fisher

Nursing Management
August 2014 
Volume 45  Number 8
Pages 9 - 12
  PDF Version Available!

A clearly stated research question or hypothesis is one of the critical first steps in designing a research study that can actually produce usable results. The question outlines where the study will be conducted, defines the population of interest, and determines the types of interventions that may be tested. It also helps the researcher select the measures that will be used to collect data and sets the stage for analysis methods. The question that guides a search of research evidence to support or refine management practice also plays a key role, similar to a research question, in structuring and guiding the search process. This guiding question is called a PICO question: (P) patient, population, or process of interest, (I) intervention or best practice to be assessed, (C) comparison group or unit, and (O) outcome or effect of interest.A format using the time factor (PICOT) is also sometimes used. The variable of time (T) is helpful if, for example, you're interested in looking at the effect of an intervention over a particular period of time. For example: "In the adult oncology postoperative surgical patient population (P) is patient-controlled analgesia (I) compared with PRN medication (C) more effective (O) within the first 24 hours after surgery (T)?" In this example, the nurse leader is only interested in looking at the first 24 hours after surgery on an inpatient unit, so it's appropriate to use time in the question to help narrow the search. If the time frame isn't an important factor, stay with the PICO question format so as not to limit the search.When developing the PICO question for an evidence-based nursing management issue, the critical task is to ask the question using the correct terminology so that these key words can then be used to create a literature search with useful solutions. It's a challenge to find the most relevant and useful information in the vast sea of databases and Internet information that now exists.1,2 Finding the right information

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