NUR 45200: Quality & Safety in Professional Nursing Practice: PICO Questions

5-minute video provides an overview of:

1. how to formulate a PICO question,
2. put together a search strategy to use in library databases,
3. and locate sources based on the desired level of evidence (LOE).

Effectiveness Questions (PICO)

P = Population / Patient / Problem: Group of people or issue of concern 
I = Intervention: Treatment or action taken 
C = Comparison / Control:  A different intervention OR control group (usual care / no intervention)
O = Outcome: Specific effect(s) of the intervention or what matters to the nurse and patient
T = Timeframe (if applicable)

Meaningfulness Questions (PICo)

P = Population: The group of people that are of concern in the question
I = Phenomenon of Interest: Events or experiences being studied 
Co = Context: Primary conditions and background circumstances involved
T = Timeframe (if applicable)

Tips & Reminders:

• PICO questions do not have to be written in P-I-C-O order. 
• Comparison is not required for PICO questions; if you are comparing an intervention or phenomenon with usual care or a control group, e.g. comparing intervention vs. no intervention taken, you do not have to include a Comparison element in the question unless it improves clarity.
• If you are Comparing two different interventions, these are your primary variables for the study and as such they need to be related and measurable against each other. Using the scientific method, you want to make sure you are comparing "apples to apples" in order for your conclusions to be valid and unbiased. 

Intervention/Therapy Effectiveness:

In _______(P), what is the effect of _______(I) on ______(O) compared with _______(C) within ________ (T)?

In _______(P), how effective is _______(I) compared with _______(C) on ______(O) over ________ (T)?

Etiology:

Are ____ (P) who have _______ (I) at ___ (Increased/decreased) risk for/of_______ (O) compared with ______ (P) with/without ______ (C) over _____ (T)?

Diagnosis or Diagnostic Test:

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/Predictions:

Does __________ (I) influence ________ (O) in patients who have _______ (P) over ______ (T)?

Meaning:

How do ________ (P) diagnosed with _______ (I) perceive ______ (Co) during _____ (T)?

 - Adapted from Melnyk B., & Fineout-Overholt E. (2010). Evidence-based practice in nursing & healthcare. New York: Lippincott Williams & Wilkins

When creating the PICO question, it is important to focus on topics relevant to nursing practice. 

Below are examples of nursing related questions:

Intervention/Effect/Therapy PICO Question:

In adult patients with total hip replacements (P) how effective is early ambulation (I) compared to bed rest (C) on decreasing post-op DVTs (O)?

Note: The question may also appear as:

What is the effectiveness of early ambulation (I), compared to bed rest (C), on decreasing post-op DVTs (O) in adult patients with total hip replacements (P)?

Meaning PICo Question:

How do pregnant women (P) newly diagnosed with diabetes (I) experience reporting their blood sugar levels (Co) to their healthcare providers?