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PICO is a formula used to develop a researchable clinical question.
The purpose of a PICO question is to help breakdown a research question into smaller parts, making the evaluation of evidence more straightforward.
P: Population, patient, or problem
I: Intervention or indicator
C: Comparison or control
O: Outcome
Note: Not every question will have a time frame or a comparison. Outcomes should be a measure of clinical well-being/quality of life.
P: Population, patient, or problem
Who is the patient or population? (Think demographics: age, sex, gender, race).
What problem or disease or situation are you facing?
I: Intervention or indicator
What do you plan to do for your patient? (medications, diagnostic tests, therapies, procedures)
What intervention is implemented to help make a difference to your patient/population?
C: Comparison or control
What other interventions should be considered? What can we compare our research too?
Is there a control group you would like to compare your intervention with?
O: Outcome
What is the desired or effective outcome of the intervention compared to the control?
Your full PICO question is:
"Among hospitalized chronic smokers, does a brief educational nursing intervention lead to long term smoking cessation [when compared with no intervention]?"
Patients on coronary artery bypass graft (CABG) waiting lists often experience anxiety and depression and your nurse manager wants to know if it would be a good idea to reach out to these patients with presurgical home visits and follow-up calls from a specialist cardiac nurse.
P: patients on CABG waiting lists
I: program consisting of presurgical home visit and follow-up calls form a specialist cardiac nurse
C: no intervention
O: decreased patient anxiety and depression
For patients on CABG waiting lists, does an intervention program consisting of presurgical home visits and follow-up calls from a specialist cardiac nurse lead to decreased patient anxiety and depression [when compared with no intervention]?
You work in the Big City Hospital ICU. Your mechanically ventilated patients sometimes contract nosocomial pneumonia, which leads to costly complications. You want to know if raising the head of the bed lowers the chance of the patient contracting pneumonia compared to letting the patient lie flat on their back.
P: mechanically ventilated ICU patients
I: semi-fowlers position
C: supine position
O: lower incidence of nosocomial pneumonia
In mechanically ventilated ICU patients, does positioning the patient in semi-fowlers result in a lower incidence of nosocomial pneumonia when compared to the supine position?
In the past few years, your hospital has installed antibacterial foam dispensers on all the nursing units. You’ve had nurses asking you if the foam is just as effective as washing their hands with water and soap.
P: hospital nurses
I: using antibacterial foam
C: hand washing with soap and water
O: decreased bacteria count
In hospital nurses, does antibacterial foam decrease bacteria count on hands as much as hand washing with soap and water?
You’re a new nurse on a labor and delivery unit. You’ve noticed that most women give birth in the lithotomy position at the encouragement of their doctors. However, you’re sure you heard in nursing school that other positions are less likely to lead to deliveries with forceps or a vacuum...or did you? You want to find some literature to back up your claim.
P: laboring women delivering in a hospital
I: positions other than the lithotomy position
C: lithotomy position
O: decreased incidence of assisted deliveries
In laboring women delivering in the hospital, do positions other than lithotomy position lead to a decreased incidence of assisted deliveries?
You’re the nurse manager of a NICU unit. One concern of parents of infants receiving tube feedings is being able to successfully breastfeed their child upon discharge. One of your staff nurses asks if it would be helpful to give the infants cup feedings instead of tube feedings during their NICU stay.
P: Infants in the NICU
I: cup feeding throughout the hospital stay
C: tube feedings throughout the hospital stay
O: greater reported success with breastfeeding post-discharge
In infants in the NICU, will cup feeding throughout the hospital stay lead to greater success with breastfeeding post-discharge when compared to tube feedings?
You work with patients with advanced cancer and have been taught to suggest pain diaries for your patients as a form of pain management. You’ve been wondering for a while now if these diaries actually improve pain control or make pain worse by making patients more aware of their pain.
P: patients with advanced cancer
I: keeping a pain journal
C: no intervention
O: lower reported pain scores
In patients with advanced cancer, does keeping a pain journal result in lower reported pain scores when compared to no intervention?
You work in a pediatrician’s office and give patients their routine vaccinations. The younger children are often fearful of needles, and some of the RNs use toys to distract the patients. You want to know if this technique actually has an effect on the children's pain response.
P: young children
I: distraction techniques during immunization
C: no intervention
O: lower pain scores rated by the Faces pain scale
In young children, do distraction techniques during immunization administration using toys result in lower pain scores when compared to no intervention?
You work on an inpatient psychiatric unit. One of your patients with chronic schizophrenia, Joe, normally mumbles to himself, but will occasionally speak to others when residents play games together. Noticing this, you say to a coworker that maybe social skills group training sessions would bring out Joe’s conversational skills. Your coworker shakes her head and says "I don’t think so. Joe is in and out of this hospital, he’s a lost cause."
P: Inpatient chronic schizophrenia patients
I: social skills group training sessions
C: standard care
O: increased conversational skills as evidenced by greater number of interactions with peers
In inpatient chronic schizophrenia patients, do social skills group training sessions increase conversational skills when compared to standard care?
A diabetic patient from a nursing home has recently been admitted with a stage III pressure ulcers on his heels. The unit nurses have called you in for a wound consult. You have to choose between standard moist wound therapy and using a wound vac.
P: elderly diabetic with stage III foot ulcers
I: negative pressure wound therapy
C: standard moist wound therapy
O: improved wound healing as measured by pressure ulcer grading system guidelines
In elderly diabetic patients with stage III foot ulcers, does negative pressure wound therapy lead to improved wound healing when compared to standard moist wound therapy?
The main concern for most of your patients coming out of anesthesia in your PACU is pain. You want to explore nursing interventions you can use on top of medication administration to decrease pain. One coworker mentions trying to make the PACU feel less clinical by playing soft music to relax patients.
P: PACU patients
I: soft music as an adjunct to standard care
C: standard care alone
O: lower reported pain scores
In PACU patients, will playing soft music in the PACU as an adjunct to standard care result in lower reported pain scores when compared to standard care alone?