PICOT and Evidenced-Based Practice
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PICOT and Evidenced-Based Practice
The word PICOT is a mnemonic forming the elements of a clinical research question. The PICOT process begins with the provision of a case scenario and a case question that is designed to elicit an answer. PICOT questions entail (P) patient, population or problem, (I) intervention which means the intervention or treatment being reviewed for consideration, (C) comparison or control which means other interventions that should be deliberated, (O) outcome or objective is the outcome desired or expected and (T) time frame which refers to the period that would be taken to achieve the desired outcome (Schardt et al., 2007).
The PICOT process
The PICOT process entails seven steps:
- Formulating the PICOT question- this is the first step of the PICOT process where the researcher comes up with a research question based on the topic of interest.
Example of a PICOT question
Among intensive care patients (Population), how does frequent repositioning (Intervention) compared with the use of support surfaces (Comparison) lower the prevalence of pressure ulcers’ development (Outcome) within 30 days (Time)?
- The second step is the identification of the keywords for the PICOT question.
P- Intensive care patients
I- Repositioning
C- support-surfaces
O- lowers the prevalence of pressure ulcers
- The third stage is planning the evidence search strategy
This step entails looking into various databases and other reliable and credible sites that can provide information and answers to the formulated research question. One can utilize a database search strategy known as the “query” which is available in databases like PubMed. This database provides two options for narrowing down search results which are health services queries and clinical queries (Melnyk & Fineout-Overholt, 2018). One can also narrow down the search strategy by customizing the search on preferred language, year of publication, type of publication, peer review, and full text. Limiting the search results improves the effectiveness and the rigor of the search results narrowing them down to the most relevant data sources.
- Execute a search
This fourth step entails searching the PICOT elements individually. The search can be achieved through the use of keywords. For example, based on the PICOT statement some of the keywords that can be used include pressure ulcers, repositioning, and sleeping. During the search, one should alternate the use of the words ‘and’ and ‘or’. One can also use synonyms for the keywords used.
- Refining the results
The fifth step entails refining results. During this step, the researcher limits the number of articles searched. This can be achieved by using different strategies like the search of peer-reviewed journals or research documents. One can also set the limit of years of publication which would narrow down the search results.
- Reviewing the content
The sixth step of reviewing the content entails reviewing the research results to check whether the necessary information is available in the searched articles to answer the designed research question. This step is important because if the articles derived do not answer the deigned question, one would be required to carry out another search until they get the most relevant articles.
- Determining if the research results meet the set standards
This is the last step which requires the researcher to check whether the research results provide the best available evidence. It is vital to acknowledge that it would be best to use high-quality evidence as it would be adopted in the clinical settings to improve the patient’s well-being.
Six Types of PICOT Questions
- Therapy questions
Therapy questions are designed to query the effectiveness of interventions as designed to improve the patient’s health outcomes. Some of the interventions offered include surgical procedures, lifestyle changes, medications, and counseling.
- Prevention questions
Prevention questions are questions regarding the efficacy of interventions in preventing diseases and mortality. It is equally important to assess both harms and benefits of interventions.
- Diagnosis questions
Diagnosis questions query the ability of procedures or tests to differentiate between those with medical conditions and those without.
- Prognosis questions
Prognosis questions query the probable causes of patients’ disease or the likelihood that they will develop a certain illness.
- Etiology questions
Etiology questions query the cause of harm brought about by an intervention or exposure to an agent.
- Meaning questions
Meaning questions query patients’ experiences and concerns to ascertain whether the intervention can be generalized to a population with similar characteristics.
PICOT question and evidence-based practice are of paramount importance as they help the researchers to come up with valid research questions which not only influence clinical practice but also which would facilitate the advancement of research. Extensive research could be used to answer clinical queries and promote the adoption of improved clinical practice.
References
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Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins.
Schardt, C., Adams, M. B., Owens, T., Keitz, S., & Fontelo, P. (2007). Utilization of the PICO framework to improve searching PubMed for clinical questions. BMC medical informatics and decision making, 7(1), 1-6.