Searching for high-quality clinical research evidence – whether you are a nurse or a researcher – can be a daunting task, yet it is an integral part of the evidence-based practice process. One way to streamline the nursing research process for nurses and researchers of all backgrounds is to utilize the PICO search strategy. PICO is a format for developing a good clinical research question prior to starting one’s research. It is a mnemonic used to describe the four elements of a sound clinical foreground question. (Yale University’s Cushing/Whitney Medical Library).
The question needs to identify the patient or population we intend to study, the intervention or treatment we plan to use, the comparison of one intervention to another (if applicable) and the outcome we anticipate. These make up the four elements of the PICO model: Patient/Population/Problem, Intervention, Comparison, Outcome. Additionally, researchers have the option of adding (T) to the PICO formula, capturing the Timeframe of the study (PICO(T).
PICO is a format for developing a good clinical research question prior to starting one’s research.
PICO is a format for developing a good clinical research question prior to starting one’s research.
The PICO process starts with a case scenario from which a question is constructed that is relevant to the case and is phrased in such a way as to facilitate finding an answer. Once a well-structured question is formulated, researchers will be in a better position to search the literature for evidence that will support their original PICO question.
Case Scenario:
You are a Registered Nurse working on a Urology unit. One of your patients is a 55-year-old man who is recovering from abdominal surgery — specifically a laparoscopic prostatectomy. The patient complains of abdominal pain and nausea. His abdomen is distended, and he has no bowel sounds. The physician suspects a paralytic ileus and confirms the diagnosis based on the combination of clinical features and imaging.
At the next Evidence-Based Nursing Practice Committee meeting, you discuss this case. The committee decides to do a case study to determine if there is evidence to suggest that a simple intervention such as chewing gum post-operatively can prevent a post-operative ileus following abdominal surgery.