PICO(T) Questions and an Evidence-Based Approach

Description

Unformatted Attachment Preview

1
Create a 3-5 page submission in which you develop a PICO(T) question for the
diagnosis you worked with in the first two assessments and evaluate the evidence you
locate, which could help to answer the question.
Expand All
Introduction
PICO(T) is an acronym that helps researchers and practitioners define aspects of a
potential study or investigation.
It stands for:
● P – Patient/population/problem.
● I – Intervention.
● C – Comparison (of potential interventions, typically).
● O – Outcome(s).
● T – Time frame (if time frame is relevant).
The end goal of applying PICO(T) is to develop a question that can help guide the
search for evidence (Boswell & Cannon, 2015). From this perspective, a PICO(T)
question can be a valuable starting point for nurses who are starting to apply an
evidence-based model or EBPs. By taking the time to precisely define the areas in
which the nurse will be looking for evidence, searches become more efficient and
effective. Essentially, by precisely defining the types of evidence within specific areas,
the nurse will be more likely to discover relevant and useful evidence during their
search. When applying the PICO(T) approach, the nurse can isolate the interventions of
2
interest and compare to other existing interventions for the evidenced impact on the
outcome of the concern.
You are encouraged to complete the Vila Health PICO(T) Process activity before you
develop the plan proposal. This activity offers an opportunity to practice working through
creating a PICO(T) question within the context of an issue at a Vila Health facility. These
skills will be necessary to complete Assessment 3 successfully. This is for your own
practice and self-assessment and demonstrates your engagement in the course.
Reference
Boswell, C., & Cannon, S. (2015). Introduction to nursing research. Jones & Bartlett
Learning.
Professional Context
As a baccalaureate-prepared nurse, you will be responsible for locating and identifying
credible and scholarly resources to incorporate the best available evidence for the
purposes of enhancing clinical reasoning and judgement skills. When reliable and
relevant evidence-based findings are utilized, patients, health care systems, and
nursing practice outcomes are positively impacted.
PICO(T) is a framework that can help you structure your definition of the issue, potential
approach that you are going to use, and your predictions related to the issue. Word
choice is important in the PICO(T) process because different word choices for similar
concepts will lead you toward different existing evidence and research studies that
would help inform the development of your initial question. When writing a
3
PICO(T)-formatted research question, you want to focus on the impact of the
intervention and the comparison on the outcome you desire.
Scenario
For this assessment, please use the diagnosis you worked with in the first two
assessments.
Instructions
After reviewing the materials you created to research a specific diagnosis in the first two
assessments, apply the PICO(T) process to develop a research question and research
it.
Your initial goal is to define the population, intervention, comparison, and outcome. In
some cases, a time frame is relevant and you should include that as well, when writing
a question you can research related to your issue of interest. After you define your
question, research it, and organize your initial findings, select the two sources of
evidence that seem the most relevant to your question and analyze them in more depth.
Specifically, interpret each source’s specific findings and best practices related to your
chosen diagnosis, and explain how the evidence would help you plan and make
decisions related to your question.
If you need some structure to organize your initial thoughts and research, the PICOT
Question and Research Template document (accessible from the “Create PICO(T)
Questions” page in the Capella library’s Evidence Based Practice guide) might be
helpful.
In your submission, make sure you address the following grading criteria:
4
● Define a practice issue to be explored via a PICO(T) approach. Create a
PICO(T)-formatted research question
● Identify sources of evidence that could be potentially effective in answering a
PICO(T) question (databases, journals, websites, etc.).
● Explain the findings from articles or other sources of evidence as it relates to
the identified health care issue.
● Explain the relevance of the findings from chosen sources of evidence to
making decision related to a PICO(T) question.
● Communicate using writing that is clear, logical, and professional with correct
grammar and spelling using the current APA style.
Example Assessment: You may use the following to give you an idea of what a
Proficient or higher rating on the scoring guide would look like:
● Assessment 3 Example [PDF]
● Download Assessment 3 Example [PDF]
Additional Requirements
Your assessment should meet the following requirements:
● Length of submission: Create a 3-5 page submission focused on defining a
research question and interpreting evidence relevant to answering it.
● Number of references: Cite a minimum of four sources of scholarly or
professional evidence that support your findings and considerations.
Resources should be no more than 5 years old.
5
● APA formatting: Format references and citations according to the current
APA style.
Portfolio Prompt: Remember to save the final assessment to your ePortfolio so that
you may refer to it as you complete the final capstone course.
Competencies Measured
By successfully completing this assessment, you will demonstrate your proficiency in
the course competencies through the following assessment scoring guide criteria:
● Competency 1: Interpret findings from scholarly quantitative, qualitative, and
outcomes research articles and studies.
○ Explain the findings from articles or other sources of evidence that
are relevant to the health care issue.
● Competency 2: Analyze the relevance and potential effectiveness of evidence
when making a decision.
○ Identify sources of evidence that could be potentially effective in
answering a PICO(T) question.
○ Explain the relevance of the findings from chosen sources of
evidence to making decision related to a PICO(T) question.
● Competency 3: Apply an evidence-based practice model to address a
practice issue.
○ Define a practice issue to be explored via a PICO(T) approach and
develop a PICO(T)-formatted research question.
6
● Competency 5: Apply professional, scholarly communication strategies to
lead practice changes based on evidence.
○ Organize content so ideas flow logically with smooth transitions;
contains few errors in grammar/punctuation, word choice, and
spelling.
○ Apply APA formatting to in-text citations and references exhibiting
nearly flawless adherence to APA format.
PICO(T) Questions and an Evidence-Based
Approach Scoring Guide
NON-P
DISTIN
ERFO
CRITERIA
PROFI
GUISH
BASIC
RMAN
CIENT
ED
CE
Define a
Does
Identifi
Define
Define
practice
not
es a
sa
sa
define
practic
practic
practic
a
e
e issue
e issue
practic
issue,
to be
to be
issue to
be
7
explored
e issue
but
explore
explore
via a
to be
does
d via a
d via a
explore
not
PICO(
PICO(
d via a
frame it
T)
T)
PICO(
within
approa
approa
h and
T)
the
ch.
ch.
develop
approa
context
Develo
Develo
ch.
of a
ps a
ps a
PICO(
PICO(
PICO(
T)
T)-form
T)-form
questio
atted
atted
ed
n or
researc
researc
research
approa
h
h
ch.
questio
questio
n.
n.
PICO(T)
approac
a
PICO(T)
-formatt
question
.
Notes
how
the
explora
tion of
the
practic
8
e issue
will
benefit
from a
PICO(
T)
approa
ch.
Identify
Does
Attemp
Identifi
Identifi
sources
not
ts to
es
es
identify
identify
source
source
source
source
s of
s of
s of
s of
eviden
eviden
e that
eviden
eviden
ce that
ce that
could be
ce that
ce, but
could
could
could
does
potenti
be
be
not
ally be
potenti
potenti
connec
effectiv
ally
ally
t them
e in
effectiv
effectiv
to the
answer
e in
of
evidenc
potential
ly
effective
in
9
answeri
ng a
PICO(T)
question
.
e in
PICO(
ing a
answer
answer
T)
PICO(
ing a
ing a
questio
T)
PICO(
PICO(
n, or
questio
T)
T)
the
n.
questio
questio
connec
n.
n.
tion is
Presen
unclear
ts
.
criteria
or
rational
used to
determi
ne
potenti
al to
answer
the
PICO(
T)
10
questio
n.
Explain
Does
Lists
Explain
Explain
the
not
the
s the
s the
explain
finding
finding
finding
the
s from
s from
s from
finding
articles
articles
articles
articles
s from
or
or
or
or other
articles
other
other
other
or
source
source
source
other
s of
s of
s of
source
eviden
eviden
eviden
s of
ce, but
ce that
ce that
e that
eviden
does
are
are
are
ce that
not
relevan
relevan
are
offer a
t to the
t to the
relevan
full
health
health
findings
from
sources
of
evidenc
relevant
to the
health
t to the
care
health
issue.
Notes
11
care
care
explan
care
which
issue.
issue
ation.
issue.
source
s are
the
most
credibl
e.
Explain
Does
Identifi
Explain
Explain
the
not
es the
s the
s the
explain
relevan
relevan
relevan
the
ce of
ce of
ce of
relevan
the
the
the
findings
ce of
finding
finding
finding
from
the
s from
s from
s from
finding
chosen
chosen
chosen
s from
source
source
source
chosen
s of
s of
s of
source
eviden
eviden
eviden
s of
ce, but
ce to
ce to
does
making
making
relevanc
e of the
chosen
sources
of
evidenc
12
eviden
not
decisio
decisio
ce.
offer a
n
n
full
related
related
explan
to a
to a
ation of
PICO(
PICO(
to a
how it
T)
T)
PICO(T)
relates
questio
questio
to the
n.
n.
e to
making
decision
related
question
.
PICO(
Notes
T)
which
questio
finding
n.
s are
the
most
relevan
t or
likely to
lead to
positiv
e
13
outcom
es.
Organiz
Does
Attemp
Organi
Organi
e
not
ts to
zes
zes
organiz
organiz
content
content
e
e
so
with a
content
content
ideas
clear
flow
so
with
flow
purpos
logically
ideas
some
logicall
e.
flow
logical
y with
Conten
logicall
flow
smooth
t flows
y with
and
transiti
logicall
smooth
smooth
ons;
y with
ns;
transiti
transiti
contain
smooth
contains
ons.
ons.
s few
transiti
Contai
Contai
errors
ons
ns
ns
in
using
errors
several
gramm
cohere
gramma
in
errors
ar/punc
nt
r/punctu
gramm
in
tuation,
paragr
content
so ideas
with
smooth
transitio
few
errors in
14
ation,
ar/punc
gramm
word
aphs,
word
tuation,
ar/punc
choice,
correct
word
tuation,
and
gramm
choice,
word
spellin
ar/punc
and
choice,
g.
tuation,
spellin
and
word
g.
spellin
choice,
g.
and
choice,
and
spelling.
free of
spellin
g
errors.
Apply
Does
Applies
Applies
Exhibit
APA
not
APA
APA
s strict
apply
formatti
formatti
and
APA
ng to
ng to
flawles
formatti
in-text
in-text
s
in-text
ng to
citation
citation
adhere
citations
headin
s,
s and
nce to
gs,
headin
referen
APA
formattin
g to
15
and
intext
gs and
ces
formatti
referenc
citation
referen
exhibiti
ng of
s, and
ces
ng
headin
referen
incorre
nearly
gs,
ces.
ctly
flawles
intext
g nearly
Does
and/or
s
citation
flawless
not use
inconsi
adhere
s, and
quotes
stently,
nce to
referen
or
detracti
APA
ces.
paraph
ng
format.
Quotes
rase
noticea
and
correctl
bly
paraph
y.
from
rases
the
correctl
content
y.
es
exhibitin
adheren
ce to
APA
format.
.
Inconsi
stently
uses
headin
gs,
quotes
16
and/or
paraph
rasing.
Use the resources linked below to help complete this assessment.
Expand All
PICO(T) Process
The resources below explore the PICO(T) process:
● Abbade, L. P. F., Wang, M., Sriganesh, K., Jin, Y., Mbuagbaw, L., & Thabane,
L. (2017). The framing of research questions using the PICOT format in
randomized controlled trials of venous ulcer disease is suboptimal: A
systematic survey. Wound Repair & Regeneration, 25(5), 892-900.
○ This article presents a study that examined the use of PICO(T)
questions to locate evidence related to specific types of resources
and research.
● Ho, G. J., Liew, S. M., Ng, C., Shunmugam, R., & Glasziou, P. (2016).
Development of a search strategy for an evidence based retrieval service.
PLoS One, 11(12), 1-14.
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0167170
17
○ This article presents a study comparing the use of PICO(T)
questions in a literature search to other search strategies.
This first two chapters in the following text, of which the Capella library has limited
copies, could be helpful in expanding your knowledge regarding the PICO(T) process.
● Boswell, C., & Cannon, S. (2020). Introduction to nursing research. Jones &
Bartlett Learning.
Communicating Research
The resources below explore communicating research:
● Bullington, J., Söderlund, M., Elisabeth Bos Sparén, Kneck, Å., Omérov, P., &
Cronqvist, A. (2019). Communication skills in nursing: A
phenomenologically-based communication training approach. Nurse
Education in Practice, 39, 136-141.
○ This article presents the approach to communication in clinical
situations and also discusses the barriers related to nurses sharing
and communicating.
● Gutiérrez-Puertas, L., Márquez-Hernández, V.,V., Gutiérrez-Puertas, V.,
Granados-Gámez, G., & Aguilera-Manrique, G. (2020). Educational
interventions for nursing students to develop communication skills with
patients: A systematic review. International Journal of Environmental
Research and Public Health, 17(7), 2241.
○ This article provides preliminary evidence of the effectiveness of
interventions used to train nursing students in patient-centered
18
communication. Although all the interventions obtained significant
results in communication skills, it has not yet been determined
which methodology is more effective.
Program Resources and Library Resources
Writing Resources
A variety of writing resources are available in the NHS Learner Support Lab, linked in
the courseroom navigation menu. Access these resources to help you better
understand and improve your writing.
APA Style and Format
Capella University follows the style and formatting guidelines in the Publication Manual
of the American Psychological Association, known informally as the APA manual. Refer
to the Writing Center’s APA Module for tips on proper use of APA style and format.
Library Resources
Access the following library resources:
● BSN Program Library Research Guide.
○ The library research guide will be useful in guiding you through the
Capella library, offering tips for searching the literature and other
references for your assessments.
● Databases A-Z: Nursing Health Sciences.
○ This is a list of the library databases that are relevant to nursing
and health sciences.
● Evidence-Based Practice in Nursing Health Sciences.
19
○ Library guide to EBP-related topics with a focus on nursing and
health sciences.
● Find Scholarly Peer-Reviewed Sources.
○ Guide to help you more efficiently locate scholarly and
peer-reviewed resources.
● Get Critical Search Skills.
○ This guide offers a five-step approach to improving your research
search effectiveness.
Case Studies
If you choose not to use a problem from your practice experience as the basis of this
assessment, consider reviewing the following case studies:
● National League for Nursing. (n.d.). ACE.D unfolding cases.
https://www.nln.org/education/teaching-resources/professional-developmentprogramsteaching-resourcesace-all/ace-d/unfolding-cases
● National League for Nursing. (n.d.). Unfolding cases: Advancing care
excellence for seniors.
http://www.nln.org/professional-development-programs/teaching-resources/ac
e-s
.
1
Using a PICO(T) Framework and Evidence to Develop Care Practices
Learner’s Name
Capella University
NURS-FPX4030: Making Evidence-Based Decisions
Instructor Name
August, 2020
Copyright ©2019 Capella University. Copy and distribution of this document are prohibited.
2
Using a PICO(T) Framework and Evidence to Develop Care Practices
When developing care practices for patients, the PICO(T) research framework, which
expands to Population/Patient, Intervention, Comparison, Outcome, and Time, can be used to
create an effective care plan and ensure that patients’ needs are met. Relying on secondary
research, the author of this paper will define a practice issue surrounding patients with dementia,
apply the PICO(T) process, identify sources of evidence that may provide answers to the
research question, explain key findings from articles, and explain the relevance of those key
findings.
Use of the PICO(T) Approach when Caring for Patients with Dementia
The practice issue identified for resolution is the need to develop care practices that
effectively manage agitation in patients with dementia in nursing homes that are outside of
pharmacological approaches. The question being explored is: Is the non-pharmacological
approach, specifically an intervention approach, more effective than the pharmacological
approach in managing behavioral symptoms (such as agitation) in patients with dementia?
The intervention approach identified is person-centered care or patient-centered care
(PCC), an approach that emphasizes more on an individual’s experiences and the communication
of his or her needs than on the pure implementation of a health care provider’s expertise (Desai,
et al., 2017). The population being studied are patients with dementia with agitative behavioral
symptoms in nursing homes. As the objective is to explore care practices that address this issue,
only factors related to care in nursing homes are considered. The study does not take into
consideration cultural, political, and social factors (Kim & Park, 2017).
Identification of Sources of Evidence
DICE Model
Copyright ©2019 Capella University. Copy and distribution of this document are prohibited.
3
The DICE (Describe, Investigate, Create, and Evaluate) model is a notable PCC
intervention model that identifies optimal treatment options for patients with dementia with
neuropsychiatric symptoms. Developed by a panel of interdisciplinary experts at the University
of Michigan Program for Positive Aging, the model is constitutive of a four-step approach. The
first step of the approach is the accurate description of the patient’s behavior, the second is the
identification of possible underlying causes, the third is the creation and implementation of
treatment plans, and the fourth is the assessment of the strategies developed (Desai et al., 2017;
Kales et al., 2014).
The model’s essential recommendations for facilitating improvement in neuropsychiatric
symptoms among patients with dementia are educating the caregiver; forging better
communication between the patient and the caregiver; assisting the caregiver in organizing
meaningful activities such as cooking, painting, or reading depending on the patient’s interests;
and training the caregiver on simplifying his or her work routines (Desai et al., 2017; Kales et al.,
2014).
Individualized Intervention Model
The individualized intervention model is a model in which intervention activities are carried
out based on the history, needs, abilities, and preferences of patients with dementia. In this
model, PCC-based activities are directly carried out by trained health care staff with expertise in
social work, recreational therapy, geriatric psychiatry, and psychology (Kim & Park, 2017).
Care Staff-Directed Model
In the care staff–directed model, PCC activities are based on the staff’s education and
training on empathy and person-centeredness. The model also makes a provision for offering
Copyright ©2019 Capella University. Copy and distribution of this document are prohibited.
4
staff regular feedback for their work. The intervention period in such a model ranges from 3
months to 2 years (Kim & Park, 2017).
Findings from Articles
As PCC is a major nonpharmacological approach to treating agitation in patients with
dementia, its effectiveness is studied by making a comparative analysis to the pharmacological
approach to manage behavioral symptoms in patients with dementia. Pharmacological treatment
in general refers to the use of psychotropic medication to manage agitation or neuropsychotic
symptoms (NPS) in patients with dementia (Madhusoodanan & Ting, 2014; Kales et al., 2014).
Some of the common pharmacological interventions include the use of antipsychotropics,
antidepressants such as sertraline and citalopram, and sedative-hypnotics through the use of
benzodiazepines to control acute agitation (Madhusoodanan & Ting, 2014). The use of
psychotropic medication poses high risks of mortality and harmful side effects (Kales et al.,
2014). Psychotropic medication is also expensive and is restricted by regulatory bodies.
However, the use of pharmacological intervention is justified when the benefits outweigh the
risks or in situations wherein nonpharmacological interventions have proven unsuccessful
(Madhusoodanan & Ting, 2014).
The PCC approach has proven effective in addressing the etiology of aggressive
outbursts. Unlike the pharmacological approach, which is based on treating symptoms, the PCC
approach contributes to the resolution of underlying causes (Desai et al., 2017). The study by
Kales et al. (2014) finds reasonable evidence of the DICE program’s contribution toward better
clinical practices and improvement in aggressive behavior, and it observes that the approach
results in fewer hospitalizations and readmissions. In their systematic review and meta-analysis
of 19 primary studies, Kim and Park (2017) found 15 studies that measure the impact of PCC on
Copyright ©2019 Capella University. Copy and distribution of this document are prohibited.
5
agitation using the Cohen-Mansfield Agitation Inventory (an agitation mapping instrument) and
the Brief Agitation Rating Scale. They found that 8 of the 15 studies show positive effects on
agitation with individualized interventions (with a significant mean difference of -0.513),
showing better effects than with care staff–directed interventions (with a significant mean
difference of -0.160).
As this paper relies on secondary research on the PCC intervention to manage agitative
behavior in patients with dementia in nursing homes, there are multiple time frames for the
various intervention studies reviewed. While some studies had a long intervention period ranging
from 9 months to 2 years, others had shorter intervention periods of just a few weeks. From the
above exploration of the research problem based on the PICO(T) framework, it is clear that this
framework has contributed to the delineation of precise intervention practices and has brought
conceptual clarity on the issue of agitative behavior in patients with dementia.
Relevance of Findings from Articles
The study by Kales et al. (2014) was chosen as it provides a comprehensive explanation
of the PCC-based DICE intervention program and its potential outcomes and draws an objective
comparison of the program with pharmacological intervention. The study observed that the
DICE model was developed by a panel of experts with years of clinical and research expertise in
managing NPS in patients with dementia. The strategies formulated in the DICE approach were
found to carry a strong evidence base. As it is evidence-informed, the DICE approach could be
helpful for clinicians across diverse settings. Kales et al. (2014) conclude their study with a
discussion on the potential of the DICE approach in enhancing clinical practices and ensuring the
treatment of agitative behavior in patients with dementia.
Copyright ©2019 Capella University. Copy and distribution of this document are prohibited.
6
The rationale for selecting the study by Kim and Park (2017) was that it presents a
systematic review and meta-analysis of 19 primary intervention studies, of which 17 studies are
from long-term care facilities. In their systematic review and meta-analysis of these studies, Kim
and Park (2017) found that PCC has a significant impact on reducing NPS in patients with
dementia. Kim and Park’s (2017) review found the increased engagement between care
providers and patients and the magnitude of the program’s intensity to be the reasons for shortterm PCC intervention having greater benefits in comparison to long-term intervention. The
findings are relevant because they are based on 17 long-term, clinical PCC intervention studies
comprising both controlled and non-controlled cluster-randomized trials conducted over the past
10 years (Kim & Park, 2017).
Kim & Park’s findings prove to be the most credible. In their systematic review and
meta-analysis of primary studies, Kim and Park’s findings (2017) adhere to the guidelines of the
Preferred Reporting Items for Systematic Reviews and Meta-Analyses. They also utilize analysis
tools such as the Cochrane Collaboration’s risk of bias and the risk of bias assessment tool to
ensure quality screening of the studies.
Conclusion
There is a need to develop care practices that are outside of pharmacological approaches
for managing agitation in patients with dementia. The PICO(T) framework was applied to
determine if the intervention approach of person-centered care or patient-centered care (PCC)
was more effective than the pharmacological approach by identifying sources of evidence,
explaining the findings and proving the relevance of those findings. The articles by Kales et al.
(2014) and Kim and Park (2017), provide precise, reliable, and relevant information to
adequately explore the effectiveness of the PCC approach.
Copyright ©2019 Capella University. Copy and distribution of this document are prohibited.
7
References
Desai, A., Wharton, T., Struble, L., & Blazek, M. (2017). Person-centered primary care
strategies for assessment of and intervention for aggressive behaviors in dementia.
Journal of Gerontological Nursing, 43(2), 9–17. https://search-proquestcom.library.capella.edu/docview/1862119355?pq-origsite=summon
Kales, H. C., Gitlin, L. N., & Lyketsos, C. G. (2014). Management of neuropsychiatric
symptoms of dementia in clinical settings: Recommendations from a multidisciplinary
expert panel. Journal of the American Geriatrics Society, 62(4), 762–769.
https://ncbi.nlm.nih.gov/pmc/articles/PMC4146407/#
Kim, S. K. & Park, M. (2017). Effectiveness of person-centered care on people with dementia: A
systematic review and meta-analysis. Clinical Interventions in Aging, 12, 381–397.
https://doaj.org/article/400107a4cbaa44e6b7c0e3531bb4abac
Madhusoodanan, S., & Ting, M. B. (2014). Pharmacological management of behavioral
symptoms associated with dementia. World Journal of Psychiatry, 4(4), 72–79.
https://ncbi.nlm.nih.gov/pmc/articles/PMC4274589/
Copyright ©2019 Capella University. Copy and distribution of this document are prohibited.
1
​
Capella University
​
Library Guides
​
Skill Building Guides
​
Evidence-Based Practice in Nursing & Health Sciences
​
Create PICO(T) Questions
Evidence-Based Practice in Nursing & Health Sciences
This guide covers some of the basic principles of EBP in healthcare, as well as links to EBP
resources.
​
Guide Home
​
Create PICO(T) Questions
​
Find EBP Articles
​
Locate Books about EBP
​
Review Levels of Evidence
​
Critically Appraise the Evidence
​
Learn more – Selected Websites
​
Ask a Librarian
CREATE PICOT QUESTIONS – TEMPLATE
Use this Word document to help you form your PICO(T) question and get started with your library
research strategy.
Refer to the other boxes on this page and the “Find EBP Articles” page for additional tips and
strategies.
2
● PICOT Question and Library Search
PICOT QUESTION PROCESS
Creating a question using the PICOT elements will provide a framework for the research you need to
conduct an evidence-based study or to make an evidence-based decision.
PICOT Elements:
(P) – Population, Patients or Problem: The sample of subjects used in a study, or the problem
being addressed.
(I) – Intervention: The treatment that will be provided to subjects enrolled in your study.
(C) – Comparison or Control: Identifies an alternative intervention or treatment to compare. Many
study designs refer to this as the control group. If an existing treatment is considered the ‘gold
standard’, then it should be the comparison group. A control group is not required for every type of
study.
(O) – Outcome: The clinical outcome that measures the effectiveness of the intervention.
(T) – Time: Duration of the data collection. Some versions don’t include this element, and time may
not be specified in cases where the question is focused on prediction or diagnoses.
3
PICOT Question Format Examples:
Please be sure to check your assignment, as it may direct you to use a different format.
● Intervention: In _______ (P), how does _______ (I) compared to _______ (C) affect
_______ (O) within _______ (T)?
● Prognosis/Prediction: In _______ (P), how does _______ (I) compared to _______ (C)
influence/predict _______ (O) over _______ (T)?
● Diagnosis or Diagnostic test: In _______ (P) are/is _______ (I) compared to _______
(C) more accurate in diagnosing _______ (O)?
● Etiology: Are _______ (P), who have _______ (I) compared to those without _______ (C) at
_______ risk for/of _______ (O) over _______ (T)?
● Meaning: How do_______ (P) with _______ (I) perceive _______ (O) during _______ (T)?
Example PICOT Questions:
● For residents of long-term care facilities (P), how does implementation of a hydration
assessment tool (I) compared to current practice (C) affect the number of hospital admissions
with the diagnosis of dehydration (O) during a three-month period (T)?
● In acute care hospitals (P), how does having a rapid response team (I) compared with not
having a response team (C) affect the number of cardiac arrests (O) during a three-month
period (T)?
4
● In women with gestational diabetes (P), how does a monitored diet and exercise program
over the course of pregnancy (I &T), compare to the use of metformin only (C) reduce the
incidence of high birth weight babies(O)?
● In patients admitted for acute myocardial infarction (P), how well does the hospital’s new data
model created from EMR data (I) compared to current practices (C) predict readmission rates
(O) within 30 days after initial discharge (T)?
● For patients of a rural health clinic (P), does the use of text message reminders (I), compared
with telephone calls (C) reduce the number of missed appointments (O) over a six month
period (T)?
References:
● Melnyk, B.M., Fineout-Overholt, E., Stillwell, S. & Williamson, K. M. (2010). Evidence-Based
Practice: Step by Step: The Seven Steps of Evidence-Based Practice. AJN, American
Journal of Nursing, 110, 51-53.
● Posing the research question: Not so simple
● To make your case, start with a PICOT question
● What is your research question? An introduction to the PICOT format for clinicians.
● Melnyk, B. M., & Fineout-Overholt, E. (2015). Evidence-based practice in nursing &
healthcare: A guide to best practice. (Not in library)

Purchase answer to see full
attachment