PICOT Questions in Nursing

PICOT Questions in Nursing

Formulating a Researchable Question

The first step in conducting evidence-based practice research in nursing is to create a researchable question. Research questions that are too broad or too narrow can hinder the research process.

Clinical Example:

Too Broad: How can infection be controlled?
This topic is overly broad and would result in an overwhelming number of results.

Too Narrow: What is the most effective method of infection control among Asian American babies born at 32 weeks in the Johns Hopkins Neonatal Intensive Care Unit?
This question is too specific, and it’s unlikely that there is published research on this precise topic.

Just Right: What is the impact of hand washing on infection control compared to hand sanitizers in the NICU over 6 months?

Non-Clinical Example:

Too Broad: Is heart disease evenly experienced by all races?
This question is too broad and would yield a vast array of results. The wording needs to be more specific, using synonyms to encompass all possible variations of the term “heart disease.”

Too Narrow: Is the cardiovascular mortality rate in January different by race at the Johns Hopkins Intensive Care Unit?
This question is overly specific, and it’s unlikely that there is research specifically focusing on this location and population.

Just Right: What is the impact of race (Black Americans versus White Americans) on long-term cardiovascular mortality after controlling for age and income in United States adults?

PICOT and Other Models

PICOT is a helpful mnemonic to remember the key components of a well-focused research question:

P = Patient, Population, or Problem
I = Intervention, Prognostic Factor, or Exposure
C = Comparison (optional)
O = Outcome
T = Time

Examples of PICOT questions in nursing:

PICOT examples:

Intervention/therapy

1. Intervention/Therapy:

In the aged population, what is the effect of exercise programs on accidental falls, as compared with no exercise?

2. Etiology:

Are adult smokers with a history of childhood asthma at increased risk of COPD compared to adult smokers with no history of asthma?

3. Diagnosis or Diagnostic Test:

Is the Hemoglobin A1C test more accurate in diagnosing diabetes as compared to fasting blood sugar levels?

4. Prevention:

For people with type 2 diabetes, does zinc supplementation reduce the future risk of foot ulcers compared to placebo?

5. Prognosis/Predictions:

In adults with osteoarthritis, does low vitamin D levels in the bloodstream predict the rate of future hip fractures?

6. Meaning:

How do cancer patients diagnosed with alopecia perceive their self-esteem during and after chemotherapy?

PICOT Questions in Nursing – Public Health:

PICO(T) is commonly used to formulate research questions in public health:

Population/Participants: Non-institutionalized civilian residents of the United States

Intervention (or Exposure): Hypertension (or Low Socioeconomic Status)

Comparison: Respondents without hypertension

Outcomes: Cardiovascular disease or cardiovascular mortality

Types of Studies: Cross-sectional, Longitudinal

Alternate Models:

1. PECO – Population | Environment | Comparison | Outcome

2. SPICE – Setting | Population | Intervention | Comparison | Evaluation

3. CIMO – Context | Intervention | Mechanisms | Outcome

4. ECLIPSE – Expectation | Client group | Location | Impact | Professionals | Service

5. SPIDER – Sample | Phenomenon of Interest | Design | Evaluation | Research Type

Search Terms

Once you have formulated your research question, it is essential to identify relevant keywords or search terms to use in library databases to find articles that address your question. Remember that not all articles need to cover all aspects of your question.