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Evidence-Based Nursing: 1. ASK: Developing A Clinical Question

For BSN students, learn the basics of EBP in nursing, how to write a clinical question and appraise evidence.

1. ASK: Developing a Clinical Question

Evidence-based practice begins with asking a focused clinical question. The acronym PICO(T) is a commonly used framework for developing clinical questions. By breaking a research question down into its major concepts, PICO(T) assists the researcher in searching for evidence efficiently with the most relevant keywords. PICO(T) stands for: 

P=Problem or Patient or Population

I=Intervention

C=Comparison Intervention

O=Outcome

(T)=Time 

 

Here is the basic structure of the six main types of PICO-based clinical questions: 

1. THERAPY QUESTION

In ____________ is _________________ compared with ________________more effective for _________________?


2. ETIOLOGY
Are ______________ who _______________ at higher/lower risk of ____________ compared with _____________ ?

3. DIAGNOSTIC QUESTION
In________________ is ________________more accurate in diagnosing _______________ compared with ____________?

4. PREVENTION QUESTION
In ___________ does the use of _________________ reduce the risk of ____________ compared with ______________?

5. PROGNOSIS QUESTION
In patients with _____________within  __________________ what is the risk of __________________? 

6. MEANING/QUALITATIVE QUESTION
How do _______________ diagnosed with _______________ perceive __________________?

Melnyk, B. M., & Fineout-Overholt, E. (2011). Evidence-based practice in nursing & healthcare: A guide to best practice. Wolters Kluwer/Lippincott Williams & Wilkins.

 

Examine the resources below to learn how to use PICO to build a clinical question. 

Let's look at an example of a scenario that we can turn into a PICO-based clinical question.

A hospital is experiencing a high rate of ER nurse turnover due to burnout. The hospital administration would like to investigate whether a mindfulness-based stress reduction program would be more effective in reducing burnout among their nurses compared to no intervention. 

 

Our PICO keywords would be: 

P=Patient, Problem, or Population I=Intervention or Treatment C=Comparison; Alternative Treatment, Standard Treatment, or Placebo O=Outcome; What do you want to measure or prove? 
Emergency room nurses Mindfulness-based training programs No intervention reduced burnout

 

We can now use these PICO concepts to build our clinical question:

In emergency room nurses, what are the effects of participation in mindfulness-based training programs on nurse burnout compared to no intervention? 

 

 

 

Try using one of these templates to guide you in developing your own PICO(T) clinical question.