Formulating a PICO(T) Question

Asking questions is at the heart of evidence-based practice.

If nurses never asked questions about how to improve patient care based on scientific research evidence, then no beneficial changes or advancements in nursing practice would occur. Cultivating a spirit of inquiry is essential for evidence-based practice implementation.

The PICO(T) model is used widely in evidence-based practice to construct a focused, well-built, and searchable clinical question. This page provides you with the following content to guide you in developing a PICO(T) question of your own:

What is a PICO(T) Question?

Evidence-based practice (EBP) is a systematic approach to patient care decision-making based on current, best available research evidence.

The first step in EBP involves re-phrasing a clinical patient care issue in the form of a focused, searchable, and answerable question.

PICO(T) is a template for creating a well-built clinical question for evidence-based inquiry.

P - Patient/Population/Problem

I - Intervention/Variable of Interest

C - Comparison ("standard care" or "usual care")

O - Outcome(s)

T - Time

In _____ (P), what is the effect of _____ (I), compared with _____ (C), on _____ (O) within _____ (T)?

Tips for Building a PICO(T) Question

PICO(T) Elements

How to Identify Each PICOT Element

Patient/Population/Problem

Who is your patient or population?

Consider the following:

Age group
Gender
Race
Healthcare setting

What is your patient/population's problem?

Consider the following:

Condition or illness
Disease process
Diagnosis
Life situation
Nursing diagnosis
Symptoms
Self-care deficits

Intervention/Variable of Interest

What intervention can you as a nurse implement for your patient/population?

Consider the following:

Nursing interventions
Therapies
Alternative/complementary/holistic therapies
Medication administration/management
Pharmacologic interventions
Non-pharmacologic interventions
Procedures
Patient education techniques

Comparison

For NURS 3290, your C (Comparison) will be standard care or usual care

Outcome(s)

What is the desired outcome or optimal effect of the intervention?

Consider the following:

Improvement of [fill in the blank]
Prevention/prophylaxis of [fill in the blank]
Reduction in [fill in the blank]
Decreased rate of [fill in the blank]
Patient outcomes
Quality of life
Patient safety
Satisfaction
Knowledge

Time

How long would it take to reach a desired outcome? Or, what is the time frame of your patient scenario?

Consider the following:

Within [fill in the blank] weeks/months/year(s)
Preoperative/perioperative/postoperative period
Hospital length of stay
Patient's lifespan
Patient's treatment duration
Recovery period
These are only examples. The timeframe can be very specific or very broad.

Ideas for Your PICO(T) Question

Your required textbook provides a wealth of material for generating and brainstorming ideas for PICO(T) Questions.

Be sure to review Chapter 8 in your Introduction to Evidence-Based Practice text for ideas and examples of clinical questions for EBP.

Two copies of this book are on reserve in the Mulford Library. To use a copy in the library, please ask a staff member at the library front desk to retrieve it for you.

Introduction to Evidence-Based Practice by Lisa Hopp; Leslie Rittenmeyer
Call Number: WY100.7 H798i 2021
2 copies on Mulford Reserve. Ask a library staff member at the front desk to retrieve it for you.

Helpful web resources for PICOT question ideas can be accessed below:

Johns Hopkins - EBP Exemplar Library
Explore this database of EBP projects completed by clinicians. Many of these projects include good examples of PICOT questions.
PICO Questions [from University of Kansas Medical Center]
This site provides examples by patient care setting under the "PICO Question Examples" section
UToledo DNP Student EBP Projects
Access and read the full-text of UToledo DNP students' EBP projects. The PICOT questions utilized in these projects may provide you with inspiration and ideas for your own PICOT.
Ohio State DNP Final Projects

Example: PICO(T) Question and Search Strategy

PICO(T) Question Example:

"In adult cancer patients experiencing fatigue (P), what is the effect of meditation (I), compared with standard care (C), on quality of life (O) within 6 months (T)?"

Building a Database Search Strategy for the PICO(T) Question:

A well-built PICO(T) question forms the basis of a database search strategy for finding research literature.
Concepts from the PICO(T) question are used to construct a comprehensive database search strategy with search terms describing each relevant component of the PICO(T).
Relevant elements of your PICO(T) question can be used to develop a "starter" list of keywords (including synonyms) to use in a database search. Most commonly, the most important parts of a PICO(T) question for searching are the P, I, and O.
After developing a "starter" list of search terms, you can then begin brainstorming your search strategy for combining terms with OR or AND, and using other techniques such as a truncation (i.e. a keyword search for letharg* will also find articles with the term lethargic or lethargy):

PICO(T) Elements	Example	Starter List of Synonyms and Search Terms	Initial Keyword Search Strategy
P - Patient/Population/Problem	Adult cancer patients experiencing fatigue	Cancer Neoplasms Oncology Tumor Tumour Malignancy Fatigue Tiredness Lethargy Exhaustion	cancer* OR neoplasm* OR oncolog* OR tumor* OR tumour* OR malignan* AND fatigue* OR tired* OR letharg* OR exhaust*
I - Intervention/Variable of Interest	Meditation	Meditation Mindfulness Breathing Relaxation Yoga Guided imagery	meditat* OR mindful* OR breath* OR relax* OR yoga OR "guided imagery"
C - Comparison (may be "standard care" or "usual care")	Standard care	Not needed as a search term
O - Outcome(s)	Improving quality of life	Quality of life Quality of living Life quality Well-being	"quality of life" OR "quality of living" OR "life quality" OR well-being OR wellbeing OR "well being"
T - Time	6 months	Not needed as a search term