Professional nurses rely on research findings to inform practice decisions; they use critical thinking to apply research directly to specific patient care situations.
Think about an independent nursing practice problem you care passionately about and would be interested in searching for evidence.
The below problems should not be used:
*medical/doctor/physician problems such as medications, or medications administration or effects, diagnostics such as EKGs, labs, cardiac catherizations.
*staffing, nurse-to-patient ratios, workforce issues are organizational/system /political/administrative/multi-stakeholder problems which nursing cannot solve independently.
Describe a significant nursing clinical issue, topic of interest, or practice problem that is important to you. Describe why you chose the problem/topic.
Write your clinical question in the PICO(T) format for your nursing practice problem.
Chamberlain College of Nursing
NR439: Evidence-Based Practice
NR 439 PICOT Question Guide
The following contains PICOT question guides/templates to use to help write questions using all
of the PICOT elements. Each template contains a guide that you can use to write a complete
PICOT question, examples of PICOT elements, and illustrations1. Review some tips and hints
below to think about for each of the PICOT elements that can help create a sound clinical
nursing PICOT question:
P=Population of patients:
Think about a group of patients you are interested in studying—
identify the group by age ranges, diagnosis/disease of interest,
history or length of time with the diagnosis/disease of interest,
location, unit, or setting, gender type (if applicable), race (if
applicable), or other identifiable characteristics such as Medicare,
Medicaid, immobile, ventilated, inpatient, outpatient, etc.
I=Intervention:
Consider the nursing action or intervention you are thinking that
would make a difference? From your search for evidence, what is
the evidence indicating that nurses can do to help improve the
problem or issue you have chosen?
C=Comparison:
Think about comparing to the intervention of interest or the
alternative such as routine/standard care. If no comparison, state
not implementing the intervention or no comparison group.
O=Outcome:
Reflect upon what would be the measurable, relatable indicator that
would demonstrate the intervention is making a difference or not?
What would be the needed outcome that you could
observe/check/measure? For example, “the pain is okay” would
not be a measurable outcome. Rates pain level less than 3 on pain
scale would be measurable.
T=Timeframe:
For this element, reflect on how long it would take to implement
your study by collecting data or the time needed to observe to see
if any changes occurred or will occur. Think about 1 month, 3
months, 6 months etc… Use a timeframe that is realistic.
Chamberlain College of Nursing
NR439: Evidence-Based Practice
Template A
Among/In _________________________ (P), does______________________ (I)
(**decrease/increase/impact/influence/affect/reduce/improve**) _____________________
(O) compared to ______________________________ (C) over
______________________________(T)?
(**choose one term**)
Example:
Among 65+ and older diabetic immobile adults in long-term care (P), does a
bedside oral care kit and checklist protocol (I) compared to routine oral care
without a bedside oral care kit (C) affect the number of times oral care is
completed (O) over 3 months (T)?
P=Population of patients: 65+ and older diabetic immobile adults in long-term care
I=Intervention: bedside oral care kit and a checklist protocol
C=Comparison: routine oral care without a bedside oral care kit
O=Outcome: number of times (frequency) oral care is completed
T=Timeframe: 3 months
Chamberlain College of Nursing
NR439: Evidence-Based Practice
Template B
Among/In _________________________ (P), would______________________(I)
(**decrease/increase/impact/influence /affect/reduce/improve **)_____________________
(O) compared to ______________________________ (C) over
______________________________(T)?
(**choose one term**)
Example:
In male ICU patients who are 65+ and older diagnosed with COPD (P), would the
confusion assessment screening tool (CAST) (I) impact the number of early
identification of delirium (O) compared to no screening tool (C) over 6 months
(T)?
P=Population of patients: Inpatient male ICU patients 65+ and older diagnosed with COPD
I=Intervention: confusion assessment screening tool (CAST)
C=Comparison: routine care/no screening tool
O=Outcome: number of early identification of delirium
T=Timeframe: 6 months
Chamberlain College of Nursing
NR439: Evidence-Based Practice
Template C
Among/In _________________________ (P), will ______________________ (I)
(**decrease/increase/impact/influence/affect/reduce/improve **)_____________________ (O)
compared to ______________________________ (C) over
______________________________ (T)?
(**choose one term**)
Example:
Among Hispanic pregnant women between 36-40 weeks (P), will completing a
lactation course (I) increase the number of breastfeeding initiations by or within 6
hours of delivery (O) compared to no lactation course (C) over 6 months?
P=Population of patients: Hispanic pregnant women between 36-40 weeks
I=Intervention: lactation course completed
C=Comparison: no lactation course
O=Outcome: number of breastfeeding initiations within 6 hours of delivery
T=Timeframe: 6 months
Chamberlain College of Nursing
NR439: Evidence-Based Practice
Template D
Among/In _________________________ (P), what is the effect of ______________________
(I) on ____________________ (O) compared to ___________________________ (C) over
______________ (T)?
Example:
In pediatric non-Hispanic Black males ages 8-18 years old with a 5 year history of
type 1 diabetes (P), what is the effect of the Glucose Buddy Diabetes Tracker app
(I) on maintaining HbA1C levels