7 Steps for Formulating a PICOT Questio

7 Steps for Formulating a PICOT Question

For professional accuracy, we will follow the 7 Steps to the perfect PICO Search Evidence-Based Nursing Practice, an EBSCO Health white paper authored by Kathy A. Jensen, MHA, RN. You can follow these simple steps to help formulate a good PICOT question for your project, capstone, thesis, or regular class assignment.

1. Write a broad Clinical Question

The PICOT process always begins with stating abroad clinical question. Alternatively, you can start with a nonspecific inquiry. We can use the example below: What is the effectiveness of early ambulation, compared to bed rest, on decreasing post-op DVTs in adult patients with total hip replacements?

2. Determine the Components of the PICOT formula

Once you have your general question, you can sift the content to develop specific components or keywords for your PICOT formula. In short, you will be structuring your question, beginning with identifying the keywords for the PICOT mnemonic. P - Adult patients with total hip replacements I - Early ambulation C - Bed rest O - Decrease post-operation deep vein thromboses (DVTs) Note that we do not have a time limit for the intervention and must drop it. When finally formulated, your PICOT question will read: In adult patients with total hip replacements (Patient population), how effective is early ambulation (Intervention of interest) compared to bed rest (Comparison intervention) in decreasing post-op DVTs (Outcome)?

3. Develop an appropriate search strategy

With the PICO question you formulated, you can narrow it down to specific databases and other search sites where you might get information and answers. Note that you should only lean towards accredited scholarly nursing databases. You should then formulate a search strategy to maximize the search terms. For instance, you can look up synonyms and phrases related to the intervention.

4. Conduct a search

When searching the databases, begin by searching the PICOT element individually. For example, when researching post-op patients with DVTs, use the search term "post-op DVTs", but you can also consider "early ambulation post-op-" or "bed rest post-op" as viable search terms. Note that you can combine searches into one search to get better results. Remember, you will be looking for qualitative or quantitative articles to help answer your PICOT question.

5. Refine the Results

The next step is to refine the results yielded from the search. You can do so by adding limiters. Limiters are control parameters that allow you to focus your results on the most important and relevant content without going through outdated, invalid, or irrelevant evidence to answer the PICO question. Some limitations can include the publishing date, evidence-based study, or type of study. Using the Evidence-based Practice limiter ensures that you get evidence-based journals, articles focusing on EBP, and research articles (case studies, meta-analyses, RCTs, systematic reviews, clinical trials, and research papers on EBP.

6. Review your literature

Check the results for credibility, validity, and relevance in answering your PICOT question. Then, choose the studies that have met your search threshold or limit. If there are articles viable to your study that are not available in full-text, check whether the librarian could locate them for you. You can also search the web for PDF copies of the same, in case someone is generous enough to upload the article to their website or blog.

7. Assess the strength of the evidence

As a matter of completing your PICO search, you should be able to categorize the articles based on the hierarchy of evidence. The hierarchy of evidence determines the strength of evidence. Therefore, select the journal articles based on the highest level of evidence, such as systematic reviews and meta-analyses, and use them to answer your PICO question. Those who have adopted the seven-step PICO framework have found the search process easy. You can then fill out the PRISMA diagram to document your search and write up your nursing project, dissertation, capstone paper, or thesis. Next, look at our guide on how to write a change project.

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