PICOT is utilized by the health care community to identify and study a nursing or medical practice problem. Consequently, PICOT examples that may provide insight into the use of the PICOT process, may not be relevant to nursing practice as they are based on a medical practice problem.
There are many differences between nursing and medical practice problem as both health care disciplines has different approach towards looking at a patient problem. The goal of medical diagnosis process is to formulate a clinical judgment for the following reason: to identify or rule out a disease, to explain the findings and their likely causes to the patient, predict the disease’s course and modify its predicted course (Chiffi,D., Zanotto.R.2015). Medical providers rely on many diagnostic tests and procedures along with their assessments and clinical reasoning to develop the diagnosis. For example, the patient who presented with abdominal pain, nausea vomiting goes through the medical work up including blood work and diagnostic studies such as CAT scan towards the medical diagnosis of acute pancreatitis &alcohol withdrawal symptom. While the medical problems focus on patient’s clinical outcome, nursing diagnosis on this situation might be focused on patient as a whole. In this case, patient’s goal of care is based on nursing problem. Some of the problem /nursing diagnosis might be Intolerance to pain due to the pancreatitis or ineffective coping due to the loss of loved one. Nursing problem will guide nurses to approach clinical conditions of patients more holistically and provide support to not just the individual but the community.
Nurses practice revolves around the nursing process (Toney—Butler, Thayer, 2021). Nurses practice revolves around the improvement of the patient and the care process. It resembles the PICOT in many ways like the intervention/would be the planning process, the comparison/would be the implementation and the outcome /would be the evaluation. PICOT is used to develop the question needed to be researched and answered with evidence (Helbig, 2018) and the nursing process steps provide answers in the evaluation phase. The difference between a nursing or medical practice problem, nurses practice works to improve patient care and medical provides the cause or pathology of the patient. Nurses must practice within their scope of practice (OP, 2010). It is important for nurses to ensure their PICOT is based on nursing care and not a diagnosis. Nursing diagnosis is different from diagnosing a patient’s health issue for treatment as doctors do. Nurses must remain within their scope of practice.
PICOT question is the first step in evidence-based practice, and many times the question is written poorly. It should not be written in past tense, its used to help search for the best evidence to answer the question (Gallagher Ford, 2019). It has been noted that there is difficulty in finding quality information and at times we lack the skills to evaluate the literature. There is a evidence-based research tool (EBR) which improved the ability of nursing students to find and review articles and correctly apply the PICOT (Long, et al., 2016).
An example of a nursing PICOT:
P: Patient – Adults 65 and over with constipation
I: Intervention – Encourage to exercise 45 min per day
C: Comparison – Patients who do not exercise
O: Outcome – Increased bowel movements in a week
T: Time Frame – 1 month
An example of a medical PICOT:
P: Patient – 65-year-old complaining of knee pain
I: Intervention – MRI
C: Comparison – MRI of normal knee
O: Outcome – Diagnosis of Arthritis
T: Time Frame – 2 weeks
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