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Evidence Based Practice for Nursing

Looking to know more about Evidence Based Practice? This is the libguide for you!

What is PICO(T)?

When doing a search for Evidence Based Practice (EBP) it is important to begin with a well structured question. Really understanding what information you're looking for will help guide your searching to be more effective, efficient, and relevant. 

PICO(T) is a mnemonic device that can help frame your research question. It is not a mandatory part of the search process but a very effective tool to focus a search. 

P Patient or Population Who is the patient or population that you're going to treat? Disease? Age group? Gender? What other characteristics do they have?
I Intervention What is the main intervention, exposure, or treatment you want to explore? 
C Comparison Are there alternatives that you want to compare to the intervention? Its okay if there are none! 
O Outcome What are you hoping to accomplish, measure, improve, or affect?
T

Type of question or study

Time 

What type of question is this? Therapy? Diagnosis? Prevention? 

What type of study are you looking for? Case study? Clinical Trial? Randomized Control Trial?

What is the timeframe of your research? EX: Are you looking for titles that were published with in the last 10 years?

Items to note:

  • You do not have to have all 5 letters filled out in order to use a PICO(T). 
    • Fill in as much information as you can and leave blank the letters that you don't have information for. 
    • Typically you want at least 2 letters filled out - otherwise you might end up with too many results!

How do I format a PICO(T) Question?

Let's use an example: 

A mom brings in her 3 year old son with a history of chronic ear aches. She read on Facebook that probiotics help prevent infections and wants to know more. This mom is looking for a comprehensive amount of evidence and not a one off study. How would you set up this PICO(T)? 

Hint: using a chart is simple and effective!

Patient/ Population Child, ear infection
Intervention Probiotics
Comparison  None 
Outcome Preventing reinfection
Type Prevention studies / Systematic reviews? 

From our PICO(T) we now have a beginning set of "search elements". Use the highlighted colors as designations for each component. Think of each element like a category that you will need to expand on as you search. Once we have a PICO(T) created we can start gathering search terms. Use those terms in conjunction with Boolean operators in order to execute an effective search. 

PICO and Beyond

The PICO(T) format is not the only medical mnemonic that can be used to form a clinical question. There are alternatives that can help you better format your question to fit your research needs. 

PECO - If there is no intervention (ie. a treatment/therapy) try PECO and substitute I for E. The exposure can be things like: exposure to noise, pollution, or other environmental factors

P Population 
E Exposure (an unintentional occurrence or happening)
C Comparison
O Outcome

PICOC - is best used for questions looking into cost effectiveness, Improving service models, and economic evaluations. 

P Patient, Population or Problem 
I Intervention 
C Comparison
O Outcomes 
C Context (In what context is the problem occurring?)

CoCoPop - Best to help find the prevalence of a condition 

Co Condition 
Co Context (when or where something is taking place)
Pop Population

SPICE - Best for qualitative questions that evaluate things like meaningfulness, experiences, happiness, etc. 

S Setting
P Population or Perspective
I Intervention 
C Comparison 
E Evaluation 

ECLIPS - Good for queries on healthcare management. 

E Expectation
C Client Group
L Location 
I Impact
P Professionals
S Service