Nursing PICOT Questions Nursing PICOT Questions refer to the patient population (P), question of interest or intervention (I), comparison group (C), outcome (O), and time frame (T). Asking questions in this format helps generate a search that provides the most relevant and quality information related to a topic, and also shortens the time it takes to get those search results. An example of an intervention-focused PICOT question might be: In patients with total knee arthroplasty (population), what is the effect of nerve blockade (intervention) versus opioid pain relievers (comparison) in managing postoperative pain (outcome) during the first 24 hours after surgery (Time)? An example of a PICOT question of interest might be: How do patients with chronic obstructive pulmonary disease (COPD) after rehabilitation (Population) with stage 3 (Question of interest) perceive their ability to perform daily activities (Outcome) after the first month (Time) of rehabilitation? [No comparison group].
Nursing PICOT Questions: Find and collect relevant evidence
To begin your search for evidence, use each keyword from the generated PICOT question. Once results are available for intervention or treatment, the study can be evaluated to determine which provides the most conclusive level of evidence. There are seven levels of evidence, with Level I the highest quality and Level VII the lowest quality:
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- Level I: evidence from systematic reviews or meta-analyses of randomized controlled trials
- Level II: evidence from well-designed randomized controlled trials
- Level III: evidence from well-designed control trials that are not randomized
- Level IV: evidence from case-control studies or cohort studies
- Level V: evidence from systematic reviews of descriptive or qualitative studies
- Level VI: data from one descriptive or qualitative study
- Level VII: evidence from expert opinions
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The highest levels of evidence, systematic reviews, and meta-analyses summarize evidence relevant to a particular topic by searching and evaluating studies that are specific to the question being asked. Meta-analysis is a systematic review that also uses quantitative indicators such as statistics to summarize the results of the studies analyzed.
Pyramid structure. The pyramid of information resources used to generate evidence can help determine which is the most effective. Strong and least biased evidence. This is the top of the pyramid. Here you can find support in making a decision, which can be found in the medical record. Mid-Pyramid – Evidence Reviews. This includes systematic reviews, how-tos, topic summaries, and article summaries. At the bottom of the pyramid are original sketches. The bottom is also considered the base of the pyramid and where the evidence begins. This includes research articles. Those looking for evidence here need specialized knowledge and skills to not only find the evidence itself but also to appreciate its value.
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