Nursing: Evidence-Based Practice & PICO

When selecting a PICO topic, consider these three things:

1. Does research about the topic meet the parameters of the assignment?

Your assignment requires you to find research that is evidence-based and current (within the last five years). If your topic is too new, there may not be enough primary research yet published. If your topic is too old, the primary research may have been published well before your five year window.

TIP: Before fully committing to a topic, do some pre-searching in the Library databases to test for prevalence of primary research and currency of that research. Don't search for hours. If you aren't finding anything, seek a librarian's assistance or move on to another topic.

2. Can you apply your findings to nursing practice?

In most cases you will need to use your critical thinking to synthesize the findings in your required articles and infer how the outcomes apply to nursing practice.

Ask yourself things like:

• How do my findings from each article relate to each other?  Is there a general set of conclusions I can draw?
• What are the implications of these conclusions for nursing practice?
• If what I have found represents best practice, what does it mean for nursing?

TIP: Don't limit yourself to nursing journals. There will be primary research articles published in other medical, health, and wellness journals that include the field of nursing or whose findings can be inferred for nursing practice. Again, it requires critical thinking on your part to read the articles thoroughly, synthesize the results, and draw conclusions for nursing practice.

3. Is the topic interesting to you?

Students usually do better if they have a genuine interest in their topic. Take a moment to consider what you care about. Is there something you've experienced or read that you would like to know more about? Is there something within nursing practice that you think needs to be improved? Which population do you hope to work with in the future? Even if you are not sure about all of these questions right now, consider if there is some area of nursing practice that you'd like to explore through the PICO assignment.

"Evidence-based practice (EBP) provides nurses with a method to use critically appraised and scientifically proven evidence for delivering quality health care to a specific population" (Majid, et al., 2011).

What's the difference between evidence-based practice and nursing research?

"Evidence-based practice is used to close the gap between the research being conducted and the practice—the 'research/practice gap" (HealthLeaders Media). 

So research is what helps you put evidence into practice!

Nurses and other health professionals factor in expertise, evidence from research articles and studies, and patient values and preferences. If you are asked to do research on an evidence-based practice you'll need to ask a clinical question related to a particular patient or type of patient. PICO can help you.

PICO is a way to organize the information you are gathering for Evidence-based Practice.

When you have a topic in mind, wrote down what you know so far for each part of PICO. You will now have some key words to use as you do library research to find articles and studies to support what you know and inform you of further options and comparisons. 

For example: your topic is whether follow up calls from a nurse after hospital discharge prevent patient readmission.

P would be patients who have just been discharged from the hospital

I would be a phone call from a nurse

C would be any other protocols you find that would be alternatives to calling -- including no follow up calls, or following up with patients a different way, such as emailing.

O would be the outcome you want for these patients -- lower rates of readmission.

Your keywords could be nurse, call, discharge, readmission.