How do you Write a PICOT Question?
What is a PICOT Question?
A PICOT Question is a question that is formatted in an accepted format, and used to develop answerable, researchable questions, especially in nursing. PICOT question mainly answers four main areas including population, intervention, control, outcome, and time.
Formulating a PICOT Question
To formulate a PICOT question, there are three critical elements that should be addressed. The three elements include population, the proposed intervention, the control to compare with the intervention, the expected outcome, and the time within which the intervention will be considered.
In women of age 60 and above at risk of developing osteoporosis, is educations and medication for one year effective in reducing the complication of osteoporosis compared to none?
In the example given above, the question breaks down as follows:
Population – Women of age 60 and above
Intervention – Education and medication
Control – None, which means there is no intervention
Outcome – Reducing the complications of osteoporosis
Time – One year
PICOT statement is the same as the PICOT question. The PICOT statement, which prominently features in PICOT essays, essentially describes the way in which the PICOT question has been put together to express a statement. However, when asked to describe the PICOT statement in a PICOT essay, you are supposed to give more details about the PICOT questions, explaining each part of the question in details.
Here is a good example of a PICOT Statement Paper
In high risk patients, does the use of silver-hydrogel urinary catheters reduce incidences of catheter-associated urinary tract infections compared to using uncoated urinary catheters per 1,000 patient days?
Owing to their vulnerability, high risk patients are at a higher risk of developing complications if the infections are not addressed. In addition, high-risk patients suffering from conditions such as diarrhoea, and diabetes are at a high risk of developing catheter-associated urinary tract infections (CAUTIs). Among the high risk patients, use of normal urinary catheters significantly increases the costs of hospitalization. Moreover, using normal uncoated urinary catheters in high-risk patients increases the levels of morbidity and mortality.
Interventions (using silver-hydrogel urinary catheters)
High risk-patients in the intervention group were treated using silver-hydrogel urinary catheters. Following the introduction of the device, the patients were monitored regularly. High risk patients who had a UTI on admission and those who had long-term indwelling urinary catheters were excluded from the study. In addition, urology patients and those who could not be contacted easily were excluded.
Comparison (uncoated catheters)
High-risk patients in the control group were treated using the normal uncoated catheters. The exclusion criteria used was similar to that one of the intervention group. The patients were monitored through their inpatient stay during which they were evaluated for any symptoms of UTI.
Silver-coated catheters showed a significant reduction in the development of catheter-associated bacteriuria. The rate of non-coated catheter was 4.9/1000 patient days and that of non-coated catheters was 2.7/1000 patient days (Lai & Fontecchio, 2000). This translates to 45% reduction in CAUTIs.
A study conducted by Gentry (2005) supports these results. This study found out that the use of silver-coated catheters led to a 33.5% reduction in CAUTIs. The results of these studies indicate that silver-coated catheters are beneficial to high-risk patients, and those requiring an indwelling catheter for longer than 48 hours.
Measuring the outcomes was done weekly, for a period of six months.
How to Write a PICOT Statement
The process of writing a PICOT statement example starts with identifying an area of interest in nursing. Once the area of interest is identified, the next process is to identify an issue that is prevalent in that area and seek to develop solutions towards addressing the problem. To develop the problem background, a thorough analysis of the most recent evidence based studies published in the last five years is important to gain an understanding of what is already covered in that area. From the nursing literature review, a gap is identified which forms the basis for formulating a PICOT statement to test a new intervention to address the problem.
In a PICOT Essay or when doing a PICOT Question and you are asked to do a PICOT analysis, you are supposed to follow the example given above. In this case, a PICOT Analysis requires a detailed analysis of the PICOT question, same like doing a PICOT question. A PICOT analysis uses evidence based method to justify the reason why every aspect of the PICOT question is selected and included. It is detailed and where possible, give examples. Here is an example of a PICOT Analysis:
My PICOT Question was: What is the incidence of infection for ICU patients, during admission, in those who had personnel who washed their hands vs. those who did not?
the target population include patients admitted to the ICU. The intervention of interest is the correct hand washing following the laid down standards for the nurses and other medical personnel. The comparison to this intervention is now washing hands, which include inaccurate hand washing practices.
The main outcomes is reduction in the incidence of nosocomial infections, once the patients is admitted to the ICU. Correct hand washing practices during admission should result to lower rates of nosocomial infections once patients have been admitted.
The time frame is during admission to the ICU. This is a crucial moment when most patients are likely to undergo different procedures where medical personnel use their hands.
How to Write a PICOT Question
When doing a PICOT Essay, the first step knows how to accurately frame a PICOT Question. This starts with doing a background research on a nursing health problem you are aware of, or going through recent health news to brainstorm the best health problem to research about.
Then, narrow down to the most affected population and the particular nursing health problem they are facing and do a research on the possible nursing interventions and the timeframe those interventions can be done. This will help you design the intervention and the time frame. For control, select an alternative nursing intervention as the control.
Importance of PICOT Question
A PICOT Question is important because it acts as the guideline when doing a nursing intervention. It helps to select a nursing health problem and a nursing intervention designed to address the nursing problem identified. It acts as a framework for tackling a nursing problem. This is more important when doing a complicated assignment like a nursing dissertation.
PICOT Examples of Diabetes
For obese patients above the age of 65, do using community recreation activities reduce the risk of diabetes mellitus compared to education problems on lifestyle change?
PICOT Example of Hypertension
For patients with deep vein thrombosis, is D-dimer testing or ultrasound more accurate for diagnosis?
PICOT Question and Literature Search
A good PICOT question develops from a thorough literature search on the area of interest. The PICOT question must be based on an intervention and this intervention should address a gap in nursing. A good literature search will review all the interventions already done to address the problem and the existing gap. This gaps forms the possible solution to the problem and a PICOT question proposes an intervention that will cure the gap. The literature should be very current, possibly not more than five years old, to ensure that it considers the most current interventions to address the problem. All the selected should should have a higher level of evidence and Boolean logic using search terms like “and”, “or”, and “not” to vary the search results.