PICO Question on HPV

In Part 3 of the Course Project, you consider how the evidence you gathered during Part 2
can be translated into nursing practice.
Now that you have located available research on your PICO question, you will examine
what the research indicates about nursing practices. Connecting research evidence and
findings to actual decisions and tasks that nurses complete in their daily practice is
essentially what evidence-based practice is all about. This final component of the Course
Project asks you to translate the evidence and data from your literature review into
authentic practices that can be adopted to improve health care outcomes. In addition, you
will also consider possible methods and strategies for disseminating evidence-based
practices to your colleagues and to the broader health care field.
To prepare:
Consider Parts 1 and 2 of your Course Project. How does the research address your PICO
question?
With your PICO question in mind, identify at least one nursing practice that is supported
by the evidence in two or more of the articles from your literature review. Consider what
the evidence indicates about how this practice contributes to better outcomes.
Explore possible consequences of failing to adopt the evidence-based practice that you
identified.
Consider how you would disseminate information about this evidence-based practice
throughout your organization or practice setting. How would you communicate the
importance of the practice?
---------------------------------------------------------------------------Asking a Good Question (PICO)
Asking the right question is a difficult skill to learn, yet it is fundamental to the evidencebased decision-making process. This process almost always begins with a patient
question or problem. A "well-built" question should include four parts, referred to as
PICO that identify the patient problem or population (P), intervention (I), comparison (C)
and outcome(s) (O). 1
The first step in developing a well-built question is to identify the patient problem or
population. Describe either the patient's chief complaint or generalize the patient's
condition to a larger population.
When identifying the P in PICO it is helpful to ask:
How could you describe a group with a similar problem?
How you would describe the patient to a colleague?
What are the important characteristics of this patient?
Primary Problem
Patient's main concern or chief complaint
Disease or health status
Age, Race, Sex, Previous ailments, current medications
Should these characteristics be considered as I search for evidence? 1

The P phrase could be more detailed if the added information influences the results you
expect to find.
Identifying the Intervention is the second step in the PICO process. It is important to
identify what you plan to do for that patient. This may include the use of a specific
diagnostic test, treatment, adjunctive therapy, medication or the recommendation to the
patient to use a product or procedure. The intervention is the main consideration for that
patient or client. 1
The Comparison is the third phase of the well-built question, which is the main
alternative you are considering.1 It should be specific and limited to one alternative
choice in order to facilitate an effective computerized search.
The Comparison is the only optional component in the PICO question. One may only
look at the Intervention without exploring alternatives, and in some cases, there may not
be an alternative.
The Outcome is the final aspect of the PICO question. It specifies the result(s) of what
you plan to accomplish, improve or affect and should be measurable. Outcomes may
consist of:
relieving or eliminating specific symptoms
improving or maintaining function
or enhancing esthetics.
Specific outcomes will yield better search results and allow you to find the studies that
focus on the outcomes you are searching for. When defining the outcome, more effective
is not acceptable unless it describes how the intervention is more effective.
For example, more effective in preventing caries, or in decreasing probing depths.
In addition to identifying the PICO components, it is important to clarify the type of
question you are asking and the related research method. The categories for types of
questions are:
Therapy/Prevention
Diagnosis
Etiology
Prognosis
Based on four PICO component, a final PICO question can be stated as:
For a patient with Tetracycline staining, will chairside (ZOOM) bleaching as compared to
over the counter White Stips decrease staining and increase tooth whiteness.
Once you have identified a patient problem and defined your question using PICO, you
are ready to find the most current valid evidence.

The PICO Worksheet and Search Strategy provides the framework for developing this
step of the process by guiding one to write each component of the PICO question and is
also a guide in developing a search strategy, which aids in the retrieval of relevant clinical
evidence.
Conducting a computerized search with maximum efficiency to answer the question is
the second step in the EBDM process
References
Sackett DL, Richardson WS, Rosenberg W, Haynes RB (1997). Evidence-based
medicine: How to practice and teach EBM. New York: Churchill Livingston.