NUR 370 Nursing Research PICOT Assignment The importance of a well written resea

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NUR 370 Nursing Research
PICOT Assignment
The importance of a well written research question was emphasized in this week’s lecture. For your first
assignment, you will read the “The Underappreciated and Misunderstood PICOT Question: A Critical Step in
the EBP” editorial provided. In a five-page essay, you will:
Explain PICOT and its components
Discuss the application of PICOT
Discuss the errors in the formulation of PICOT and the impact those errors have in research results
Critically analyze the editorial provided and explain how a correct PICOT question guides the finding of EBP
Write your own well formulated PICOT question.
Assignment details:
1- Name the file: ACI_NUR370[week number]_[Student ID]_[Last name].[Initial of first name]. For
example, a student named John Smith with a student ID 12345, turning in this assignment in week 2
will title the assignment file as ACI_NUR370W2_12345_Smith.J.doc
2- Create cover slide:
a. The name of the assignment
b. The name of the course
c. Name of your professor
d. Your name
3- Page 2,3, & 4 you will develop your essay. You will complete additional research and include at
least 1 additional source to complete your assignment.
4- Finally, list your references in APA style in page 5. If the APA reference list exceeds page 5, you
may use as many additional pages as possible to list all your sources.
DUE DATE: MAY 19TH, 202.
Editorial
The Underappreciated and Misunderstood
PICOT Question: A Critical Step in the EBP
Process
Regardless of what model of evidence-based decision-making and practice is selected, Step #1 in the EBP process is to
ask the burning clinical question in PICOT format.
As an early and critical step in the EBP process, it is remarkable to discover how often PICOT questions are incorrectly written. Whether it is the fact that the value of
the PICOT question is underappreciated, the purpose of the
PICOT question is misunderstood, or the approach to formulating and using a PICOT question is taught incorrectly,
the outcome is the same: People are writing incorrect
PICOT questions, which leads to a problematic EBP process
(Table 1).
The purpose of a PICOT question is simple: It is the
mechanism to identify the terms to be used to search for
the best evidence to answer a burning clinical question. In
other words, the PICOT question is the search strategy. The
search strategy leads to an unbiased and effective search.
The unbiased and effective search leads to the evidence.
The evidence answers the question and underpins the evidence-based recommendation, decision, or practice. Instead
of uncovering hundreds of studies, most of which do not
answer the clinical question because of a poorly designed
PICOT question, use of a correctly formed PICOT question
when conducting a search allows for a small number of
relevant studies to be discovered to answer the question.
The fact that this first step in the EBP process is often
undervalued, misunderstood, and miscommunicated is not
a benign problem. It is, instead, a major error that leads to
a number of critical problems that carry through the rest of
the EBP process and can lead to very biased recommendations and those not based on best evidence, the exact opposite of the intent of EBP.
The best way to conduct a great search for evidence is
to write an excellent PICOT question and take that question to a skilled librarian. Many of the dangers caused
by an incorrectly formed PICOT question can be averted
with the expertise of a librarian, and they are surely the
evidence-based practitioners’ most important “searching”
partner. However, not every curious clinician has access to
a librarian. Therefore, PICOT skills have to be developed,
refined, honed, and mastered to avoid faulty results.
The following are some basic tips for writing well-designed PICOT questions.
PICOT questions should not be wordy. Instead of a “P”
of “hospitalized geriatric patients with dementia,” a “P”
that would lead to a better search is “geriatric patients with
dementia” OR “geriatric dementia patients” because you
want to search for and find all the literature about the “P”
(population) of interest. Your intent may be to implement
the evidence found on this population when they are in the
hospital, but that is your project not your question. PICOT
questions should not include unnecessary words. Instead,
PICOT questions should include only the key term(s) you
are interested in. Instead of an “I” of “applying a sterile
dressing,” an “I” of “sterile dressing” will lead to a better
search. Extra words such as “provide,” “implement,” “use,”
“deliver,” or “apply” add more words for the search engine
to look for that are not important. Only include the key
words that matter.
PICOT questions should not be used to find evidence to
support the solutions that clinicians have already decided is
the right answer. Instead, PICOT questions should be used
to find out what is the best practice. Instead of an “I” of
“providing distraction activities,” an “I” that would lead to
a better search is “interventions” OR “strategies” because
the best practice is often something that you (and your
committee or task force or council) did not know about
or consider. For instance, what if the best intervention for
addressing agitation in dementia patients is music therapy?
You would never discover the right answer if you only
searched for something that you had already decided on.
This critical error leads people to search for evidence to
support their idea, and it may not be—and often is not—
the best idea. This mistake can be made inadvertently or
with true intention. In the first scenario, you do not realize
that you are making the mistake. In the second scenario,
you intentionally look for evidence to support your idea
and intentionally do not look for anything else. Either way,
this problem needs to be avoided.
PICOT questions are always written in the past tense. You
are searching for things that have already occurred. Research
questions, on the other hand, are written in the present tense.
PICOT questions never include a directional term such
as “increased” or “improved.” Once a directional term is
included, the search is biased; if you only look for studies
where a particular intervention “increased” an outcome of
interest, you will miss all the articles where the intervention “decreased” that outcome. This is a dangerous mistake.
PICOT questions cannot be changed once you have
started searching. More PICOT questions can be written
Worldviews on Evidence-Based Nursing, 2019; 16:6, 422–423.
© 2019 Sigma Theta Tau International
423
Editorial
for the same inquiry, but you cannot change a question
that you have already used. That question is already part
of your EBP adventure and needs to be included in your
story.
Your PICOT question does not always match the change
project or initiative you originally imagined or planned.
That is because a well-written PICOT question leads you
to the best practice to answer your inquiry, not the answer
you were thinking about or for which you had hoped.
It is critical to invest time in writing a great PICOT question, as it is the gateway to an efficient, effective search and,
ultimately, to making robust, evidence-based recommendations with confidence to assure the best decision-making
possible and to improve care and outcomes.
Lynn Gallagher Ford, PhD, RN, NE-BC, DPFNAP, FAAN,
Senior Director, Helene Fuld Health Trust National
Institute for EBP in Nursing & Healthcare, College of
Nursing, The Ohio State University, Columbus, OH, USA;
Director, Clinical Core, Helene Fuld Health Trust National
Institute for EBP in Nursing & Healthcare, College of
Nursing, The Ohio State University, Columbus, OH, USA
Bernadette Mazurek Melnyk, PhD, APRN-CNP, FAANP,
FNAP, FAAN,
Vice President for Health Promotion, University Chief
Wellness Officer, Dean and Professor, College of
Nursing, The Ohio State University, Columbus, OH, USA;
Professor of Pediatrics & Psychiatry, College of
Medicine, The Ohio State University, Columbus, OH, USA;
Executive Director, Helene Fuld Health Trust National
Institute for EBP in Nursing & Healthcare, The Ohio State
University, Columbus, OH, USA;
Editor, Worldviews on Evidence-Based Nursing, The Ohio.
Table 1. An Example of a Poorly Written PICOT
Question and the Corrected Version
This is an example of a PICOT question that is wrong in
all facets. A dissection of the question will help
identify the poorly written components.
In hospitalized geriatric patients more than 65 years of
age with dementia (P), how does providing distraction
activities (I) compared with providing traditional
hospital care (C) decrease agitation (O)?
P: hospitalized geriatric patients more than 65 years of
age with dementia
I: providing distraction activities
C: providing traditional hospital care
O: decrease agitation
1. The terms in this PICO question are too wordy.
The words placed into the search database are
the exact words the computer is going to scan in
the literature, so the more words, the less you will
find.
2. By including the word “providing” in the I and C
search, you would miss any study where the title
included words such as “implementing” or
“utilizing” because the computer would be looking
specifically for “providing.”
3. This PICOT is not written in past tense; as such, it
is a research question.
4. PICOT questions should not include any directional
words. They will cause a biased search.
The correctly written PICOT question to yield the most
efficient search would be:
In geriatric patients with dementia (P), how do distraction activities (I) compared with traditional care (C)
affect agitation (O)

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