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Forming Focused Questions with PICO: Case Study

Case: Patient Education

  • You are a nurse working in a busy inpatient medical surgical unit. The patients on your unit are admitted for a wide variety of conditions: renal, GI, dermatologic, etc.
  • All patients admitted that are chronic smokers are given brief counseling by an RN and a self-help brochure about smoking cessation, but no follow up counseling after that.
  • You hear your coworkers complaining that they feel like they are wasting their time because they think the patients will resume smoking after discharge.
  • You decide you want to find out if this minimal contact intervention works in the long term.

P: Consider when choosing your patient/problem

  • What are the most important characteristics?
  • Relevant demographic factors
  • The setting

I: Consider for your intervention

  • What is the main intervention, treatment, diagnostic test, procedure, or exposure?
  • Think of dosage, frequency, duration, and mode of delivery

C: Consider for your comparison

  • Inactive control intervention: Placebo, standard care, no treatment
  • Active control intervention: A different drug, dose, or kind of therapy

O: Consider for your outcome

  • Be specific and make it measurable
  • It can be something objective or subjective

PICO: Putting it together

Your full PICO question is:

Among hospitalized chronic smokers, does a brief educational nursing intervention lead to long term smoking cessation [when compared with no intervention]?