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]?