Posted: September 7th, 2021

PICOT Statement: The 5 extremely vital steps

A Picot Statement

Clinicians ask between 1 to 19 questions to every 10 patients they care for. However, the answers to almost two-thirds of these questions are not conclusively answered. These unanswered questions hold the key to better quality research, which in turn results in improved healthcare. Evidence-based medicine enables clinicians to clearly outline clinical information through well-developed and focused questions. Evidence-Based Practice nursing (EBP) is the crux of an effective problem-solving approach to healthcare. It is important because it provides a clear framework for designing clinical questions that are specific to the patient. It integrates clinical expertise, research evidence, ethics, and values into offering quality patient care.

Importance of Evidence-Based Practice Nursing

Evidence-based practice nursing is the process of collecting, interpreting, evaluating, and integrating clinically significant and applicable research. The main objective of EBP is to translate the existing evidence into a clinical problem so that it can be applied to clinical decision-making. There is ample research to show that there is a link between effective research and better patient care decisions.

An improvement in patient care decisions leads to hospitals that perform optimally. Finding high-quality clinical research evidence is the key to improved patient outcomes. The standard of evidence-based medicine requires physicians to come up with clinical questions that address issues in terms of the problem/population, intervention, comparison, outcome, and time. This is referred to as the PICOT frame. To formulate these questions in EBP, the PICOT statement format is used. The word PICOT is an acronym that represents five key components of a clinical research question:

P – Population / Patient Problem:

• This involves describing the patient (Disease or health status, age, race, sex)

I – Intervention

• This section lists the treatment plan in terms of tests, therapies and medications

C – Comparison

• Is there an alternative plan of treatment or patient care? How effective would it be?

O – Outcome

• What is the desired outcome? Is the goal to reduce symptoms, eliminate symptoms or full health?

T – Time

• What is the time frame for treatment?

For a clinical question to be deemed effective, it should address all the five parts of the PICOT framework.

The PICOT Process

The PICOT process begins with a clinical query. Each element of the PICOT process facilitates the development of a well-structured research question.

In order to develop a PICOT statement, the researcher must identify why the study is important.

To effectively implement evidence-based practice (EBP) the first step is to develop a culture that supports it.  

Example of How PICOT Works

The PICOT process begins with a vague question such as, “How effective is hip replacement surgery?” “How can we determine whether hip replacement surgery is effective?” Through the PICOT statement process, these questions are answered in a manner that addresses the specific problem. In this case, the following may be the description for each element of the PICOT statement.

P – On whom will the research on hip replacement surgery be performed, what is their health status?

I – What is the effectiveness of the intervention method? (hip replacement surgery)

C – Is there another method of hip replacement treatment that would be more effective in comparison?

O – What is the desired outcome of the hip replacement surgery? How will it be determined whether it is effective?

T – How long will the hip replacement process take? Within which period will it be deemed effective?

Formulating an effective PICOT statement

Developing effective questions is one of the problems that nursing students and professionals encounter in the course of their clinical practice. An effective researchable question should be able to be challenged, analyzed, and examined.

Typically, the clinician needs to know two types of questions about the particular disease being researched. These are the background questions and foreground questions. The background questions ask for general knowledge while the foreground questions ask for specific knowledge.

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