Picot Mnemonic Paper

This question format model, helps in optimization of applied research specifics, medical style questions, updated peer review of research, and even allows assessing students to support evidence based practice in defining appropriate questions (Holloway et al. 2004).

“PICOT is an acronym for the elements of the clinical question: patient population (P), intervention or issue of interest (I), comparison intervention or issue of interest (C), outcome(s) of interest (O), time it takes for the intervention to achieve the outcome(s) (T).” (Stillwell et al., 2010, p. 59).

14 million Canadians visit Emergency Departments (ED) every year, and also reported to having the highest use of EDs (Ontario Hospital Association, 2006). ED overcrowding in Canada has become an epidemic. ED overcrowding has been defined as “a situation in which the demand for emergency services exceeds the ability of an (emergency) department to provide quality care within acceptable time frames” (Ontario Ministry of Health and Long Term Care, 2014). This has been an ongoing problem across Canada. Ontario has developed an initiative to reduce ED wait times by implementing a variety of strategies and collaborating with other institutions. This paper describes the Emergency Room National Ambulatory Intuitive (ERNI), an

A PICOT question is formulated in order to assist the researcher in obtaining answers to a specific question, decreases the uncertainty surrounding the issue, and provides a systematic approach to achieve an answer (Melnyk, & Fineout-Overhold, 2013). The authors find that each component of the PICOT question drives the next step of the evidence based practice process. First, a specific population must be determined by controlling the group to a certain age range or special sub-group. By compiling a specific group the clinician is more likely to formulate better evidence to support the issue. Next, an intervention is introduced and can be a therapy, test, disease process, etc. The authors conclude that, “the more specifically the intervention or issue of interest is defined, the more focused the search will be” (p.29). Then, a comparison group is added, but only necessary if completing a quantitative study. Lastly, an outcome is determined of which the study will reveal by a given time period.

A focused clinical research question is comprised of four essential elements: the patient, population, or problem (P); the intervention of interest (I); the comparison of interest or the standard of care (C); and the outcome of interest (O). These four components represent the acronym PICO (Stone, 2002). As the elements of PICO become more precise, the review of the literature becomes more focused. For example, elements of PICO may translate into medical subject headings that can direct searches of the literature (Stone, 2002). Also, clinical questions for specific patient populations can be identified so that relevant information can be found on databases and Internet search engines easily (Adams, 2012). The facilitation of the data collection process is determined by how well the PICO components are articulated during the development of the focused clinical question (Stone, 2002).

Throughout this semester we were asked to chose a PICOT question and analyze another student’s information. The PICOT is an acronym standing for P- patient population, I- intervention, C- comparison intervention and current practice, O- outcome, and T- time you would like to achieve the goal (Nieswiadomy, 2012,

I would like to give you some insight as to the daily operation of a major Emergency Department in this city. Not unlike many other “ER’s” the nursing staff is tasked with the triage or assessment of patients in order to sort by priority. The nurse is then tasked with maintaining flow of the department and ensuring the timely care and physician evaluation of patients. This requires clinical nursing judgement and expertise which is tested constantly. To explain this plainly, nurses are faced with a meat grinder which cannot stop. There may be twenty patients in the lobby with ambulances lining up. The room nurses are trying to

    The modern day emergency room is a department that is constantly busy. In the hustle of caring for patients, there are some details of the patient’s care that can be overlooked in a standard phone report to the accepting nurse. With this in mind, a change is needed so that there is an optimum patient outcome for each and every one of the people that walk through the doors of the emergency room and get admitted.

A comprehensive database research was conducted through online library to research for evidence in relation to the PICOT question. According to a level VII study, beta

Suppose there is a patch call with a patient exhibiting chest pain and the ambulance is five minutes out. In this case, the room is equipped and prepared with all the essential needs for the chest pain patient upon their arrival in the ambulance. After the patient has arrived, the primary nurse on duty receives a report from the Emergency Medical Technician (EMT) that accompanied and provided initial care to the patient in the ambulance. At the same time, the secondary nurse and ERT become technical, or hands on. The patient is administered oxygen, cardiac monitors are placed, an EKG is administered, locks and labs are drawn, normal saline is administered, and a urinalysis is taken along with the patients’ blood glucose level. Each of these tasks is initiated prior to the Emergency Room Medical Doctor (MD) seeing the patient, or at the same time. Emergency

Finding a question to research seems like such an easy task however, in order to be able to do research one must find a topic with enough clinical research available in order to be able to compare and study. When preparing to do research it is imperative to have some type of format or structure to use as a guide while preforming your search. The PICOT format is a format that is very helpful in guiding efficient clinical searches (Melnyk & Fineout-Overholt, 2015).

When Rebecca asks why the PICOT question is so important, Carlos explains that it's a consistent, systematic way to identify the components of a clinical issue. Using the PICOT format to structure the clinical question helps to clarify these components, which will guide the search for the evidence.6, 7 A well-built PICOT question increases the likelihood that the best evidence to inform practice will be found quickly and efficiently.5-8

“Evidence-based practice (EBP) is an approach to health care wherein health professionals use the best evidence possible, i.e., the most appropriate information available, to make clinical decisions for individual patients” (McKibbon, 1998). It is patient/family centered and involves complex and contentious decision making that is based on evidence available as well as the patient situations, characteristics and preferences. The evidence found does not make the decision, but helps support the patient care process. Health care is ever changing and involves multiple different aspects that evidence based practice gives the health care providers the formalization of the care process. There are

Evidence based practice is the combination of clinical expertise, patient values and the best research evidence into the decision making process in order to have a better care for the patient. It’s a patient focused practice so the clinician should make use of the best recent evidence from the research along with patient’s preferences. According to Fineout-Overholt and Stillwell (2015), “formulating the clinical question is like identifying the characteristics of the needle”(p.25). The clinical research question asked ideally defines the best research design for the study. To ease doubt and facilitate getting the right information at the right time, EBP stresses first asking a well-built question, then searching the literature for an answer

Several existing problems precipitated the creation of the triage system implemented by Kathryn Angell in an effort to deliver improved medical care. The main problem was a lack of coordination in service delivery. This lack of coordination caused excessive wait times on the order of anywhere from 23 to 40 minutes to see a nurse, 40 to 50 minutes to see a doctor, and as long as 55 minutes to get a prescription filled. The practice of all nurses being involved initially in seeing all patients caused duplication of efforts, including repeating questions and examinations, and resulted in procedural bottlenecks. Additionally, there were inconsistent levels of service and extreme variation in treatment because of the different experience