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identify a problem or concern that nursing can change and develop a PICO question to guide the change project.

Purpose: To identify a problem or concern that nursing can change and develop a PICO question to guide the change project.

Directions: Use the form below to complete the PICO assignment in Milestone #1. This includes filling in the table with information about your research question and your PICO elements.

Step 1: Identify the problem. What have you noticed in your work or school environment that isn’t achieving the desired patient or learning outcomes? What needs to change in nursing, what can you change with the support of evidence in the literature? Briefly describe the problem or practice issue that you want to research. What is your practice area; clinical, education, or administration?

Step 2: How was the practice issues identified? How did you come to know this was a problem in your clinical practice? Review the listed concerns and check all that apply.

Step 3: What is the scope of the problem? Does this problem affect an individual, population, or an entire institution?

Step 4: Select the key PICO terms for searching the evidence. Clearly define your PICO question. List each element P (problem, population, or problem), I (intervention), C (Comparison with other treatment/current practice), and O (Desired outcome). Is the potential solution something for which you (as nurse or student) can find a solution through evidence research? Look in your book for guidelines to developing your PICO question.

Step 5: What evidence must be gathered? Everyone should have a literature search. However, what other sources of reliable information will be helpful for your particular question?

Step 6: State the search question in narrow, manageable terms. What terms will you use in order to make sure that your search is wide enough to obtain required information but narrow enough to keep it focused? How will you narrow your search if needed?

PICO Worksheet
What is the practice issue/problem? 
What is the practice area?___ Clinical___ Education ___ Administration___ Other
How was the practice issue identified? (check all that apply)___ Safety/risk management concerns___ Unsatisfactory patient outcomes___ Wide variations in practice___ Significant financial concerns ___ Difference between hospital and community practice___ Clinical practice issue is a concern___ Procedure or process is a time waster___ Clinical practice issue has no scientific base___ Other
What is the scope of the problem?___ Individual___ Population___ Institution/system
What is the PICO question?___ P– (Patient, population, or problem):___ I– (Intervention):___ C– (Comparison with other treatment/current practice):___ O– (Desired outcome):
What evidence must be gathered? (check all that apply)
___  Literature search___ Guidelines___  Expert Opinion___  Patient Preferences___  Clinical Expertise___  Financial Analysis___  Standards (Regulatory, professional, community)___ Other
State the search question in narrow, manageable terms: 

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