Nursing: Evidence-Based Practice

Background Questions

• Asks for general knowledge about a disease or disease process
• Have two essential components:
  • A question root (who, what, when, etc.) with a verb
  • A disorder, test, treatment, or other aspect of healthcare
  • Example: What causes migraines? or How often should women over the age of 40 have a mammogram
• The background question is usually asked because of the need for basic information. It is not normally asked because of a need to make a clinical decision about a specific patient.

Foreground questions

• Ask for specific knowledge about managing patients with a disease
• Have 3 or 4 essential components (see PICO below)

Different types of questions are answered by different types of research/studies. Common types of questions include:

Duke University Medical Center Library (2015). Introduction to Evidence-Based Practice.

The first step in the EBP process is to ask a clinical question that can be answered with evidence-based research. To help us take our clinical problem and turn it into a focused and answerable question, we can use the PICO formula.

PICO, or PICO(T), stands for:

• P - Population/Patient/Problem
• I - Intervention or prognostic factor
• C - Comparison
• O - Outcome
• T - Time (added when there is a time component to the question)

Once you've identified each aspect of your PICOT, here is a formula that you can use to turn it into a question:

THERAPY

In __________________(P), what is the effect of __________________(I) compared to _____________ (C) on ________________(O within _____________(T)?

INTERVENTION

In ____________________(P), how does ____________________ (I) compared to ____________________(C) affect _____________________(O) within ___________(T)?

PROGNOSIS/PREDICTION

In ______________ (P), how does ___________________ (I) compared to _____________(C) influence __________________ (O) over _______________ (T)?

DIAGNOSIS OR DIAGNOSTIC TEST

In ___________________(P) are/is ____________________(I) compared with _______________________(C) more accurate in diagnosing _________________(O)?

ETIOLOGY

Are____________________ (P), who have ____________________ (I) compared with those without ____________________(C) at ____________ risk for/of ____________________(O) over ________________(T)?

MEANING

How do _______________________ (P) with _______________________ (I) perceive _______________________ (O) during ________________(T)?