The PICO Process

Generating a Research Based Question

The PICO Process



To aid students in developing knowledge of the PICO process and to aid students in developing the PICO framework for their EBP group project.



The student will be able

  1. to describe the PICO process.
  2. transition a clinical question to a research based question.
  3. translate the PICO process into a working model for developing the beginning of the research process.


Target Audience

  1. N322 Research Students (supplement to Chapter 2 Lecture)
  2. N470 Leadership Students (review from N322).






Essential Elements of a Research Based Question

  • Flows from a clinical question
  • Focuses on a problem
  • Focuses on a population
    • Focuses on a subpopulation
  • Defines and Specifies Variables
    • Independent (x) Variable(s)
    • Dependent (y) Variable(s)
  • Lends itself to testing
  • Is directly related to nursing practice

Why use the PICO process?

  • Enhances understanding of both science generation and science utility
  • Encourages EBP in guiding nursing practice which yields better outcomes
  • Is simple, concise yet comprehensive in beginning any clinical investigative inquiry

The PICO Process

  • Start with identifying the clinical question—evolving into the research question
    • Is there an association/relationship/cause and effect between x and y?
    • Is doing x more beneficial than y in yielding positive outcomes?
    • Is x more beneficial in y in cost effectiveness/time management?
  • P: Problem & Population
    • What is the problem?
    • In what age ranges of the life cycle
    • Sub population (if applicable)
    • Setting (acute care, long term care, community, etc)
  • I: Intervention
  • C: Comparison Intervention
    • List an actual intervention to compare
    • Remember-no intervention IS NOT a comparison
  • O: Outcome desired:
    • Think hypothesis here-Make a statement as to what you are looking for
  • Evidence to guide interventions.





Nurse Jan, a surgical floor nurse is working at ABC Hospital with Nurse Fred who is a traveling nurse.  During the course of the shift, Nurse Fred is perplexed as to why ABC Hospital does not have a post-operative pain management team.  Fred indicates that patient comfort is significantly enhanced, post operatively, within all of the hospitals he has worked where there was a post operative pain management team as compared to the small number of hospitals he worked without such teams.


Nurse Jan starts to formulate an action plan for possible change in practice.

She first starts by checking for appropriate evidence in the form of articles and clinical practice guidelines.  Then she reduces the information to the PICO process.


PICO-The Correct Way

Research Question:

For post operative patients on surgical units with an in-house post operative pain management team, are there better outcomes related to pain relief as compared to those hospitals without in house pain management teams?

P: Post operative pain; Adult patients aged 18 years of age and older; Acute Care setting, post operative surgical floor.

I: Post operative pain management team.

C: Usual Care, as defined by pain management protocol by nursing staff.

O: To decrease post operative pain

CPG: Post-operative pain management. In: Guidelines on pain management.  PLEASE INCLUDE URL LINK.






PICO-The Wrong Way

Research Question:

Do pain management teams actually matter?

P: Pain after surgery.

I: Team

C: No Team

O: To help with pain



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