Skip to Main Content

Nursing Resources: Step 1: Ask a Well-Built Question

This guide provides an overview of the nursing resources available via the St. Thomas Libraries.

Ask a Well-Built Question

The first step in EBP is creating a focused question to answer. A clinical question needs to be directly relevant to the patient or problem at hand and phrased in such a way as to facilitate the search for an answer. PICO makes this process easier. It is a mnemonic for the important parts of a well-built clinical question. It also helps formulate the search strategy by identifying the key concepts that need to be in the article that can answer the question.

P = Population/Patient/Problem - How would I describe the problem or a group of patients similar to mine?

I = Intervention - What main intervention, prognostic factor or exposure am I considering?

C = Comparison - Is there an alternative to compare with the intervention?

O = Outcome - What do I hope to accomplish, measure, improve or affect?

Questions are commonly either concerned with the efficacy of a therapy/intervention (such as drug treatments, clinical therapies, or lifestyle changes), diagnosis (concerning the ability of a test to accurately diagnose), or a prognosis (concerned with likelihood or risk).

Example:

Premature infants transition too early from the safety of the womb into the unprotected world of the NICU environment and are unable to handle many of the stimuli required to sustain life. Music therapy is an emerging intervention that may help stabilize the negative physiologic changes during exposure to stressors in the NICU.

For this scenario, we can build our PICO question like this:

P- premature infants in the NICU

I-  music therapy

C- no comparison (null comparison)

O- reduction of negative physiological responses (or any positive changes)

Using PICO, we can formulate a well-built question:

“For premature infants in the NICU, does music therapy reduce negative physiological responses?”

We start by forming our PICO question, then generate keywords and synonyms for search terms, and then use Boolean operators (AND and OR) to map out a search strategy.

The P (patient or population) and the I (intervention or treatment) are generally searched first.

The C (comparison) and O (outcome) are less often included in a search.