Evidence-based practice (EBP) is a process of making decisions about healthcare that is based on the best available research evidence. It is a systematic approach to problem-solving that involves integrating research evidence with clinical expertise and patient preferences.

Nursing practice problem is a problem that specifically relates to the nursing profession. It may be a problem with the way that nurses deliver care, or it may be a problem with the healthcare system itself.

Medical practice problem is a problem that relates to the diagnosis, treatment, or prevention of disease. It may be a problem with the way that doctors deliver care, or it may be a problem with the healthcare system itself.

Examples:

Nursing practice problem:

Patients with pressure ulcers are not receiving timely and appropriate care.

Medical practice problem:

Patients with diabetes are not meeting their blood sugar control goals.

Why is it important to ensure your PICOT is based on a nursing practice problem?

PICOT is a mnemonic that stands for:

• Patient: Who is the patient population?
• Intervention: What is the intervention or exposure of interest?
• Comparison: What is the intervention or exposure being compared to?
• Outcome: What is the desired outcome?
• Time: Over what period of time will the outcome be measured?

When formulating a PICOT question, it is important to ensure that the question is relevant to nursing practice. This means that the question should focus on a problem that nurses can directly address.

For example, the nursing practice problem example above could be turned into a PICOT question as follows:

In patients with pressure ulcers (P), does the use of a pressure-relieving mattress (I) compared to standard care (C) reduce the incidence of new pressure ulcers (O) over a period of 6 months (T)?

This PICOT question is relevant to nursing practice because it focuses on a problem that nurses can directly address, namely the prevention of pressure ulcers.

On the other hand, the medical practice problem example above could be turned into a PICOT question as follows:

In patients with diabetes (P), does the use of an insulin pump (I) compared to multiple daily injections (C) improve blood sugar control (O) over a period of 6 months (T)?

This PICOT question is not as relevant to nursing practice because it focuses on a problem that doctors primarily address, namely the treatment of diabetes. However, nurses may still play a role in helping patients with diabetes manage their blood sugar levels, such as by teaching them how to use their insulin pump or how to give themselves injections.

By ensuring that your PICOT question is based on a nursing practice problem, you can be sure that your research findings will be relevant to and applicable to your practice.

Here is another example of a PICOT question that is based on a nursing practice problem:

In hospitalized patients (P), does the implementation of a daily rounding program (I) compared to standard rounding (C) reduce the incidence of hospital-acquired infections (O) over a period of 3 months (T)?

This PICOT question is relevant to nursing practice because it focuses on a problem that nurses can directly address, namely the prevention of hospital-acquired infections. Nurses play a key role in implementing and following hospital infection control protocols.

By using the PICOT framework, nurses can develop and implement research-based interventions to improve patient care and outcomes.