7 Steps to the Perfect PICO Search in EBSCO Databases - PICO and Levels of Evidence
Step 0: Cultivate a spirit of inquiry along with an EBP culture and environment |
Step 1: Ask the PICO(T) question |
Step 2: Search for the best evidence (Ask a Librarian for Expert Assistance) |
Step 3: Critically appraise the evidence |
Step 4: Integrate the evidence with clinical expertise and patient preferences to make the best clinical decision |
Step 5: Evaluate the outcome(s) of the EBP practice change |
Step 6: Disseminate the outcome(s) (Melnyk & Fineout-Overholt, 2011) |
American Journal of Nursing - Free online articles on nursing evidence-based practice methodologies.
Source: Melnyk, B.M., Gallagher-Ford, L., Long, L.E. & Fineout-Overholt, E. (2014). The establishment of evidence-based practice competencies for practicing registered nurses and advanced practice nurses in real-world clinical settings: proficiencies to improve healthcare quality, reliability, patient outcomes, and costs. Worldviews On Evidence-Based Nursing, 11(1), 5-15. https://doi.org/10.1111/wvn.12021
1. Questions clinical practice for the purpose of improving the quality of care. |
2. Describes clinical problems using internal evidence.* (internal evidence* = evidence generated internally within a clinical setting, such as patient assessment data, outcomes management, and quality improvement data) |
3. Participates in the formulation of clinical questions using PICOT* format. (*PICOT = patient population; intervention or area of interest; comparison intervention or group; outcome; time). |
4. Searches for external evidence* to answer focused clinical questions. (external evidence* = evidence generated from research). |
5. Participates in critical appraisal of preappraised evidence (such as clinical practice guidelines, evidence-based policies and procedures, and evidence syntheses). |
6. Participates in the critical appraisal of published research studies to determine their strength and applicability to clinical practice |
7. Participates in the evaluation and synthesis of a body of evidence gathered to determine its’ strength and applicability to clinical practice. |
8. Collects practice data (e.g., individual patient data, quality improvement data) systematically as internal evidence for clinical decision making in the care of individuals, groups and populations. |
9. Integrates evidence gathered from external and internal sources in order to plan evidence-based practice changes. |
10. Implements practice changes based on evidence and clinical expertise and patient preferences to improve care processes and patient outcomes |
11. Evaluates outcomes of evidence-based decisions and practice changes for individuals, groups and populations to determine best practices. |
12. Disseminates best practices supported by evidence to improve quality of care and patient outcomes. |
13. Participates in strategies to sustain an evidence-based practice culture. |
Source: Melnyk, B.M., Gallagher-Ford, L, Zellefrow, C., Tucker, S., Thomas, Bl, Sinnott, L.T., & Tan, A. (2018) The first U.S. Study on Nurses' Evidence-Based Practice Competencies Indicates Major Deficits That Threaten Healthcare Quality, Safety and Patient Outcomes. Wordviews On Evidence-Based Nursing, 15(1), 16-25. https://doi.org/10.1111/wvn.12269