Conduct a PICOT Search

Background and foreground research are essential to determining the correct elements for your PICOT question.

Things to consider

• Don't underestimate the importance of background research. Do initial research in the library databases to determine if enough research is published to answer your background and foreground questions. This research is essential to ensure that you do not miss any appropriate interventions and that your PICOT is an effective search tool.
• Keep an open mind. You may think you know the answer to your PICOT question. Be aware of any assumptions or biases you may have that could influence or interfere with the research process.
• No one article will replicate your clinical situation exactly. You are looking for interventions that may apply to your site, not articles that answer your question. These likely do not exist. Articles that cover an intervention at a different type of site or with a different population may be valuable sources of information and contribute to the answer to your PICOT question.

A background research question asks a general question about a condition or thing. This initial search is an information-gathering exercise to determine potential interventions or strategies that may apply to the clinician's site.

Example:

A nurse is interested in reducing hospital readmissions for patients with chronic diseases. According to the research literature, what interventions may be implemented at the nurse's clinical site?

The initial search should be broad, looking for evidence about interventions related to the issue. Rather than looking for a specific intervention, use search terms like intervention and synonyms such as program or strategy.

Start with an advanced search, as advanced searches are the best way to ensure that your search is set up in a clear and organized way. Your search may look like this:

("chronic diseases" OR "chronic conditions" OR "long-term illness") AND (intervention* OR program* OR strateg*) AND ("hospital readmission*" OR re-hospitalization)

At this point, the nurse is not asked to decide about a patient group or clinical problem.

See our Develop a Search Strategy guide for more help structuring your search.

A foreground research question is developed after the background question has been researched and seeks specific information to make clinical decisions or actions.

After searching the literature, the nurse determines that a nurse-led discharge education session is a good option for reducing hospital readmissions. Now that a decision about the appropriate intervention has been made, it is time to create your PICOT question.

In patients with chronic diseases (P), what is the effect of nurse-led discharge education sessions (I), compared with standard discharge procedures (C), on readmission rates (O)?