PICO question for patient safety

Patient safety is paramount in the healthcare field. DNPs, as leaders in evidence-based practice, play a crucial role in identifying and addressing patient safety concerns. A powerful tool for guiding research in this area is the PICO question framework.

What is a PICO Question?

PICO stands for Population, Intervention, Comparison, Outcome. It’s a structured way to formulate research questions that target specific areas of patient safety. By pinpointing the patient population, the proposed intervention, a comparison group (if applicable), and the desired outcomes, a PICO question provides a clear direction for research aimed at improving patient safety.

Why are PICO Questions Important in Patient Safety Research?

• Targeted Research: A well-defined PICO question ensures your research focuses on a specific patient population at risk and a specific intervention to address that risk.
• Data Collection: The PICO question dictates the type of data you need to collect to assess the effectiveness of your proposed intervention.
• Evaluation: It establishes clear benchmarks for measuring improvement and determining the impact of your intervention on patient safety.
• Communication: A clear PICO question fosters better communication with stakeholders and project collaborators, ensuring everyone is on the same page.

Crafting a PICO Question for Patient Safety Research

Let’s explore how to build a PICO question for your patient safety research project:

• Population (P): Identify the specific patient group at risk for a particular safety issue. This could be based on age, diagnosis, or specific procedures.
• Example: Patients undergoing surgery for hip replacement.
• Intervention (I): Define the specific intervention you’re proposing to improve patient safety.
• Example: Implementing a checklist to ensure all necessary pre-surgical safety checks are completed.
• Comparison ©: If applicable, define the comparison group. This could be the current standard practice, or another intervention you’re comparing yours to. Not all patient safety research requires a comparison group.
• Example: The current pre-surgical checklist used by nurses.
• Outcome (O): Specify the measurable outcomes you aim to achieve through your intervention. These outcomes should be directly linked to the chosen population and intervention and reflect improved patient safety.
• Example: A reduction in hospital-acquired infections after surgery.

Example PICO Question

In patients undergoing surgery for hip replacement (P), will implementing a comprehensive pre-surgical safety checklist (I), compared to the current checklist C, lead to a reduction in hospital-acquired infections (O) after surgery?

Remember: A well-constructed PICO question serves as the roadmap for your patient safety research project. It guides your data collection, analysis, and ultimately, the potential impact of your research on improving patient safety practices.

Additional Tips

• Focus on Measurable Outcomes: When defining your outcome (O), choose metrics that can be objectively measured and quantified. This allows you to clearly assess the success of your intervention.
• Consider Feasibility: Be realistic about the feasibility of your proposed intervention and the resources required for implementation.
• Align with DNP Goals: Ensure your PICO question aligns with the broader goals of your DNP program and your personal interests in patient safety.

By following these steps and considering these tips, you can develop a strong PICO question that empowers you to conduct impactful research and contribute to the ongoing quest for optimal patient safety in healthcare.

18 PICO Questions for Patient Safety Research Examples

1. P: Patients receiving medication via central lines © I: Will implementing a standardized double-checking protocol by nurses (I) compared to the current practice ©, reduce the incidence of medication administration errors (O)?
2. P: Elderly patients admitted to the hospital (P) I: Will implementing a fall risk assessment and prevention plan on admission (I), compared to standard care ©, decrease the number of in-hospital falls (O)?
3. P: Patients with a history of pressure injuries (P) I: Will using a specific type of pressure-relieving mattress (I), compared to a standard mattress C, decrease the development of new pressure injuries (O) during hospitalization?
4. P: Nurses working night shifts (P) I: Will implementing mandatory fatigue risk management strategies (I), compared to no such strategies C, reduce medication administration errors (O)?
5. P: Patients undergoing blood transfusions (P) I: Will utilizing electronic barcode scanning for blood product verification (I), compared to manual verification C, minimize the risk of transfusion errors (O)?
6. P: Patients with indwelling urinary catheters (P) I: Will implementing a standardized urinary catheter care protocol (I), compared to usual care C, decrease the incidence of catheter-associated urinary tract infections (CAUTIs) (O)?
7. P: Patients prescribed opioids for chronic pain management (P) I: Will implementing educational workshops for patients on safe opioid use and disposal (I), compared to standard discharge instructions C, reduce the risk of opioid misuse and overdose (O)?
8. P: Children undergoing tonsillectomy surgery (P) I: Will implementing a pre-operative “teddy bear clinic” to familiarize children with medical equipment (I), compared to no such intervention C, reduce anxiety and improve cooperation during surgery (O)?
9. P: Patients with a high risk of hospital readmission (P) I: Will implementing a telemonitoring program for post-discharge follow-up (I), compared to standard follow-up care C, reduce hospital readmission rates (O)?
10. P: Nurses working in a high-stress environment (P) I: Will offering mindfulness training programs (I), compared to no such intervention C, reduce nurse burnout and improve patient safety through increased focus and attention to detail (O)?

Additional PICO Questions Examples

1. P: Patients with language barriers (P) I: Will utilizing professional medical interpreters during consultations (I), compared to relying on family members for translation C, improve patient understanding of treatment plans and reduce medication errors (O)?
2. P: Clinicians working long hours (P) I: Will implementing mandatory handoff standardization protocols (I), compared to current practices C, improve communication clarity and reduce the risk of missed information during shift changes, impacting patient safety (O)?
3. P: Patients receiving mechanical ventilation (P) I: Will implementing daily sedation weaning protocols (I), compared to physician discretion alone C, reduce ventilator-associated pneumonia (VAP) rates (O)?
4. P: Patients undergoing minimally invasive surgery (P) I: Will using surgical checklists specifically designed for minimally invasive procedures (I), compared to general surgical checklists C, reduce surgical complications (O)?
5. P: Patients with chronic health conditions (P) I: Will implementing medication reconciliation programs at hospital admission and discharge (I), compared to no such program C, minimize medication discrepancies and improve patient safety (O)?
6. P: Patients receiving chemotherapy (P) I: Will implementing a nausea and vomiting management protocol (I), compared to standard care C, decrease the incidence of chemotherapy-induced nausea and vomiting (CINV) and improve patient quality of life (O)?
7. P: Clinicians working in fast-paced environments (P) I: Will utilizing decision support systems for medication prescribing (I), compared to relying solely on clinician expertise C, reduce medication prescribing errors (O)?
8. P: Patients with diabetes (P) I: Will implementing a self-management education program for diabetic foot care (I), compared to standard diabetic education C, reduce the risk of diabetic foot ulcers (O)?