Introduction

The field of study of nursing is very diverse. Many students prefer to enrol each year in a variety of courses, including those in medicine, nursing, infant care, Health care, medical trials, etc. One of the modelling techniques, conceptual frameworks, and methods covered in these classes that are useful for nursing professionals is the PICO model (Suwarningsih, 2021). Clinicians must use the best available research to inform their decisions in order to follow the principles of evidence-based practice. The clinician must formulate an effective clinical question with all the components necessary to find pertinent research literature in order to locate that research quickly. According to experts offering evidence-based nursing assignment help in Australia, the PICO model is a method used in evidence-based practices to identify and respond to questions in terms of a specific patient problem that aids clinically and is relevant for evidence (Alison, et al., 2017). A pertinent response to the uncertainty that frequently arises in patient care is the decision-making process, which is based on the way to develop the related components of this methodology.

PICO Process With Examples

According to the Centre for Evidence-Based Medicine (CEBM), “A key competency for practicing Evidence-Based Medicine is the formulation of appropriate clinical questions (El Miedany et al., 2022). These inquiries should be pertinent to the issues facing patients, as well as to your research process and the level of detail in your responses. Both patients and doctors will benefit from this. But the clinical foreground inquiries are based on the 4 elements that our evidence-based nursing assignment help experts discuss below. In general, the PICO model can be thought of as a tool that aids in formulating and focusing on the primary question in the form of a viewable concern (Leonardo, 2018). 

PICO procedure starts with a case from where a question can be construed according to the relevance to the case which is phrased in such a way as to facilitate finding a better solution. To know more about the PICO model students can take help from online assignment help experts.

Step 1 Is About To Formulate The Model Question

Considering registration as a working nurse in a urology department, one of a patient aged more than 50 is recovering from abdominal surgery.  The patient raises her complaint about the pain in her abdominal area along with little nausea. Her abdomen is distended and she has no bowel sounds. The appointed physician guesses a paralytic ileus and ensures the diagnosis on the basis of the combination of clinical features. Based on this case the research question arises is there any proof that chewing gum after abdominal surgery affects the development of an ileus in comparison to not chewing gum afterward?

Step 2 Shows The Keywords For Each PICO Element

The PICO model, which stands for four different elements P indicates the patients’ problem, I for intervention, C for control or comparison, and O indicates outcome is an evidence-based learning strategy (Scells, et al., 2017). Different relevant keywords can be used for four different elements. 

Step 3 Shows Planning For The Search Strategy

Plan a search strategy by choosing the database(s) to search and identifying the key components of the concern. Conversion of natural language terms into CINAHL headings, subject descriptors, or synonyms has to be made. For example, Searching for surgery, the keyword like postoperative or recovery, the operation can be used. 

Step 4 Adds Execution Of The Search

Before beginning with the search, it’s necessary to make sure that the search mode is set for any relevant phrase. Here the cause is significant as this option allows for the accurate phrase in searching. For example at the time searching for any relevant phrase of heart disease, the model used to definite the system used in the search for the records where some words relevant to heart disease appear as a phrase. To know more about students can take assistance from SourceEssay assignment help Toronto experts.

Step 5 Adds Refining Of Outcomes

In this step for refining the results, the application of limiters can be done as it allows to focus on the outcome to the most relevant and pertinent content that ensures no wastage of time. For example, where one wishes to limit the outcomes by date and type published to date, the use of this option is made for searching the relevant articles within the particular date range. 

Step 6 Include Reviewing The Literature

Select and review the articles that are most pertinent to the PICO question after adding limiters to the combined search and running the results again. The goal in this situation is to locate an article that is specifically relevant to the search but isn’t available in full text. Here for checking with the library to see whether they can help to locate the full text of the required article source.

Step 7 Shows The Determining The Level Of Evidence

According to the essay typer, the level of evidence in each pertinent article must be ascertained as the last step in a perfect PICO search. There is a hierarchy of evidence levels and strengths when looking for the best evidence that is currently available. Selecting journal articles with the highest level of evidence, like Meta-Analyses or Systematic Reviews, is necessary when reviewing the literature.

Elementary Discussion Of The PICO Model

Patient problem is the first element of the PICO model where at the time of deciding the diagnosis of any health problem of a patient, it’s necessary to collect all the information about the patient. This information, how the patient is feeling, what are problems he is going through when he found the problems and urges, what is his age, regular habits, and others. This helps to make the correct decision.

Intervention is the second element as per the name, this help in suggesting the techniques that can be used to make the patient’s health better. This can vary on the basis of the type of diagnosis along with the health issues of the patient. For example, Medications, rest, changing habits, yoga, exercise, therapy, and operation. 

Comparison or control is the third element of the model which comes at the time of identifying the issue through which the patient is suffering and that needs the urgency to lay out the requirement to do for betterment. For example, treatment is like exercise as compared to medicines.

The outcome is the last element of the model which shows the need for checking whether the outcome obtained from the intervention is expected previously or not. For example, the outcome as expected from the treatment impacts that one does not want to go through, and possible side effects that are not accounted for previously.

Why PICO Model Is Used

According to the analysis (Kim et al., 2012), the PICO model was introduced to provide assistance in structuring a well-developed clinical question that enables a relevant literature search. Since it’s known to people in a nursing course, it has played a significant role as a conceptualized model in EBM (Agoritsas et al., 2012). According to coursework help experts, there is various evidence observed on the impact of using this PICO model as a search strategy tool though it’s still lacking along with the studies which have been included in this review that do not permit people in building a significant body of evidence. For the purpose of practicing EBM with the remunerating evidence-based methodologies and that also make sure that rigorous methodology results as the review of work required to assess the applicability of particular conceptualizing methods. 

In addition, it can be argued that it is critical for future research on this subject to address three potential bias risks: (i) searcher skills, (ii) model and question match, and (iii) search quality (Eriksen, and Frandsen, 2018). Few studies have examined the impact of using the PICO model as opposed to other models or unguided searching on the calibre of literature search results overall. In particular, despite a thorough search and selection procedure, three such studies have been discovered. Due to the heterogeneity of these studies, quantitative analysis was not feasible, and no conclusive findings regarding the impact of the PICO model’s use on the calibre of the literature search could be made. According to the evidence-based medicine (EBM) paradigm, doctors should frame their clinical questions in terms of the issue or population, the proposed solution, the comparative data, and the expected results. A PICO frame is made up of all these components. Despite the fact that this framework was created to make it easier to create clinical queries, it has not been empirically tested whether PICO structures can adequately represent the information needs of physicians. By examining 59 actual primary-care clinical questions, PICO frames are used to represent knowledge (Suwarningsih, 2020). The PICO frame’s suitability as a knowledge representation for clinical questions put in plain language by working doctors (Zhang et al., 2020). It is widely accepted that the key to effectively locating high-quality evidence and making decisions based on that evidence is the formulation of a focused clinical question with well-articulated PICO components. All varieties of clinical questions are now covered by PICO frames, which were initially developed for therapy questions. Empirical studies have demonstrated that the use of PICO frames enhances the precision and theoretical explanation of diagnostic problems elicits more details during pre-search reference interviews, results in more complex search strategies, and produces more precise search results.

Questions And Study Design Under The PICO Model

The PICO model aids Australian specialists in classifying up-front queries into the diagnosis, treatment, prognosis, and etiology/harm. Examples include

Therapy: Asking the right questions to get the desired result. It includes medication, counseling, dietary changes, and surgical intervention (Libguides: Nursing (2022).

Diagnosis: Identification of concerns regarding the disorder of the patient that manifests as a specific symptom.

Prognosis: Questions about the likelihood that a disease or condition will manifest.

Etiology: Damage caused by the questions as a result of exposure to or intervention.

Understanding background and foreground question types may help you select the most appropriate research design for the chosen question. Always seek out the study design that will produce the greatest amount of evidence. Here in the following table, These Different type of questions asked under the model has been illustrated through the use of the following table.

Knowing the differences between back-story and foreground questions may help to select the most appropriate research design for the chosen question. The kind of study design that produces the most evidence is what you should always seek out. Most students frequently fail to finish their PICO Model assignments in order to effectively complete the assignment. Lack of time and ignorance are a couple of possible causes. Consideration is given to the usage of appropriate PICO tools, such as the Educational Prescriptions Table, PICO Linguist, and Evidence-Based Practice: PICO method, and PICO and Search Query Worksheet.

Summing Up

After the end of the discussion of the PICO model with all it’s sides, examples and application, the conclusion can be made. It has been noted that developing an evidence-based nursing practise culture within a health centre is not a simple task. The best available research evidence must be integrated with clinical knowledge, patient values, and other factors. Many people find it difficult to conduct a thorough search for credible clinical research evidence. The search procedure will be streamlined and produce the best evidence that is currently available to inform clinical decisions and investigate unconventional methods and treatments by using the PICO format.

Reference

7 steps to the Perfect Pico Score: Evidence-based nursing practice (2022) ebsco.

Agoritsas, T., Merglen, A., Courvoisier, D.S., Combescure, C., Garin, N., Perrier, A. and Perneger, T.V., 2012. Sensitivity and predictive value of 15 PubMed search strategies to answer clinical questions rated against full systematic reviews. Journal of medical Internet research, 14(3), p.e2021.

Alison, J.A., McKeough, Z.J., Johnston, K., McNamara, R.J., Spencer, L.M., Jenkins, S.C., Hill, C.J., McDonald, V.M., Frith, P., Cafarella, P. and Brooke, M., 2017. Australian and New Zealand P ulmonary R ehabilitation G uidelines. Respirology, 22(4), pp.800-819.

El Miedany, Y., El Gaafary, M., GadAllah, N., Mansour, M., Fathy, N., Hassan, W., Mortada, M., Galal, S., Eissa, M., Tabra, S.A. and Foad, N., 2022. Psoriatic arthritis treatment to the target: a consensus, evidence-based clinical practice recommendations for the management of psoriatic arthritis and its concomitant clinical manifestations. Egyptian Rheumatology and Rehabilitation, 49(1), pp.1-15.

Eriksen, M.B. and Frandsen, T.F. (2018) The impact of patient, intervention, comparison, outcome (PICO) as a search strategy tool on literature search quality: A systematic review, Journal of the Medical Library Association : JMLA. U.S. National Library of Medicine.

Expert, O.A. (2022) Pico model – definition and example – everything you need to know, my essaymate. Available at: https://www.myessaymate.com/blog/pico-model-definition-and-example (Accessed: December 20, 2022). 

Houser, J. (2018). Nursing Research: Reading, Using And Creating Evidence. Burlington, Massachusetts: Jones & Bartlett Learning

Kim, H., Fujiwara, A.I., Hansenc, B.B.E., Ogakid, M. and Wiley, J., 2012. (wileyonlinelibrary. com.

Leonardo, R., 2018. PICO: model for clinical questions. Evid Based Med Pract, 3(115), p.2.

Schub, E. B., & Walsh, K. C. (2017). Evidence-Based Nursing Practice: Implementing. CINAHL Nursing Guide

Suwarningsih, W., 2020, September. Template Pattern for Simple Question Transformation. In 2020 3rd International Conference on Computer and Informatics Engineering (IC2IE) (pp. 188-193). IEEE.

Suwarningsih, W., 2021. Virtual assistant upper respiratory tract infection education based natural language. Computer Science and Information Technologies, 2(3), pp.132-146.

Zhang, T., Yu, Y., Mei, J., Tang, Z., Zhang, X. and Li, S., 2020. Unlocking the power of deep PICO extraction: Step-wise medical NER identification. arXiv preprint arXiv:2005.06601.