Evidence-Based Practice

Evidence-based research begins by asking a question. The PICO Format is used to formulate clinical questions that are both searchable and answerable.

P = Patient or Population

What is the population or group of patients you are considering? age, sex, ethnicity, type of patient, etc.

I = Intervention

What intervention are you considering? What do you want to do for this group?

C = Comparison

What alternative option are you comparing against the intervention? (control, placebo, another treatment, surgery, etc.)

O = Outcome

What do you hope to accomplish or measure as a result?

Example:

Does the use of waterless, alcohol-based hand sanitizer in addition to handwashing with antiseptic soap and water by all people in the neonatal intensive care unit reduce the number of hospital-acquired infections?

P = people in neonatal intensive care unit

I = use of waterless, alcohol-based solution in addition to handwashing with antiseptic soap and water

C = standard hand washing with antiseptic soap and water

O = reduced number of hospital-acquired infections

Now that you have an answerable question, create a list of keywords (or terms) that you will use when searching the evidence. Use important terms or concepts from your question, patient/population, intervention, and outcome.

• handwashing
• hand sanitizer
• hand hygiene
• intensive care unit
• ICU
• neonatal
• hospital acquired infection
• cross infection

Multiple terms should be combined using the Boolean operators "AND" and "OR".

OR will expand your search because OR returns results that contain either term. Combine terms representing similar concepts with OR.

• intensive care unit OR ICU
• hospital acquired infection OR cross infection

AND will limit your search because AND will only return results that contain both terms. Combine terms representing different concepts with AND if you your results need to contain both concepts in a single study, article, etc.

• handwashing AND intensive care unit
• handwashing AND hospital acquired infection

Using both AND and OR: Tip! Most database search options separate the search boxes with AND by default. Use each search box to separate terms representing different concepts. Add terms representing similar concepts to each search box and separate with an OR.

Next Step: Identify Appropriate Resources

The following books have chapters that specifically address how to formulate an appropriate clinical question.