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PICOT Process

PICOT Process

Whereas a nursing practice problem is identified during the nurse’s assessment of the patient’s condition, a medical practice problem focuses on the patient’s pathology. Fleming (2014) defines nursing practice problems as those encountered in the nursing practice that deal with modalities of patient care such as trauma prevention, support, assessment and appraisal, health screening, comfort, healthcare coordination, and health education. A nursing practice problem ranges from the patient’s care needs when they enter the hospital to the time of diagnosis and assessment after the care. It requires in-depth data collection on the patient. An example of a nursing practice problem is when a patient enters the facility with a fever, headache, and other physical symptoms, then the patient is referred to a nurse for the relevant nursing diagnosis. Other factors identified as nursing practice problems include nursing shortage, turnover, job dissatisfaction, and burnout (Mrayyan, 2007). On the other hand, when the patient is observed to have a condition that requires pathology to be examined, and the caregiver finds out that this problem could be more serious, then this is referred to as a medical practice problem.

It is important to ensure that the PICOT is based on a nursing practice problem because it helps formulate a search strategy by identifying the key concepts to be addressed. According to Stillwell et al. (2010), ensuring a well-built PICOT question enhances the probability that the best evidence to inform practice will be obtained in an efficient manner. Furthermore, having a PICOT question consistent with the nursing practice problem can help the nurse clarify the components of the problem, and this will guide their search for evidence. This will enable the nurse to use evidence-based practice to ensure healthcare delivery is done in a manner that integrates the best evidence from research and the patient care data with the expertise of the clinician as well as the patient’s values and preferences.


Fleming, J. W. (2014). Selecting a clinical nursing problem for research. Image: The Journal of Nursing Scholarship, 16(2), 62-64.

Mrayyan, M. T. (2007). Nursing practice problems in private hospitals in Jordan: Students’ perspectives. Nurse Education in Practice, 7(2), 82-87.

Stillwell, S. B., Fineout-Overholt, E., Melnyk, B. M., & Williamson, K. M. (2010). Evidence-based practice, step by step: asking the clinical question: a key step in evidence-based practice. AJN The American Journal of Nursing, 110(3), 58-61.


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PICOT Process

PICOT is utilized by the healthcare community to identify and study a nursing or medical practice problem. Consequently, PICOT examples that may provide insight into the use of the PICOT process, may not be relevant to nursing practice as they are based on a medical practice problem.

PICOT Process

PICOT Process

Describe the difference between a nursing practice problem and a medical practice problem. Provide one example of each. Discuss why is it important to ensure your PICOT is based on a nursing practice problem.

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