How to perfect Pico search in 7 simple steps.


Looking for the best clinical research evidence can be intimidating, yet it is an important part of the evidence-based practice process. In fact, a large number of nurses and researchers from different backgrounds streamline and improve the research process by using the perfect PICO search strategy.

PICO is a short-form for Patient/Problem, Intervention, Comparison, and Outcome. It is a search strategy that allows you to develop a good clinical question before starting your research.

Do you want to achieve your desired research outcomes? Here are 7 easy steps to perform a perfect pico search and kickstart your nursing research process.

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7 Easy steps to perform a perfect PICO search.

  • Step 1: Formulate the PICO question.
  • Step 2: Identify keywords for each PICO element
  • Step 3: Plan the search strategy.
  • Step 4: Execute the search.
  • Step 5: Refine the results.
  • Step 6: Review the results.
  • Step 7: Access the evidence.

Step 1: develop a PICO question.

The PICO process starts with a case scenario from which you can formulate your question which is relevant to the case and express it in such a way as to facilitate finding answers.

Thus, the first step to performing a good PICO search should be to develop a PICO question. You should consider your scenario carefully before formulating your PICO question.

For example, let’s say you are a registered nurse working in a urology unit. One of your patients who is recuperating from abdominal surgery starts to complain of abdominal pain and nausea. From the diagnostics, the physician suspects paralytic ileus and later asserts his suspicions based on clinical features and imaging.

After you discuss this case with the evidence-based nursing practice committee, you decide to do a case study to determine whether there is data that a simple intervention such as chewing gum post-operatively can prevent post-operative ileus after abdominal surgery.

In this case, you can develop a research question such as:

In patients undergoing abdominal surgery, is there evidence to show that chewing gum post-operatively or not doing so can affect postoperative ileus?


Step 2: Identify keywords for each PICO element.

After you have developed a well-structured PICO question for your scenario, you are in a better position to search the literature for evidence that can support your PICO question. Therefore, the next step involves identifying keywords for each PICO element.

For example, in the scenario given in step 1: you can identify the following keywords in each PICO element:

  • Patient/Population – the patient undergoing abdominal surgery.
  • Intervention – chewing gum
  • Comparison – not chewing gum
  • Outcome – affects postoperative ileus.

Step 3: Plan your search strategy.


Tips on how to plan your search strategy.

  • Determine which database(s) to search.
  • Identify the major elements of your question.
  • Translate natural language terms to subject descriptors, CINAHL headings, and synonyms.

perfect pico search

Step 4: Execute the search.


Before starting your search, choose a good database and set results to contain at least one of the search terms. After you have chosen a database of your choice, start searching starting from patients who fit into your case scenario. Then, look for interventions and their outcomes on the patients under study.

Finally, complete your search by combining the population, the interventions, and the outcomes.

Step 5: Refine your results.


After you have completed your search, you can refine your results by adding limiters. This allows you to focus your outcomes on the most relevant content ensuring that you are not wasting time wading through content that may not be useful.


Step 6: Review the literature.


After you have added limiters to your results, you should choose the relevant articles to your PICO question.

Step 7: Determine the level of evidence.

Determining the level of evidence is the last step in performing a perfect PICO search strategy. This step involves categorizing the evidence from the relevant articles you got from step 6 into a hierarchy that shows the strength and level of the evidence.




Although performing a perfect PICO search can be daunting, these 7 simple steps will help you to streamline your PICO research process.

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