PICOT Paper

PICOT PAPER 1
PICO Framework, Analyzing a Case Study
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PICOT 2
PICO Framework, Analyzing a Case Study
Current nursing care is based on Evidence-Based Practices (EBPs) which have been
founded on evidence-based research. New data which is acquired or utilized in research must,
therefore, be communicated clearly among all the stakeholders within the health setting. All
stakeholders are hence entitled to efficiently collaborate to support and incorporate EBP in their
everyday practices. In order to explore whether the use of midazolam in preoperative care for
pediatric provides better post-operative pain control, this paper reflects on how knowledge on
nursing care is disseminated bother under professional and personal practices (Usury, 2014).
Clinical Question
In the course of my work at a Surgery Recovery Unit in a local hospital, I came across
pediatric patients who were undergoing surgical procedures. Children who were below 10 years
had their IV starting at the operating room when undergoing general anesthesia whereas those
who were over 10 years had theirs while in the preoperative phase. The two victim categories
were given oral midazolam preoperatively. However, because the access to IV was limited, IV
midazolam was not administered, midazolam was only administered orally. An anesthesiologist
was responsible for evaluating the children and ordering the midazolam; also there were no set
policies and protocols for that. I started to observe some inconsistencies with the children who
had been administered with midazolam prior to the surgery which dawned to me that the children
who had been given midazolam preoperatively had their post-operative pain controlled in an
effective way.
Generally, when research or a discussion brings about questions like presented in my case
above, the PICOT framework has always been the best way to formulate the questions. In the
PICOT framework (Niewswiadomy, 2012), P denoted the population or patients, I denoted the

PICOT 3
area of interest, C denoted comparison, O denoted the desired outcomes while T denoted the
duration of time. In this paper, the question to be explored using the PICOT framework “is
midazolam medication when administered preoperatively to patients more effective in reducing
post-operative pain than when it is not administered in pediatric cases?” in this case, P stood for
pediatric patients, I denoted the administration of midazolam in an orally, C was its comparison
with failed administration, O was the pain management post-operative while T denoted post-
operative duration. Pediatric patient safety after undergoing surgical procedures is believed to
improve when there are consistent preoperative medication procedures and policies
implemented. If post-operative pain management can be improved, the satisfaction of patients
can also increase.
Methodology
Three databases which are related to the medical and nursing fields (Cinahl, Cochrane,
and Pub-Med) where used to research the PICOT question in this case. In each of these three
databases, an advanced search was used where possible, which included the keywords and
phrases. In most of the searches, the versed word did not reveal enough articles as it was
expected, but when the search was advanced to cover midazolam and parenthesis were added to
the keywords, there were more options displayed. So, the advanced search entailed “oral or
versed midazolam”, “children or pediatric” and “preoperative or postoperative pain”.
Article selection was further squeezed after several abstracts for sampled articles were
read. The abstracts were important because they provided hints on whether an article was to be
included or excluded from the list easily. Mainly, the articles which were12 years old and below
were preferred in the research.