PICO Analysis and Search Strategy for Hospice Patient Care

This report presents a PICO (Patient, Intervention, Comparison, Outcome) analysis focused on improving the quality of care for hospice patients and their families. The research question investigates the impact of hospice family members' understandings on patient care. The report outlines the PICO elements and provides a detailed search strategy utilizing databases such as PubMed and CINAHL via NHS ATHENS, emphasizing evidence-based nursing practices. It describes the PICO process, including formulating the question, identifying keywords, planning the search, executing the search, refining results, reviewing literature, and determining the level of evidence. The report also includes a PICO table with search terms and strategies for each element, along with references to support the research. The goal is to provide a framework for nurses to enhance patient outcomes through family-centered care and evidence-based interventions in end-of-life situations.

1. Based on the scenario the research question is:
“In the patient with end life care in the nursing home, is there evidence to suggest that hospice
family members’ perspicacity’s and understandings help in quality care of the patient”.
PICO (T) elements Keywords
Patient/population Hospice family members
Intervention Hospice family members’ perspicacity’s and understandings
Comparison Not considering family members feelings
Outcome Affects quality care
Table 1: PICO table (National Clinical Guideline Centre, 2015).
2. Checking for phenomenal clinical research confirmation can be a staggering task, yet it is
an essential bit of the evidence-based practice process. One way to deal with streamline
and improve the assessment method for restorative overseers and investigators of all
establishments is to utilize the PICO search framework. PICO is a design for structure up
a not too bad clinical research question before starting one's investigation. It is a
psychological aide used to delineate the four parts of a sound clinical cutting edge
question. For this purpose, we identify several databases like PubMed, Cochrane Library,
Medline, NHS evidence, Emcare via NHS ATHENS, CINAHL via NHS ATHENS, etc.
("List of academic databases and search engines", 2019).
A. PubMed
This database is free and maintained and developed by the national center of
biotechnology information (NCBI). It has high-quality research information which
helps in better health care decisions. It is an influential tool to increase your
knowledge and quality of care ("Home - PubMed - NCBI", 2019).
B. CINAHL via NHS ATHENS (Cumulative index to nursing health and allied health)
This database is a prime source of nursing and allied health literature. It covers all
nursing related specialties and health care options. It also covers emergencies and

critical care. It gives brisk and basic access to top nursing likewise, bound together
prosperity journals, verification based thought sheets, energetic activities, and
continuing with preparing modules. This database contains full substance for an
extensive part of the most-used journals ("CINAHL Database | Index to Nursing and
Allied Health | EBSCO | EBSCO Health", 2019).
Verification based nursing is a system set up on the aggregation, getting, assessment, and
consolidation of considerable, clinically basic, and suitable research. It isn't connected to making
new learning or favoring existing data, yet rather translating existing verification with the
objective that it will, in general, be associated with the clinical fundamental initiative. The
typical standard in current human administration systems, confirmation based nursing practice
association’s research and speculation to deal with, giving clinicians force and reliable research-
driven data to oversee understanding thought decisions. Research has shown that patient
outcomes are essentially improved when human administrations rely upon verification from
well-planned contemplates versus custom or clinical capacity alone. Better patient outcomes lead
to progressively viable execution, which is noteworthy for crisis facilities with staffing
challenges (Whelton, 2018).
PICO process-start to end
PICO is a course of action for structure up a tolerable clinical research question going before
starting one's assessment. It is a mental aide used to depict the four parts of a sound clinical
frontal territory question. The request needs to perceive the patient or people we plan to think
about, the intervention or treatment we plan to use, the assessment of one mediation to another
(if proper) and the outcome we imagine. These make up the four segments of the PICO model:
Patient/ Issue, Intervention, Comparison and Outcome. The PICO methodology starts with a case
circumstance from which a request is constructed that is appropriate to the case and is expressed
to empower finding an answer. At the point when an efficient request is characterized, the pros
will be in a better position than output the composition for evidence that will reinforce their
extraordinary PICO question (Vermeulen, 2015 and Charania, Ross-Durow, Sullivan & Dansel,
2017).
There are seven steps for ideal PICO search

1. Formulate the right PICO question: To formulate the right question, one needs to know
about what one wants to know about, what you need to be answered.
2. Identify the right keywords to each PICO component: what is study population or
individual, what is the intervention which needs to be verified, with whom you will
compare, and what are the expected outcomes.
3. Planning of investigating approach: in these steps identify the database for search,
identify the board key elements for search, translating them to natural language, and
identify synonyms.
4. Execution of the search plan: appropriate and precise execution will give the needed
results. Begin with the first element of your PICO search that is population or patient,
then proceed to intervention, compare and outcome.
5. Refining of the results: refining the result could be done by adding limitations like a year
of publication can be limit to 5 years old studies, or studies done in certain places like
USA or Australia, or the Asia Pacific, or case studies or systemic reviews or original
researches.
6. Review of literature: once u added all the limiters than again run the results. Now you can
choose the articles which are most relevant to your PICO search. Also, you can check if
you have the full assessment of the article.
7. Determining the level of the data: The last development to the perfect PICO search is to
choose the level of evidence inside each huge article. In filtering for the best open
confirmation, a level of leadership exists as for the level and nature of confirmation As
you review the journal articles, select those that rely upon the most strange measure of
confirmation, for instance, a Meta-Analyses or a Systematic Review ("Using Data
Mining Strategies in Clinical Decision Making", 2016).

3. The search strategy for the given problem: PubMed database used
PICO (T)
elements
Keywords Search terms Search strategies
Patient/populatio
n
Hospice family
members
Hospice family
members
Hospice patient's
family OR family of a
patient with an end life
situation
Intervention Hospice family
members’
perspicacity’s and
understandings
Hospice family
members’
perspicacity’s and
understandings
Perception of hospice
family OR what are
family members of end
life situation patients
going through
Comparison Not considering
family members
feelings
Outcome Affects quality care Quality care for
hospice patients
Palliative care OR
quality care
Table 2: PICO table with search strategies

References
Charania, N., Ross-Durow, P., Sullivan, B., & Dansel, L. (2017). Designing Assignments to
Establish a Foundation for Evidence-Based Practice in an Undergraduate Clinical
Nursing Course. Worldviews On Evidence-Based Nursing, 15(2), 149-151. doi:
10.1111/wvn.12198
CINAHL Database | Index to Nursing and Allied Health | EBSCO | EBSCO Health. (2019).
Retrieved 13 August 2019, from https://health.ebsco.com/products/the-cinahl-database
Home - PubMed - NCBI. (2019). Retrieved 13 August 2019, from
https://www.ncbi.nlm.nih.gov/pubmed
List of academic databases and search engines. (2019). Retrieved 13 August 2019, from
https://en.wikipedia.org/wiki/List_of_academic_databases_and_search_engines
National Clinical Guideline Centre. Care of Dying Adults in the Last Days of Life. London:
National Institute for Health and Care Excellence (UK); 2015 Dec 16. (NICE Guideline,
No. 31.) Appendix O, Research recommendations. Available from:
https://www.ncbi.nlm.nih.gov/books/NBK356016/
Using Data Mining Strategies in Clinical Decision Making. (2016). CIN: Computers,
Informatics, Nursing, 34(10), 484. doi: 10.1097/01.ncn.0000504587.62271.53
Vermeulen, H. (2015). Evidence-based quality improvement. Nederlands Tijdschrift Voor
Evidence Based Practice, 13(5), 3-3. doi: 10.1007/s12468-015-0044-z
Whelton, B. (2018). Nursing Ethics and Professional Responsibility in Advanced Practice
Pamela J. Grace PhD, MSN, RN Burlington, Massachusetts: Jones and Bartlett Learning,
2018. 3rd edition, 447 pages, including glossary and index. $72.92 soft cover. ISBN
9781284107333. Nursing Philosophy, 19(2), e12207. doi: 10.1111/nup.12207