Evidence Based Practice (Pico

The first step of the EBP process is to develop a question from a practice problem. Start with the patient and identify the clinical problems or issues that arise from clinical care.

Review the PICO article “Evidence-Based Practice, Step by Step: Asking the Clinical Question” (2010) along with the PICO PowerPoint.

Following the PICO format, write a PICO statement in an area of interest to you, which is applicable to your proposed Capstone Project at the end of your course.

References should not be more than 3-5 years old.

Evidence Based Practice (Pico Question)


Research study always begins with a research problem that a researcher wants to solve therefore a problem that can be studied through collecting and analyzing data is researchable. Evidence-based nursing practice ensures that the best evidence from research, together with patient preference and clinical experience are considered when making clinical decisions. Qualitative and quantitative studies require that certain aspects of the problem be considered to determine if it is researchable. Quantitative methods require that variables under study be clearly defined and measurable. On the other hand, qualitative studies aim at describing the phenomenon of interest as perceived by study objective (Norwood, 2010).

Reasons for research problem

Nursing research problems arise due to diverse reasons. They maybe concern of patients regarding diagnosis of certain diseases, treatment and its effectiveness, and or prevention. Nursing literature also contribute whereby a nurse identifies a topic of interest and reviews nursing literature to determine subtopics to consider under the topic. Social emerging issues in health care also facilitate health-related research. Issues like gender equality in health care, increasing number of people with chronic diseases, increasing rates of obesity cases, and research priorities of health care (Arizona State University College of Nursing and Health Innovation’s Center, 2010). These reasons and others warrant that nursing practice be accompanied with evidence based research for betterment of health care. Sleep disorders are an emerging issue that is a concern for both medical practitioners and patients. Social issues have significantly contributed to increase in stress levels with many people suffering from these disorders yet they are unaware. Nursing literature has also shown that hormonal changes contribute to this disorder with many women complaining of this health problem as compared to men.  

Examine significance of problem

The significance of an identified problem of interest should be determined before researching it further. For example if the problem is determining the effect that changes in reproductive hormones have on sleep disorders in diverse genders then its significance should be determined through several considerations. How nurses, patients, and healthcare stakeholders benefit from research findings (Burns & Grove, 2011). Whether determined results are applicable and if they approve or disapprove existing theory should be considered. How acquired findings affect current nursing practice should also be considered. This particular problem benefits nurses in that it improves there practice and enables them learn of important ways of treating patients with serious sleep disorders. Sleep treatment therapy like continuous positive airway pressure therapy and cognitive-behavioral therapy are easily applicable treatment practices that have a significant role in reducing sleep disorders in patients.

Examine feasibility of problem

This requires researcher considering study cost, study subjects availability, time, availability of facilities and equipments, research interest, cooperation, and expertise to determine if it is effective to do the study. Evidence based practice has resulted due to need for health practitioners to do what is right and beneficial for patients. This practice requires finances in carrying out research and purchase of required facilities and equipments for data collection and analysis. Nursing research requires diverse study subjects (Arizona State University College of Nursing and Health Innovation’s Center, 2010). Sleep disorders include insomnia, sleep apnea, restless leg syndrome, REM sleep behavior disorder, narcolepsy, cataplexy, sleep paralysis, and hypnagogic hallucinations. Research will require study subjects availability depending on the particular disorder. Time constraint is another factor whose inadequacy hinders research. Cooperation between researchers, study subjects, and stakeholders is necessary for successful nursing research. Nurses should be knowledgeable on all sleep disorders and their symptoms to ensure that correct inferences are made regarding the approaches to use for treatment.  

Problem Statement

Evidence-based practice is based on informed problem statements. Sleep disorders are a prevalent emerging issue in the population today. Causative factors range from diet, emotional difficulties, stress, other diseases, some medication and hormonal imbalances. There are more cases of women complaining of insomnia, headache, and fatigue as compared to men. Changes in levels of hormones like progesterone, cortisol, and estrogen increases occurrence of sleep disorders like insomnia in humans. Progesterone levels vary during female menstruation cycle and also affects sleep patterns in pregnant women. According to research estrogen levels also alter sleeping patterns in postmenopausal women. Cortisol is regarded to as the stress hormone and changes in its normal level cause insomnia. Sleep disorders are a major problem that is affecting millions of people worldwide and understanding the impact that hormones play in facilitating them will ensure that correct and efficient measures are taken in minimizing this problem.

PICO Question

Therefore the PICO question is, “what is the effect of changes in reproductive hormones on sleep disorders in different gender?”

Components of PICO question

According to PICO format, there are a minimum of two components, population of interest and variables under study. PICO fully describes and clarifies population of interest, intervention of interest, comparison variable, desired outcome, and involved time frame (Norwood, 2010). Population of interest could be based on age, gender, ethnicity, and people with certain disorder or disease among others. Gender is the population of interest upon which this PICO question is based. Intervention of interest is the variable under study and in this case presence of reproductive hormones is the intervention variable. Comparison variable is one that the intervention variable is compared to. Absence of reproductive hormones mostly in the male gender is this variable. Outcome is effect on sleep disorders. Reproductive phase is the time frame and it requires considerations on period during menstrual cycle, pregnancy and postmenopausal phase. (Arizona State University College of Nursing and Health Innovation’s Center, 2010).


Application of research practice is considered an ability of advanced practice nurses. Nevertheless, all nurses aim at providing healthcare services that positively impact the health of patients. This requires that nurses at whatever level be able to apply research findings in practice. Evidence-based research aims at applying quality research in healthcare providence for benefit of patients (Burns & Grove, 2011). Therefore nurses should be able to critically analyze research for informed and appropriate evidence-based research decisions. This requires nurses to recognize research problem statement, determine population of interest, intervention of interest, comparison variable, outcome and time.


Arizona State University College of Nursing and Health Innovation’s Center. (2010). Evidence-   Based practice, step by step. Asking the Clinical Question: A Key Step in Evidence-        Based Practice.

Burns, N., and Grove, S. K. (2011). Understanding nursing research: Building an evidence-based             practice. 5th ed. St. Louis, MO: Saunders/ Elsevier.

Norwood, S. L. (2010). Research essential: Foundations for evidenced-based practice. Boston,     MA: Pearson.