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Nursing - Information Literacy

Search Strategies--Foreground Questions

Foreground questions seek evidence to answer a need for clinical information related to a specific patient, an intervention or therapy. Identifying the PICO (T)* elements helps to focus your question:

  • P = problem/patient/population
  • I  = intervention
  • C = comparison intervention
  • O = outcome
  • (T) = time factor, type of study (optional)

Example question: Does handwashing among healthcare workers reduce hospital acquired infection?

P (problem/patient/population) hospital acquired infection
I (intervention/indicator)


C (comparison) no handwashing; masks; other solutions
O (outcome of interest) reduced infection
  1. To begin a database search, your initial strategy should begin with the P and the I only: hospital acquired infection AND handwashing
  2. After viewing the initial results, you may decide to narrow your search with terms for the Comparison and Outcome. Some models of EBP add in T (PICOT) for time factor or type of study. Other models add C for Context (PICOC). You can apply limits for time, type of study, or other contextual limits at a later time. Keep your initial search broad.