Answered By: APUS Librarians
Last Updated: Jun 13, 2023     Views: 892


PICO is an acronym used to formulate a strong clinical question that is also used to create strong search strategies for finding the best evidence. ​ Use these steps to create and apply a PICO search strategy:

  1. Organize the concepts in your clinical question using PICO.
  2. Identify the keyword/s that represent the concepts to create a strong search strategy.
  3. Test the search strategy in a biomedical literature database, including PubMed or CINAHL. Check results for relevancy, adding additional medical subject terms as keywords as needed.
  4. Apply or remove database limits as needed. 
  5. Review results.



How to Perform a PICO Search:   View this video to learn how to perform a PICO Search

7 Steps to the Perfect PICO Search - CINAHL:  In this document,  explore the importance or evidence-based nursing practice, take a deeper dive into the PICO process and provide an example of the PICO process in action through a case scenario.


Clinical question: Does hand sanitizing reduce hospital-acquired infections as well as handwashing with soap?

1. Organize the concepts in your clinical question using PICO:

PICO Concept 

hospital-acquired infections

Intervention= hand sanitizer
Comparison= soap and water
Outcome= reduced hospital-acquired infections


2. Identify the keyword/s that represent the same concepts to create a strong search strategy​


PICO Concept Keywords &
Medical Subject Headings

hospital-acquired infections hospital-acquired infection OR cross-infection OR nosocomial infection
Intervention= hand sanitizer hand sanitizer OR hand sanitizing OR handwashing methods

soap and water N/A (Omit for comparisons against standard practice) 
Outcome=  reduced hospital-acquired infections prevention


3. Test the search strategy in a medical literature database, including PubMed or  CINAHL. 

4. Check results for relevancy, adding additional medical subject terms as keywords as needed. Apply or remove database limits as needed. For a comprehensive search, remove the full-text limit.

​5. Review results.

See Also:

Nursing Research Guide:  See this guide to learn more about evidence-based practice and nursing resources. 

For more help using PICO using specific databases:




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