Evidence by PICO


To evaluate the effectiveness of health care interventions, frame them as PICO questions. Inquiries of this type are essential to evidence-based nursing.

Working with the seasoned veteran emergency/charge RN Mark Wandro, we developed the following PICO question regarding a proposed new way of measuring acuity and using it to improve nurse staffing processes.





  • For the RNs working in an emergency department and the managers staffing it... (population)
  • Does acuity-based nurse staffing driven by a real-time workload-tracking tool and acuity monitor... (intervention)
  • Compared with existing methods of nurse staffing... (comparison)
  • Achieve improved nursing outcomes and/or more efficient nurse staffing? (outcome)



Proposed new definition for purposes of nurse staffing:

1. Patient acuity:  The number of minutes of nursing care remaining to be done for a patient;  the sum of the durations of the tasks remaining to be done for the patient.

2. Unit acuity:  The total number of minutes of nursing care remaining to be done for all the patients in a hospital unit at a given moment.

Nursing Outcomes

What is meant by nursing outcomes (as opposed to patient outcomes)?

1. Perceptions by nurses of increased job satisfaction, improved workflow, decreased stress, and improved fairness of workload distribution in their nursing practice.

2. Perceptions by nursing management of decreased cost and reduced job turnover.


Is your hospital interested in doing this study with us? Please get in touch! Let's make nursing better!