Applying the PICO(T) Process

Sickle Cell Disease (SCD) is a blood disorder that is characterized by a genetic characteristic of defective red blood cells. This interferes with the red blood cells and leads to their sickling, which complicates blood circulation and results in severe issues (Tebbi, 2022). This exposes children to suffering, hospitalization, and a poor life. Children (girls and boys) with SCD lead their lives with the disease. Evidence-based practice (EBP) or the combination of research, practitioner, and patient preferences is one of the most important approaches to improve patient care. The aim of this article is to apply the PICO(T) process to create a question, conduct a literature search, and review a research article to practice caring for children with sickle cell disease (SCD).

Overview of the PICO(T) Process

The PICO(T) process is used to help inform clinical questions for a practice and research study. The process consists of population (P), intervention (I), comparison (C), outcome (O), and time (T). Our population is kids with sickle cell. Its intervention is the coordination and comparison of care and usual care (Albertson et al., 2021). The outcomes will be the reduction of pain crises and improvement, and the timeframe of the intervention could be six months. The PICO(T) model may help health professionals to get more knowledge about a problem, analyze the evidence, and implement it into practice to promote health outcomes.

Description of the Diagnosis

Sickle cell disease is a long-term genetic blood disorder that typically begins during childhood. It can be attributed to abnormal haemoglobin and stiffening and clumping of the red blood cells (Egesa et al., 2022). This leads to obstruction of blood vessels, pain, reduction in blood flow and oxygen delivery. This may lead to excruciating pain, exhaustion, and hospitalization.

Adverse health outcomes are also associated with the disease, such as poor health outcomes, high costs of health care, and low quality of life. Pain in children is common and impacts attendance at school and everyday life, as well as mood disorders (Shearer et al., 2022). In the absence of proper disease management, serious complications include high levels of organ damage, stroke, infections, and retarded growth and development of children.

Minorities and poor families are also vulnerable, underserved groups that are greatly affected by SCD. The issue of health care inequalities is a significant determinant of the disease. Families have barriers like the unavailability of health care, transportation, and financial problems (Im et al., 2025). This leads to the same access to disease diagnosis, management, and treatment. We must know about these inequalities and minimize them to help children with sickle cell disease.

Development of the PICO(T) Question

One of the problems of children with sickle cell disease is a lag in time before the patients and treatment can be approached during a crisis, and time coordination problems. This could lead to unsatisfactory results and complications. This has since been done, whereby a provision of a clinical question in PICO(T) format is made.

The PICO(T) question is as follows: In children with sickle cell disease (P), how does improved care coordination (I) and the usual care (C) affect the number and severity of recurrent pain crises and health outcomes (O) in six months (T)?

The elements of the question are informed. The population of interest is child patients with SCD. The intervention is more about the coordination between the health care providers, children, and their families. The control is typical inconsistent care. The results are a reduced number of pain episodes and improved health (Milne et al., 2024). The time represents the time for the intervention to have an effect.

Literature Search Strategy

To answer the PICO(T) question, literature searches were carried out to determine an information source. The literature search was done in PubMed, CINAHL, and Google Scholar. This covered the words (and possibly also covered) sickle cell, children, pain crisis, coordination of care, and access to services. The research articles had to be peer-reviewed, and a current article (preferably published 2022 onwards) with human children patients with sickle cell disease. We ranked the articles based on the journal, the credentials of the author, and the methodology. Therefore, we were able to select three scholarly articles.

Summary of Selected Scholarly Articles

Article 1, Schlenz et al. (2025), is a qualitative policy paper about the facilitators and barriers to sickle cell disease for children. Parents were interviewed on barriers to health care. Coordination, support, and communication were important for good care. Lack of transport and knowledge were some of the barriers to health care.

The second article by Schieve et al. (2022) is a quantitative investigation of compliance with recommended preventive health care services among children with SCD to avoid complications. It demonstrates that compliance with the preventative health care recommendation correlates with good health and with a decreased number of complications. This paper provides very robust statistical evidence for good practice.

The third paper, Freitas et al. (2025), is a rapid review that looks at the role of hospital nurses for children and families with sickle cell anemia. They discover that nurses become critical in the role of care coordinators, educators, and advocates of the patient (child) and family, and of the health care team. The results also support the fact that nursing care, consisting of therapeutic education, identification of complications, and collaboration with other health care team members, positively influences pain and other outcomes. The articles also confirm that quality nursing care decreases complications and enhances the quality of life for patients with sickle cell disease.

Credibility and Relevance of Evidence

The three articles are valid as they have been published in high-profile journals and by experts. Appropriate research designs have been chosen by the authors, such as quantitative and qualitative studies, which also adds to the studies’ validity. It is also acceptable since some of the studies are funded by relevant entities. The studies are relevant to the PICO(T) question as they look at key issues in the care of children with sickle cell disease. They discuss coordination of care, pain treatment, and health care barriers, which will be critical in enhancing child sickle cell disease care. So the evidence is relevant to guide clinical practice.

Analysis of Evidence

The chosen studies present qualitative and quantitative evidence about children with Sickle Cell Disease. The evidence of a lack of accessibility and affordability of health services, transportation, and knowledge of the staff is descriptive narratives of the experiences of children and families, found in qualitative evidence, like the one by Schlenz et al. (2025). It’s important as it offers information about management and outcomes. And the quantitative evidence of Schieve et al. (2022) provides evidence of the prevention gains. It demonstrates that adherence to recommendations of best practice in health care results in a reduction of complications and improved work outcomes, and is a wonderful practice tool.

This evidence is elaborated by Eduarda Freitas et al. (2025), which adds the role of nurses in the context of children with sickle cell disease. This study highlights nurses’ capacity to coordinate care and education of the patient and family, and prevention and management of complications. However, while the quantitative articles are of higher quality in terms of outcomes when compared to review and qualitative articles, they are of lower quality in terms of lessons. The study reveals that as the level of nursing knowledge in the early intervention/ care coordination increases, the child with sickle cell disease will have fewer painful experiences and a better quality of life.

Answer to the PICO(T) Question

The authors discovered that enhanced health care coordination is more effective among children with Sickle Cell Disease. It decreases pain frequency and the severity of the pain and enhances access to health care providers. This increases access to health care and engagement with parents (Khatri et al., 2023). And it enhances compliance by participants. This, consequently, affects the well-being and health of children.

Implications for Nursing Practice

We have implications of our study for nurses. Nurses play a role in health care coordination, health promotion, and health care access (Karam et al., 2025). Evidence-based practice can reduce the number of complications and improve the quality of life of people with Sickle Cell Disease with the assistance of nurses. Nurses can develop care coordination programs to help with communication, coordination, and support for families. And they can encourage the early identification of pain and early management to avoid complications. And they are able to champion vulnerable populations by funding and addressing poor health issues. And they will be able to continue their education and work with other health workers in order to change the lives of children.

Conclusion

In short, the PICO(T) process is a method of generating clinical questions and reviewing evidence. Sickle cell management of children is not simple, especially as far as crisis management and care coordination are concerned. The study in this article demonstrates that improved care coordination results in improved outcomes and health-related quality of life. Therefore, evidence-based practice by health care practitioners can be used to enhance care and reduce disparities in the health care of children with sickle cell disease.