Updated: March 29, 2018
Sources of Potential Clinical Questions
When it comes to clinical inquiry, the question is the key, as it provides the initiative or project with direction, helps to tell the story, and will ultimately bring focus to your searches. Now, there is not just one source for questions; a question can arise from many different places in the healthcare environment. Below is a diagram listing some of those sources for questions. Keep in mind when it comes to questions that it does not have to come from a single source, but in fact could come from a combination of sources.
Sources:
Hospital or Unit Goals:
These goals are established because they address areas or issues identified by the organization. This could be due to metrics/benchmarks not being met or through other means.
Aligning any clinical question with these goals/priorities is advisable, as it enhances the likelihood of obtaining buy-in from other stakeholders and securing resource support.VCU Health FY 2023: Quality, Safety and Service Priorities |
Old Goals - Need to Change
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The quality of healthcare and nursing care is determined through metrics that enable organizations to benchmark or compare themselves with others. If the data indicates that certain aspects of patient care or the organization are not meeting identified benchmarks, it is a clear indication that action needs to be taken. These are the areas where benchmarks are not being met.
If you are unsure about the indicators of nursing quality, they are listed below:
Nursing Quality Indicator
Your comprehensive guide to the press ganey national database of nursing quality indicators(Ndnqi). (2023, January 12). https://info.pressganey.com/press-ganey-blog-healthcare-experience-insights/your-comprehensive-guide-to-the-press-ganey-national-database-of-nursing-quality-indicators-ndnqi |
Has there been a situation in your unit related to patient care that was not as safe as needed? Alternatively, are you observing any other issues in the work environment that make it less than ideal?
Is there anything on the unit that is making patient care more challenging or increasing stress?
Is everyone on your unit, as well as on other units, following the same procedures with the same patient populations or groups? If not, the variations in practice present an opportunity for some form of clinical inquiry, grounded in evidence.
While conducting chart reviews, are you noticing any recurring issues related to patient care?
Are you discovering any new, evidence-based interventions in the literature that could help address an issue you are currently facing on your unit?
It may be easier to discuss these questions as part of a group to facilitate ideas. Can bring to your unit's shared governance committee or discuss during unit staff meetings.
Clinical Questions: Determining Validity and Feasibility
Once you have identified a problem or issue to be explored, the next step in the process is to begin formulating your clinical question. To ensure that the question is both valid and falls within the scope of nursing practice, you should refer to hospital and unit resources. It's important to remember that clinical inquiry and clinical care are collaborative efforts. Therefore, consulting both unit and hospital resources is crucial to ensure the question's validity and feasibility.
Not all questions arising in clinical practice necessarily will lead to projects/initiatives, but they can still contribute to enhanced patient care and a more positive work environment.
Considering the following topics/questions as you work towards a focused question will help to determine how successful your clinical inquiry may be if it turns into a initiative/project. These are not considered in any particular order but are things to consider as you are talking with others about your concern and ideas on how to make things better.
Questions and Resources to Consult When Determining Feasibility/Validity
Is there an evidence-based approach that has been established for addressing this problem?
There may be an existing evidence-based guideline, hospital protocol, or other guidance that supports the process or procedure being carried out. Best to check before moving forward.
Find a Practice Guideline or Unit Protocol? |
Just because you have found something that provides guidance related to care, it does not mean that your work is done. It is only considered complete when you are able to answer the following questions, which demonstrate that the publication is evidence-based and current. If not, it may be appropriate to proceed at least to ensure that the stated plan of care is evidence-based and current, and that the sources supporting the guidance are documented. |
Questions to Consider
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OHSU Clinical Inquiry Council. (2015). Oregon health & science university - evidence-based practice toolkit for nursing. Retrieved from http://libguides.ohsu.edu/ebptoolkit