How do you come up with a question?
Hospital or Unit Goals
Best when your question aligns with these goals because it helps to increase buy-in from others and improves the chances that there will resource support.
Events on the Unit
What are you stressed out about or makes your job more difficult?
Observation of processes on the unit - do you see any variations in practice
Safety Intelligence (SI) Trends (Formally known as PSN's)
Patient Satisfaction Scores and Other Hospital Data Sources
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.
These steps will help you start identifying a need for your question. After consulting with others and searching the literature if it does not yield a definite answer, then you need to proceed with the development of a PICO question to structure your EBP process.
People/Sources to Consult and Questions to Ask:
When beginning to explore your topic, you will need make sure that you ask a clear focused question. In order to insure that you do this well, you will need to answer two types of questions. Depending on the question the types of resources consulted will vary.
Background Questions: Focuses on the big picture and provides basic, general knowledge in reference to a specific condition, situation or topic.
What is the best practice for preventing nosocomial infections?
What types of patients are most at risk for falls in the inpatient setting?
What are the best interventions to encourage sleep in the inpatient setting?
When is the best time to discuss end of life care decisions with terminal patients?
Foreground Questions: a focused question that asks something specific in order to make an informed clinical decision or action.
P - (Patient, Population or Problem)
I - (Intervention)
C - (Comparison with other treatments, if applicable)
O - (Outcome)
Is therapeutic touch or guided imagery more effective when treating a patient with fibromyalgia?
In elderly patients requiring wound care, does the use of tap water as compared to normal saline reduce the incidence of infection?