Where do questions for evidence-based practice come from?
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.
|VCU Health FY 2019: Quality, Safety and Service Priorities|
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
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.
Once you have identified a problem or issue to be explored the next step in the process is to start to formulate your clinical question. In order to ensure that the question is one that is sound and within the scope of nursing practice, you will need to consult hospital and unit resources. Remember that evidence-practice and clinical care is something that is done through teamwork and so in order to ensure that a question is as sound as possible, it is important to consult unit and hospital resources.
Not all questions one has when it comes to clinical practice lead to projects but can still improve patient care and lead to a more positive work environment.
Resources to Consult and Questions to Ask:
Is your question addressed by a specific policy/procedure/regulatory agency?
When was it written? - If 5 years or more it may be time to update the policy could be selected as a project.
What is the supporting evidence? - If there are no supporting citations the policy needs to be updated.
Speak with your nurse manager or nurse clinician about the biggest concerns on the unit.
A conversation about current practice issues on the unit ("Safety Intelligence" trends, learning needs).
Consult the hospital data/ key performance indicators- falls, pressure ulcers, Patient Satisfaction scores.
How does your unit compare, what can be done better?
Seek out experts on your topic within VCU Health System and outside of the organization.
Experts may be aware of the current evidence already in practice. They will be able to help you further refine the need for your question. Some of these individuals will/are stakeholders in the potential EBP project and so referring to the stakeholder analysis tool.
Do a brief search for a practice guideline, meta-analysis or systematic review in order to ensure there is not any high-level evidence that would preclude you from performing your evidence-based practice project.