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The Clinical Inquiry Process Resource Guide

The goal of this guide is to provide nurses a resource to understand and carryout the steps of performing an evidence-based practice (EBP) project.

Finalize Team & Set Up Meeting Times

The team assembled to plan and implement the evidence-based practice project is key to its' success.  When it comes to finalizing your team you must ensure that the team is interdisciplinary in nature and is composed of those who will be able to assist in implementation and will be directly affected by the practice change(s). 

Some suggestions of team members are:

  • Providers (Physicians, Nurse Practitioners etc)
  • Pharmacists
  • Occupational and physical therapist
  • Dietitians
  • Clinical nurse II, III, IV, V

Your team should be no more than 6 to 8 members.

Meetings:

When it comes to the meetings of the team, make sure that you meet consistently and make them when most, if not all, can attend.  These meetings should have clear objectives and also be used as deadlines to get things done as you implement and evaluate the project. 

  • Need to be regularly scheduled  - Weekly or at least bi-weekly 
  • Clear objectives for each meeting
  • Build in opportunities to for all in the group to speak and assist in making decisions. 
  • Be sure to take notes and end meetings with a plan of action as to what must be must be accomplished before the next meeting and who will be responsible.  

Determining the Feasibility of the Practice Change

The team will work together to determine if the evidence is to evaluate the quality of the evidence and the feasibility of the evidence being applied in the organization at the unit, department, and hospital-wide levels.  It is key that the team consider the following when it comes to the determining the feasibility of translating the evidence into the practice.

Factors to Consider When Determining When to Translate Evidence into Practice 

The Quality of Evidence:  What sort of evidence did you evaluate?  Was of high quality or low quality?
Congruence/Consistency of the Evidence:  Are the conclusions drawn consistent across the various sources of evidence used?
Quantity of the Evidence:  How many articles have you found?  You do not need a lot of articles, but you need to continue to search until you find several articles that are of high quality and draw the same conclusions.  If you find that the articles you find vary in their conclusions, it may influence whether you can translate the evidence into practice. 
Relevance to the Question:  Does the evidence address the question at hand?  This does not mean that the evidence must always address a specific unit/department, sex or age group but should be at least something that could be used to enhance the care or treatment of the group the question is asking about.  
Clinical Significance:  Does the effect of the intervention have a practical meaning to the patient and the healthcare provider?  Would this change improve clinical outcomes?  Would this change improve clinical outcomes? Would this change improve patient or nurse satisfaction? Would this change reduce the cost of care for the patient? Would this change improve unit operations? 
Applicability & Feasibility: How appropriate is the intervention to the particular unit, department or patient population?  What resources (economic & physical) would be needed in order to make the practice change successfully?  What would this change cost ($)  How willing are members of the department to change?  What is the risk and reward of making this practice change?  How much time will this take to implement?

 

(Cvach, 2010)

If the team determines the evidence is not practical to apply, then the plan cannot go forward.  It is time for the team to reconsider implementing the change(s) until a more appropriate time is determined.

Also, be aware that just because your team feels the evidence is of a high-quality, it is important that those that will be affected, the stakeholders, also perceive the quality of the evidence is of high quality as well.  It is important that the team promotes and gathers feedback as the perception of those who will be directly affected by the practice change as the buy-in from this group will help to determine the success of the practice change within the organization.

Partnerships & Getting Buy-In

Once the team has determined if the evidence found can be implemented it is time to focus on promoting the project and developing partnerships within the organization. These partners can help to help communicate/disseminate the new knowledge and help to identify and target stakeholders/groups within the organization that must buy-in in order to bring about acceptance.  During these interactions, there will also be opportunities to receive and respond to feedback.  

Be sure in that in communications with various stakeholders and groups that you at least do two things:

  • Communicate what Is to be done.

  • Communicate why the change is being made. (What is the purpose? What are you hoping to achieve by making the change?)

So that the message is consistent and clear it may be useful for the team to come up with a communication plan.  When construction such a plan it will be important to consider the following:

  • Who needs information about the project? (stakeholders)

  • What information will various groups/individuals need? 

  • How will this information be delivered?  (Meeting presentations, email, handout, etc.)

  • When will information be pushed out/provided?  (daily, weekly, monthly)

  • Who will provide the information?  (team leader, team members)

      (Poe & Dawson, 2010)​

Some examples where the examples can be disseminated are:

  • Unit and Department Leadership  - Both Nursing and Medical 

  • Divisional Practice Committees 

  • Professional Practice Councils 

  • Hospital Nurse Sponsored Events/Meetings

    • Nursing Leadership Forum

    • Nurse Residency Poster Sessions

    • Week of the Nurse Poster Sessions

After getting leadership support and successful implementation of the practice change, it is time to disseminate outside of the organization.  This includes presenting at conferences, publishing papers as well as other opportunities as they arise. 

References

Cvach , M. "Chapter 8: Selecting Pathway to Translation." Johns Hopkins Nursing Evidence-Based Practice: Implementation and  Translation. Ed. Stephanie Poe and Kathleen M. White. Indianapolis, IN: Sigma Theta Tau International, 2010.

Poe, S. and Dawson, P.B. "Chapter 6: Managing the EBP Project." Johns Hopkins Nursing Evidence-Based Practice: Implementation and Translation. Ed. Stephanie Poe and Kathleen M. White. Indianapolis, IN: Sigma Theta Tau International, 2010.