The Clinical Inquiry Process Resource Guide

Clinical Questions:  Determining Validity and Feasibility

Once you have identified a problem or issue to explore, the next step is to begin formulating your clinical question. To ensure the question is both valid and within the scope of nursing practice, 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 will lead to projects or initiatives, but they can still contribute to enhanced patient care and a more positive work environment.

Consider the following topics and questions as you work toward a focused question to determine the success of your clinical inquiry if it evolves into an initiative or project. These are not listed in any particular order but are essential to consider as you discuss your concerns and ideas on how to improve practices.

Things to Consider When Determining Validity and Feasibility 

Clinical inquiry and the implementation of evidence into practice cannot be accomplished alone. The following things must be considered when addressing a clinical issue and moving forward with any initiative or action(s). If the answers to these questions are negative or unclear, success is less likely.  These things are what should be considered as one reviews all options throughout the process and is determining the best route to address the problem.  

---

Is there an established evidence-based approach to address this problem?

Existing evidence-based guidelines, hospital protocols, or other resources may already support the process or procedure being implemented. Review these before proceeding. If a recent, evidence-supported guideline or protocol exists, an evidence-based practice initiative may not be necessary; however, a quality improvement initiative might be needed.

---

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. Your work is only considered complete when you can answer the following questions, which demonstrate that the publication is evidence-based and current. If you cannot answer these questions, it may still 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.
When was it written? -  If 3 years or more it may be time to update the policy could be selected as a project/initiative.  What is the supporting evidence? -  If there are no supporting citations the policy needs to be updated.

---

Is the problem/issue/topic within the scope of nursing practice?

If not, you will need to collaborate with healthcare professionals who have this aspect of care within their practice responsibilities. If collaboration isn't possible, it's advisable to select a different topic for your evidence-based practice (EBP) project or initiative.

Example:

• Nursing Practice: Patient Education
• Physician Practice: Diagnosis and Treatment Plans for Patients

Organizational Priorities & Support

• Does this project align with current organizational goals and initiatives?
• Have you secured leadership support for this project?
• Are there competing priorities that might impact implementation?

What do Patients and Their Families Want or Value Regarding Care?

• Remember that each patient is unique, and their care preferences are important to consider.

Team Formation (Stakeholders) 

• Have you assembled a support group for your initiative/project?
• For interdisciplinary topics, does your team include representatives from relevant disciplines?
• Have you confirmed team members' willingness to participate?

Resource Assessment

• Does the organization have the necessary tests, equipment, and resources to implement this intervention?

Time Considerations

• How much time will be needed to explore and implement this topic?
• Do you and your team have sufficient time to dedicate to exploration and implementation?
• Are there organizational resources or teams available for partnership to optimize time usage?

Cost and Return on Investment (ROI)

• What are the anticipated costs of the practice change?
• What potential cost savings could the organization realize?

Education & Training Needs

• What training will staff need to implement this change?
• Who will provide the education?
• How will you ensure consistent training across shifts?

Data Collection and Protection of Patient Health Information

• What data will be required to measure intervention effectiveness?
• Which organizational stakeholders need to be involved in data collection?
• What measures are in place to protect patient health information?