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 integration of evidence into practice require collaboration. When addressing a clinical issue and advancing any initiative, several factors must be taken into account. If the answers to these questions are negative or uncertain, the likelihood of success diminishes. These considerations should guide the review of all options throughout the process, helping to determine the most effective approach to solving the problem.

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

Before proceeding, review any existing evidence-based guidelines, hospital protocols, or other relevant resources that may already support the process or procedure being implemented. If a recent, evidence-supported guideline or protocol is available, an evidence-based practice initiative may not be necessary; however, a quality improvement initiative might still be required.

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Find a Practice Guideline or Unit Protocol?
Finding guidance related to care doesn't mean your work is finished. Your work is only complete when you can answer the following questions, which confirm that the publication is evidence-based and up to date. If you're unable to answer these questions, it may still be appropriate to move forward—at least to ensure that the plan of care is evidence-based, current, and that the sources supporting the guidance are properly 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.

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

If this is not the case, you will need to collaborate with healthcare professionals who are responsible for this aspect of care within their practice. If collaboration isn't feasible, it’s recommended to choose 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?