Johns Hopkins Nursing Evidence-Based Practice Thrid Edition: Model and Guidelines

(^242) Johns Hopkins Nursing Evidence-Based Practice: Model and Guidelines, Third Edition
Figure 11.2 Completed Appendix B:
Question Development Tool.

6. Initial EBP question ✘ Background ❑ Foreground
   Do current bathing practices impact the transmission of (HAIs) and CAUTIs among hospitalized adult patients?


7. List possible search terms, databases to search, and search strategies.

CAUTI, catheter, indwelling, infection, urinary, basin, bath

Acquired, care, clean

8. What evidence must be gathered? (Check all that apply.)

✘ Publications (e.g., EBSCOHost, PubMed, CINAHL,

Embase)

✘ Standards (regulatory, professional, community)

✘ Guidelines

❑ Organizational data (e.g., QI, financial

data, local clinical expertise, patient/

family preferences)

❑ Position statements

9. Revised EBP question
   (Revisions in the EBP question may not be evident until after the initial literature review;
   the revision can be in the background question or a change from background to foreground
   question.)
   Could the use of plain, disposable bathing wipes, instead of traditional basin bathing, reduce the incidence of
   CAUTIs for adult patients on a medical/surgical unit?


10. Outcome measurement plan
    What will we
    measure?
    (Structure,
    process, outcome
    measure)

How will we

measure it?

(Metrics

expressed as

rate or percent)

How often

will we

measure it?

(Frequency)

Where will we

obtain the data?

Who will

collect the

data?

To whom will we

report the data?

Rates of CAUTI Incidence of

CAUTI per

1000 catheter

days

Monthly Patient medical

record

CAUTI team

member

CAUTI team

members

and unit

administration

Cost Cost per patient

day

Monthly Unit budget Finance CAUTI team

members

and unit

administration

Often, teams will begin the EBP

process with a background question

because it provides the team with all

the best practices that may exist for a

given problem. The search results for

a background question are broad and

provide a starting point when little is

known about the topic.

In this example, the team would look at

all the ways to bathe patients or cleanse

the area.

The review of the evidence often leads to a foreground

question, which is focused and specific, and compares

two or more interventions. Here, the team is examining the

use of cleansing wipes compared to basin bathing.

This outcome measurement plan was developed using

the foreground question. Outcome measures selected in

the PICO statement may change as the team reviews the

evidence.