3 The Johns Hopkins Nursing Evidence-Based Practice Model and Process Overview 37
Inquiry
In the revised JHNEBP Model, inquiry is the initial component that launches
the EBP process. The concept of inquiry, a foundation for nursing practice, en-
compasses a focused effort to question, examine, and collect information about
a problem, an issue, or a concern. The National League for Nursing (2014) de-
scribes a spirit of inquiry as “a persistent sense of curiosity that informs both
learning and practice. A nurse motivated by a spirit of inquiry will raise ques-
tions, challenge traditional and existing practices, and seek creative approaches
to problem-solving ... A spirit of inquiry in nursing engenders innovative think-
ing and extends possibilities for discovering novel solutions in both predictable
and unpredictable situations.”
Within the practice setting, such inquisitiveness, characterized by an ongoing cu-
riosity about the best evidence to guide clinical decision-making, is what drives
EBP (Melnyk, Fineout-Overholt, Stillwell, & Williamson, 2009). Questions about
practice commonly arise from nurses’ practice settings as they provide everyday
care to their patients. These questions may include whether best evidence is be-
ing used or whether the care provided is safe, effective, timely, accessible, cost-
effective, and high quality. Organizations that foster a culture of inquiry are more
likely to have staff that will embrace and actively participate in EBP activities
(Melnyk et al., 2009). Nurses have a major impact on building a culture that pro-
motes inquiry by committing to generate and apply new knowledge in practice
and to achieve quality outcomes.
Practice
Practice, the basic component of all nursing activity, reflects the translation of
what nurses know into what they do. It is the who, what, when, where, why, and
how that addresses the range of nursing activities that define the care a patient
receives (American Nurses Association [ANA], 2010; ANA, 2015).
Nurses are also bound by, and held to, standards established by professional
nursing organizations. For example, the ANA (2015) has identified 6 standards
of nursing practice (scope) that are based on the nursing process (see Table 3.1)
and 11 standards of professional performance (see Table 3.2). In addition to the
