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

3 The Johns Hopkins Nursing Evidence-Based Practice Model and Process Overview 49

The Question Development Tool (see Appendix B) guides the team in defining

the practice problem, examining current practice, identifying how and why the

problem was selected, limiting the scope of the problem, and narrowing the EBP

question using the PICO format. The tool also helps the team develop a search

strategy by identifying the sources of evidence to be searched and possible search

terms. It is important to recognize that the EBP team can go back and further

refine the EBP question as more information becomes known as a result of the

evidence search and review. Refer to Chapter 4 for more details regarding the de-

velopment and refining of an EBP practice question.

Step 4: Identify stakeholders

It is important for the EBP team to identify early the appropriate individuals

and stakeholders who should be involved in, and kept informed during, the EBP

project. A stakeholder is a person, group, or department in an organiza-

tion that has an interest in, or a concern about, the topic or project un-

der consideration (Agency for Healthcare Research and Quality, 2011).

Stakeholders may include a variety of clinical and nonclinical staff, departmental

and organizational leaders, patients and families, regulators, insurers, or policy

makers. Keeping key stakeholders informed is instrumental to successful change.

The team should consider whether the EBP question is specific to a unit, service,

or department or involves multiple departments. If it is the latter, representatives

from all areas involved need to be recruited for the EBP team. Key leadership in

the affected departments should be kept up-to-date on the team’s progress. If the

problem affects multiple disciplines (e.g., nursing, medicine, pharmacy, respira-

tory therapy), each discipline should also be included. The Stakeholder Analysis

Tool (see Appendix C) can be used to guide stakeholder identification.

Step 5: Determine responsibility for project leadership

Identifying a leader for the EBP project facilitates the process, accountabilities,

and responsibilities and keeps the project moving forward. The leader should

be knowledgeable about EBP and have experience and a proven track record

in leading interprofessional teams. It is also helpful if this individual knows the